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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 194700708
Report Date: 10/23/2024
Date Signed: 10/23/2024 03:21:37 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
09/10/2024 and conducted by Evaluator Ryan Chan
COMPLAINT CONTROL NUMBER: 47-HC-20240910121238
FACILITY NAME:ARCHANGEL CARE SERVICES LLCFACILITY NUMBER:
194700708
ADMINISTRATOR:REGALIZA, MARILENEFACILITY TYPE:
300
ADDRESS:5750 DOWNEY AVENUE, STE 301TELEPHONE:
(562) 252-2310
CITY:LAKEWOODSTATE: CAZIP CODE:
90712
CAPACITY:CENSUS: DATE:
10/23/2024
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Maria Nonato - Officer In ChargeTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Home Care Aides have not completed the required training hours
INVESTIGATION FINDINGS:
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On 10/23/24, Home Care Services Enforcement Analyst (EA) Ryan Chan conducted an investigation visit regarding the above complaint allegation. Upon arrival, EA met with Maria Nonato Officer- in-Charge.

During today’s visit, EA reviewed 10 home care aide (HCA) files. All 10 had orientation training, however they did not have training on basic safety precaution, emergency procedures, and infection control as required by the Health and Safety Code during their entry level training. 6 of 10 staff did not have the annual training courses completed as specified in the Health and Safety Code.

Based on 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(b) and 1796.44(c) is being cited on the attached LIC 9099D.

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

DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024
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 3
Control Number 47-HC-20240910121238
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: ARCHANGEL CARE SERVICES LLC
FACILITY NUMBER: 194700708
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/23/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/13/2024
Section Cited
1796.44(b)
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1796.44(b) An affiliated home care aide shall complete a minimum of five hours of entry-level training...as follows:(1) Two hours of orientation training...(2) Three hours of safety training, including basic safety precautions, emergency procedures, and infection control.
This requirement is not met as evidenced by:
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Scan completed training logs for all Home Care Aides and email to ryan.chan@dss.ca.gov
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Based on records reviewed the licensee did not ensure home care aides (HCA) completed three hours of safety training, including basic safety precautions, emergency procedures, and infection control which poses a potential risk to the health and safety of clients in care.
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Type B
11/13/2024
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...which shall include, but not be limited to, the following...(c)(1)...(c)(2)...(c)(3)...(c)(4)...(c)(5).
This requirement is not met as evidenced by:
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Scan completed training logs for all Home Care Aides and email to ryan.cahn@dss.ca.gov
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Based on records reviewed the licensee did not ensure home care aides (HCA)completed annual training in coursesin the courses specified in the Health and Safety Code which poses a potential 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: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3