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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 194700211
Report Date: 12/03/2025
Date Signed: 12/03/2025 09:46:22 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
HOME CARE SERVICES, 744 P STREET, MS 09-14-90
SACRAMENTO, CA 95814
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/20/2025 and conducted by Evaluator Joshua Rarela
PUBLIC
COMPLAINT CONTROL NUMBER: 47-HC-20251120162207
FACILITY NAME:QUALITY HOME CARE AND COMPANION SERVICES INC.FACILITY NUMBER:
194700211
ADMINISTRATOR:LALAINE MORENOFACILITY TYPE:
300
ADDRESS:9612 VAN NUYS BLVD, STE 250TELEPHONE:
(818) 581-5788
CITY:PANORAMASTATE: CAZIP CODE:
91402
CAPACITY:CENSUS: DATE:
12/03/2025
UNANNOUNCEDTIME BEGAN:
11:01 AM
MET WITH:Lalaine MorenoTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Home Care Organization is using independent contrators to provide care
INVESTIGATION FINDINGS:
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Enforcement Analyst (EA), Joshua Rarela, with the Home Care Services Branch (HCSB) conducted an inspection for the purpose of a Complaint Investigation. The EA met with the Home Care Organization (HCO) licensee named above and discussed the allegation.

During the course of the investigation, EA interviewed HCO personnel and reviewed records including the HCO's Quarterly Contribution Return and Report of Wages filed with the Employment Development Department (EDD) of California for their Home Care Aides (HCA) which noted income taxes withheld, HCAs' Criminal Record Clearances and Associations, and HCAs' Home Care Aide Registry.

(CONTINUED)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Joshua Rarela
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 47-HC-20251120162207
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
HOME CARE SERVICES, 744 P STREET, MS 09-14-90
SACRAMENTO, CA 95814
FACILITY NAME: QUALITY HOME CARE AND COMPANION SERVICES INC.
FACILITY NUMBER: 194700211
VISIT DATE: 12/03/2025
NARRATIVE
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(CONTINUATION)

The HCO licensee stated that they used an HCA on an independent contractor basis intermittently this year as the HCA worked for less than five days. The HCO licensee stated that they have since put them on the payroll and understood that HCAs have to be W-2 employees. The HCO licensee will provide the EA with the latest Quarterly Contribution Return and Report of Wages reported to the Employment Development Department (EDD) of California to reflect the taxes withheld. EA informed the HCO that it is against HCO statutes to employ caregivers who are independent contractors.

Based on the EA's observations, interviews and records review, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. A copy of this report, HCS9099-D for deficiency, and appeal rights were provided.
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Joshua Rarela
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 47-HC-20251120162207
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
HOME CARE SERVICES, 744 P STREET, MS 09-14-90
SACRAMENTO, CA 95814
FACILITY NAME: QUALITY HOME CARE AND COMPANION SERVICES INC.
FACILITY NUMBER: 194700211
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/03/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/10/2025
Section Cited
1796.37(a)(5)
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Health and Safety Code § 1796.37 (a), (5) …requirements set forth in this chapter, including all of the following…Provides the department, upon request, with a complete list of its affiliated home care aides, and proof that each satisfies the requirements of Sections 1796.43, 1796.44, and 1796.45.
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The licensee furnished proof of conversion to W-2 employees which includes: Registry on the Home Care Aide Registry, TB clearance, documentation of required training. EA also requested the licensee to provide copies of the Payroll reports and tax reporting forms, Quarterly Contribution Return and Report of
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This requirement is not as evidenced by:
The licensee stated that they used an Independent Contractor intermittently due to an emergency but has since made the HCA a W-2 employee, a finding that poses an immediate Health and Safety risk to person in care.
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Wages DE9/DE9C forms, filed with the California Employment Development Department.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Joshua Rarela
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3