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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 194700432
Report Date: 09/10/2024
Date Signed: 09/11/2024 09:02:09 AM

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
08/20/2024 and conducted by Evaluator Ryan Chan
COMPLAINT CONTROL NUMBER: 47-HC-20240820145939
FACILITY NAME:FILIPINO AMERICAN PERSONAL HEALTH CARE SERVICESFACILITY NUMBER:
194700432
ADMINISTRATOR:RANDALL AND MARILOU FROSTFACILITY TYPE:
300
ADDRESS:8671 WILSHIRE BLVD. STE 709TELEPHONE:
(323) 537-5733
CITY:BEVERLY HILLSSTATE: CAZIP CODE:
90211
CAPACITY:CENSUS: DATE:
09/10/2024
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Marilou Frost - OwnerTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Home Care Organization is utilizing 1099 independent contractor
INVESTIGATION FINDINGS:
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Home Care Services Branch Enforcement Analyst (EA) Ryan Chan conducted a complaint investigation regarding the above allegation. Upon arrival analyst met with home care organization (HCO) owner Marilou Frost.

During today's inspection, analyst interviewed the owner who stated she continued employing HCAs as 1099 employees after she was previously cited for employing HCAs as1099 because some of her employees did not want to convert to W2. The plan of correction for the previous complaint has still not been corrected.
Based on Analyst’s observations and interviews, the preponderance of evidence standard has been met, therefore, the above allegation is found to be SUBSTANTIATED. Health and Safety Code, Division 2, Chapter 13, Section 1796.42 (b) is being cited on the attached LIC 9099D.
EA concluded the visit with an exit interview and provided a copy of this report along with appeal rights to Marilou Frost.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Ryan Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
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 2
Control Number 47-HC-20240820145939
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: FILIPINO AMERICAN PERSONAL HEALTH CARE SERVICES
FACILITY NUMBER: 194700432
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/10/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/11/2024
Section Cited
1796.42 (b)
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1796.42 (b) A home care organization licensee shall do all of the following:
(b) Maintain and abide by a valid workers’ compensation policy covering its affiliated home care aides.
This requirement is not met as evidenced by:
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Provide proof of conversion of all 1099 employees to W2 and send to your analyst for your HCO. Please include your payroll report and most recent DE9C tax reporting forms. Send to gabriella.chavez@dss.ca.gov
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Based on interview with lcensee, she continued to employed 1099 workers which poses an immediate risk to the health and safety of home care aides.
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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: Ryan Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2