<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 194700492
Report Date: 01/24/2025
Date Signed: 01/24/2025 11:24:43 AM

Unsubstantiated


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
07/17/2024 and conducted by Evaluator Adrian L Mangina
PUBLIC
COMPLAINT CONTROL NUMBER: 47-HC-20240717151239
FACILITY NAME:BEYOND HOME CAREFACILITY NUMBER:
194700492
ADMINISTRATOR:PAULINE CLOKEFACILITY TYPE:
300
ADDRESS:225 E BROADWAY STE 112TELEPHONE:
(310) 600-8192
CITY:GLENDALESTATE: CAZIP CODE:
91381
CAPACITY:CENSUS: DATE:
01/24/2025
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Pauline MinanoTIME COMPLETED:
11:00 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
HCO did not provide home care services to client
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On January 24, 2025 Home Care Services Branch, Enforcement Analyst (EA), Adrian Mangina conducted an complaint investigation visit to Beyond Home Care. to deliver the complaint findings regarding the above allegation. EA met with Designee Pauline Minano (Cloke).

It was alleged that Home Care Organization (HCO) did not provide home care services to client for the amount billed. Enforcement Analyst conducted interviews with relevant parties associated with the HCO and collected documents related to the client whose care was in question. Interviews revealed that no contract could be found which outlined the amount of care to be provided and there was evidence to support that some care was being provided. Based on interviews and documentation received, it was determined that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the above allegation is found to be Unsubstantiated.

Exit interview conducted and report and HCS9098 was provided to Designee Pauline Minano via email.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2025
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 1