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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 194700492
Report Date: 01/06/2026
Date Signed: 01/06/2026 12:33:10 PM

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
11/17/2025 and conducted by Evaluator Ryan Chan
COMPLAINT CONTROL NUMBER: 47-HC-20251117131936
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:
01/06/2026
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Pauline Cloke - LicenseeTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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HCO is not honoring service contract.
INVESTIGATION FINDINGS:
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On 1/6/26, Home Care Services Branch Enforcement Analyst (EA), Ryan Chan conducted a follow up investigation visit to deliver the findings for the allegation stated above. Upon arrival, EA met with licensee Pauline Cloke.

Reporting party (RP) alleges that home care aides (HCA) did not show up for their scheduled shift with the client and the home care organization (HCO) billed the client’s insurance company for those shifts. Client receives home care services daily from 8am to 1pm then again from 5pm to 10pm. During the investigation EA reviewed time sheets, invoices, client assessment care plan, HCO no show/late policy and interviewed the HCO licensee and home care aides. A review of the HCA timesheets revealed that on 11/19/25 and 11/20/25 no HCAs reported for the 5pm to 10pm shift with the client.

(see pg 2)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Ryan Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2026
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-20251117131936
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: BEYOND HOME CARE
FACILITY NUMBER: 194700492
VISIT DATE: 01/06/2026
NARRATIVE
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Page 2

Interviews revealed that the HCA assigned to those shifts was on vacation and another HCA was scheduled for the shift, however the HCA called in on both days of her shift advising HCO that she would not be able to make it to her shift due to unforeseen emergencies. HCO attempted to call other HCAs to fill the shift but due to time constraints none were available. Additionally, interviews conducted with licensee and HCAs revealed that HCAs are trained to call the HCO if they will not be able to make a scheduled shift. EA reviewed HCA time sheets and invoices which show that these missed shifts on 11/19/25 and 11/20/25 were not billed.

Based on the evidence gathered and interviews conducted, the preponderance of evidence standard has not been met, therefore the above allegation is found to be UNSUBSTANTIATED.

EA concluded the visit with an exit interview and provided a copy of this report along with appeal rights to the licensee.
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Ryan Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2