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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 194700626
Report Date: 02/06/2025
Date Signed: 02/06/2025 03:32:04 PM

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
01/30/2025 and conducted by Evaluator Ryan Chan
COMPLAINT CONTROL NUMBER: 47-HC-20250130095942
FACILITY NAME:FELICITY CARE GROUP, INC.FACILITY NUMBER:
194700626
ADMINISTRATOR:GARNER CRUZ JRFACILITY TYPE:
300
ADDRESS:17315 STUDEBAKER RD STE 205TELEPHONE:
(424) 319-9292
CITY:CERRITOSSTATE: CAZIP CODE:
90703
CAPACITY:CENSUS: DATE:
02/06/2025
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Garner Cruz, Jr. Licensee and Maria Cadag Staffing ManagerTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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9
Home Care Aide did not complete the required training hours
INVESTIGATION FINDINGS:
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On 2/6/25, Home Care Services Branch Enforcement Analyst (EA), Ryan Chan conducted an investigation visit regarding the above complaint allegation. Upon arrival, EA met with Garner Cruz, Jr. Licensee and Maria Cadag Staffing Manager.

During today's visit, analyst reviewed ten home care aide (HCA) files. Although HCAs completed orientation, 7 of 10 HCAs did not have the additional initial training and 3 of 10 did not have annual training required per Health and Safety Code 1796.44. Licensee stated training has been completed for HCAs, however, proof of training could not be verified at the time of the visit.

Based on interviews conducted and 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 1796.44 is being cited on the attached HCS 9099D.
EA concluded the visit with an exit interview and provided a copy of this report along with appeal rights to the licensee.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Ryan Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025
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-20250130095942
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: FELICITY CARE GROUP, INC.
FACILITY NUMBER: 194700626
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/10/2025
Section Cited
1796.44 (b)(2)
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1796.44 (b)(2) Three hours of safety training, including basic safety precautions, emergency procedures, and infection control.
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Scan completed training logs for Home Care Aides and email to Gabriella.Chavez@dss.ca.gov
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Based on records reviewed licensee did not ensure home care aides (HCAs) S1, S3, S5, S6, S8, S9, and S10 did not have proof of completion of 3 hours of safety training, S1 did not have proof of completion of 2 hours of safety traininig which poses an immediate risk to the health and safety of clients in care.
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Type A
02/10/2025
Section Cited
1796.44 (c)
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1796.44(c) In addition to the requirements in subdivision (b), an affiliated home care aide shall complete a minimum of five hours of annual training. The annual training shall relate to core competencies and be population specific, which shall include, but not be limited to, the following areas:
(1) Clients’ rights and safety.
(2) How to provide for and respond to a client’s daily living needs.
(3) How to report, prevent, and detect abuse and neglect.
(4) How to assist a client with personal hygiene and other home care services.
(5) If transportation services are provided, how to safely transport a client.
(d) The entry-level training and annual training described in subdivisions (b) and (c) may be completed through an online training program.
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Scan completed training logs for Home Care Aides and email to Gabriella.Chavez@dss.ca.gov
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Based on records reviewed licensee did not ensure home care aides (HCAs) S3, S6, and S8 completed annual training which poses an immediate risk to the health and safety of clients in care.
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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: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2