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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 194700472
Report Date: 07/29/2025
Date Signed: 08/05/2025 11:30:40 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
04/29/2025 and conducted by Evaluator Ryan Chan
COMPLAINT CONTROL NUMBER: 47-HC-20250429150329
FACILITY NAME:CARING ANGELS HOME CARE LLCFACILITY NUMBER:
194700472
ADMINISTRATOR:ALBERT ANARWATFACILITY TYPE:
300
ADDRESS:609 DEEP VALLEY DR, # 200TELEPHONE:
(310) 418-0207
CITY:ROLLING HILLS ESTATESTATE: ZIP CODE:
90274
CAPACITY:CENSUS: DATE:
07/29/2025
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Jessica Davila - Staffing ManagerTIME COMPLETED:
12:00 PM
ALLEGATION(S):
1
2
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9
HCA is not on the registry
INVESTIGATION FINDINGS:
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13
On 7/29/25, Home Care Services Branch Enforcement Analyst (EA), Ryan Chan conducted a follow up investigation visit regarding the above complaint allegation. EA met with Staffing Manager Jessica Davila.

Reporting party (RP) alleges home care aides (HCA) were not cleared on the home care aide registry. During the investigation, EA reviewed 14 HCA files and interviewed Staffing Manager Jessica Davila. All 14 of the HCAs whose files were reviewed are currently registered on the home care aide registry, however, 2 of the 14 were not registered in the home care aide registry prior to placing them with clients.

Based on records reviewed, 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 1796.43(a) is being cited on the attached HCS 9099D. Ms. Davila was advised that HCAs who are not cleared on the home care aide registry are not to be placed with clients.EA concluded the visit with an exit interview and provided a copy of this report along with appeal rights to Ms. Davila.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Ryan Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2025
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 2
Control Number 47-HC-20250429150329
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: CARING ANGELS HOME CARE LLC
FACILITY NUMBER: 194700472
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/29/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/04/2025
Section Cited
1796.43 (a)
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1796.43 (a) "Home care organizations that employ affiliated home care aides shall ensure the affiliated home care aides are cleared on the home care aide registry before placing the individual in direct contact with clients...”

This requirement is not met as avidenced by:
1
2
3
4
5
6
7
Licensee will provide a plan of correction statement to EA Ryan Chan (ryan.chan@dss.ca.gov) on how they will ensure home care aides are registered on the home care aide registry prior to placing them with clients.
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9
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14
Based on interviews and records reviewed licensee did not ensure home care aides (S1 and S3) were cleared on the home care aide registry prior to placing them with clients in care which poses an immediate risk to the health and safety of clients in care.
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9
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14
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7
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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: 07/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2