194700576-7-23-2025-47-HC-SDUU-DK2TEF-20250729143949

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 194700576
Report Date: 06/18/2025
Date Signed: 07/23/2025 09:30:29 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
04/25/2025 and conducted by Evaluator Joshua Rarela

PUBLIC

COMPLAINT CONTROL NUMBER: 47-HC-20250425083048

FACILITY NAME:	FOUNTAIN HOMECARE SERVICES, LLC		FACILITY NUMBER:	194700576
ADMINISTRATOR:	EBUN AYO ONANUGA		FACILITY TYPE:	300
ADDRESS:	18305 SHERMAN WAY UNIT 13		TELEPHONE:	(818) 975-8187
CITY:	RESEDA	STATE: CA	ZIP CODE:	91335
CAPACITY:		CENSUS:	DATE:	06/18/2025
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Ebun Ayo Onanuga, Administrator		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Home Care Organization (HCO) did not provide services to a client as contracted

INVESTIGATION FINDINGS:

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Enforcement Analyst (EA), Joshua Rarela, with the Home Care Services Branch (HCSB) conducted an onsite inspection for the purpose of a Complaint Investigation. The EA met with the individual named above and discussed the findings.

During the course of the investigation, EA conducted interviews with the Home Care Organization (HCO) personnel and reviewed records including the Home Care Aide (HCA) training history, HCA criminal record history, client contract documentation, intake records, and HCO correspondence with the client's social worker.

It was alleged that the HCO caregivers failed to properly care for a client leading to a fall or leaving the client unattended at home. (CONTINUED)

***This is an amended version of the original report created on 06/18/25.***

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Joshua Rarela
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2025

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-20250425083048

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: FOUNTAIN HOMECARE SERVICES, LLC	FACILITY NUMBER: 194700576
	VISIT DATE: 06/18/2025

NARRATIVE

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(CONTINUATION)

The HCO denied the allegations and stated that they terminated services with the client's social worker as their HCAs were being verbally abused by the client's spouse. The HCO administrator reported that services were provided to the client for a brief two-week period with two caregivers assigned to alternate shifts. The administrator stated that the client’s spouse was rude and harassed the caregivers during their shifts.

Additionally, the spouse insisted that the caregivers take the client for walks despite the client’s refusal due to physical limitations. The spouse also directed the caregivers to walk the family dogs in areas known for rattlesnake presence, leaving the client unattended during these tasks. The HCO decided to terminate services with the client after the two-week period due to these circumstances.

Based on the EA's observations, interview and records review, there was insufficient evidence to prove the allegation as the preponderance of evidence standard was not met although the allegation may have happened or is valid, therefore the allegation is found to be unsubstantiated. A copy of this report was provided via electronic mail.

SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Joshua Rarela
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025

LIC9099 (FAS) - (06/04)

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