194700565-1-26-2026-47-HC-SDUU-DQYTGH-20260204134307

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 194700565
Report Date: 01/26/2026
Date Signed: 01/26/2026 12:17:58 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
01/06/2026 and conducted by Evaluator Ryan Chan

COMPLAINT CONTROL NUMBER: 47-HC-20260106164047

FACILITY NAME:	KRISTA CARE LLC		FACILITY NUMBER:	194700565
ADMINISTRATOR:	SOFYAN ALDOWIRI		FACILITY TYPE:	300
ADDRESS:	630 W DUARTE RD STE 206		TELEPHONE:	(626) 684-2647
CITY:	ARCADIA	STATE: CA	ZIP CODE:	91007
CAPACITY:		CENSUS:	DATE:	01/26/2026
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Licensee - Sofyan (Sam) Aldowiri		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Home Care Aide not providing services to client.

INVESTIGATION FINDINGS:

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On 1/26/26, Home Care Services Branch Enforcement Analyst (EA), Ryan Chan conducted a follow up investigation visit regarding the above complaint allegation. EA met with licensee Sofyan (Sam) Aldowiri.

During the course of the investigation EA interviewed home care aides (HCA) and Alejandra Munoz - Human Resource Generalist, EA also reviewed home care aide (HCA) files, home care organization (HCO) Krista Care Employee Handbook, and client intake questionnaire.

The client is a minor child with mental illness, reporting party (RP) alleged that HCA did not provide services to client and HCA did not show up for scheduled shift. An HCA was scheduled to provide services on 12/20/25 through 12/26/25 however HCA called in 15 minutes before shift on 12/20/25 indicating client was too far. HCO attempted to fill the shift (4 hours each day) but was unsuccessful.
(See pg 2)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Ryan Chan
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 47-HC-20260106164047

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: KRISTA CARE LLC	FACILITY NUMBER: 194700565
	VISIT DATE: 01/26/2026

NARRATIVE

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Documents reviewed indicate HCAs are provided the employee handbook which has procedures to follow in case an HCA is unable to work a scheduled shift, the handbook also indicates the HCA is responsible for reviewing their work schedule and to notify the HCO of potential issues, the handbook indicates HCAs are not permitted to make or accept phone calls or texts while on duty at client's homes unless they are to the HCO, a health care provider, or an emergency. The HCA then signs the "Employee Statement of Understanding" indicating they have read and understood the contents of the employee handbook.

Services were provided to client on 1/1/26 for 4 hours. RP feels HCA did not engage enough with client on this day, however, interviews revealed that client was already agitated prior to HCA arrival and at one point client did not want to come out of the bedroom. Interviews revealed HCA made attempts to engage with client but was unsuccessful.

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: 01/26/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2026

LIC9099 (FAS) - (06/04)

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