<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 194700772
Report Date: 11/15/2023
Date Signed: 12/20/2023 02:24:22 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
10/11/2023 and conducted by Evaluator Megan Vigil
PUBLIC
COMPLAINT CONTROL NUMBER: 47-HC-20231011150852
FACILITY NAME:NG FRANCHISE VENTURES LLC DBA SENIOR HELPERSFACILITY NUMBER:
194700772
ADMINISTRATOR:GALVAN, NAUNFACILITY TYPE:
300
ADDRESS:649 S FERRIS AVETELEPHONE:
(512) 905-3309
CITY:LOS ANGELESSTATE: CAZIP CODE:
90022
CAPACITY:CENSUS: DATE:
11/15/2023
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Naun GalvanTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
1. Home Care Aide is not registered on the Home Care Aide Registry prior to caring for clients.
2. Home Care Aide does not have a fingerprint clearance or Exemption prior to working for clients.
3. Home Care Organization is operating in a location not licensed by the department.
4. Home Care Adies were providing services without current TB test.
5. Home Care Aides did not sign the SOC 341A form.
6. Home Care Aides did not have required training.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 11.15.2023, Associate Governmental Program Analyst (AGPA) Megan Vigil arrived at arrived at the business office of Senior Helpers located at 13710 Whittier Blvd Ste 101, Whittier, CA 90605 at approximately 10:50 am regarding the above complaint allegations.

AGPA Vigil met with Licensee, Naun Galvan, who stated they have not been operating at address 649 S Ferris Ave. Los Angeles, CA 90022 since February 2022. Upon completion of the file review, AGPA Vigil discussed the findings of the inspection and the deficiencies that were discovered with Licensee, Galvan.

Based on AGPA's observations and interviews which were conducted and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wendy Scott
LICENSING EVALUATOR NAME: Megan Vigil
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023
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 4
Control Number 47-HC-20231011150852
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: NG FRANCHISE VENTURES LLC DBA SENIOR HELPERS
FACILITY NUMBER: 194700772
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/15/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/24/2023
Section Cited
1796.43
1
2
3
4
5
6
7
..Home care organizations that employ affiliated home care aides shall ensure the affiliated home care aides are cleared on the home care aide registry before placing the individual in direct contact with clients...
1
2
3
4
5
6
7
Licensee will immediately remove all Home Care Aides that are not cleared/registered as of 11.15.2023 from providing services to the public.
8
9
10
11
12
13
14
Licensee did not verify the background check was completed before providing services to the public. This poses an immediate Health and Safety risk to persons in care.
8
9
10
11
12
13
14
Type A
11/24/2023
Section Cited
1796.23 (a)
1
2
3
4
5
6
7
...Each person initiating a background examination to be a registered home care aide shall submit his or her fingerprints to the Department of Justice by electronic transmission in a manner approved by the department, unless exempt under subdivision...
1
2
3
4
5
6
7
Scan proof of clearance in the form of a screen capture from the Home Care Aide Registry Search site or a copy of your current personnel roster in Guardian showing registered/eligible for all employees and email to assigned Analyst by 11.24.23
8
9
10
11
12
13
14
Licensee did not verify the Home Care Aides finger-printing process was completed before providing services to the public. This poses an immediate Health and Safety risk to persons in care.
8
9
10
11
12
13
14
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: Wendy Scott
LICENSING EVALUATOR NAME: Megan Vigil
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 47-HC-20231011150852
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: NG FRANCHISE VENTURES LLC DBA SENIOR HELPERS
FACILITY NUMBER: 194700772
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/15/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/30/2023
Section Cited
1796.45
1
2
3
4
5
6
7
...(c) After submitting to an examination, an affiliated home care aide whose test for tuberculosis infection shall be required to undergo an examination at least once every two years...
1
2
3
4
5
6
7
All Home Care Aide's that do not have current TB test must be removed from providing services as of 11.15.23. Scan completed TB clearance certifications for all Home Care Aides to HCO Analyst by 11.30.23.
8
9
10
11
12
13
14
Licensee did not verify Home Care Aide's TB Test was current before providing services to the public. This poses an immediate Health and Safety risk to persons in care.
8
9
10
11
12
13
14
Type B
11/24/2023
Section Cited
1796.36 (a)(2)
1
2
3
4
5
6
7
...A home care organization … shall comply with all of the following: (2) Maintain all pertinent records of the operation in California at the California office. All records shall be available to review, copy, audit, and inspect by the Department...
1
2
3
4
5
6
7
The licensee will mail an updated HCS 200 form along with a check/money order in the amount of $100 in order to initiate the Department’s change of address process. Payment made payable to the CA Department of Social Services and mailed to 744 P Street, M.S. 9-14-90, Sacramento, CA 95814.
8
9
10
11
12
13
14
The Home Care Organization’s physical address on file was not a valid physical location for the HCO. Personnel files had been relocated to an alternate location that has not yet been approved by the Department. This poses a potential health and safety risk to clients in care.
8
9
10
11
12
13
14
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: Wendy Scott
LICENSING EVALUATOR NAME: Megan Vigil
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 47-HC-20231011150852
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: NG FRANCHISE VENTURES LLC DBA SENIOR HELPERS
FACILITY NUMBER: 194700772
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/15/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/30/2023
Section Cited
1796.44
1
2
3
4
5
6
7
(a) A home care organization licensee shall ensure that prior to providing home care services, an affiliated home care aide shall complete the training requirements specified in this section...
1
2
3
4
5
6
7
Scan completed training for all Home Care Aides to HCO Analyst by 11.30.23.
8
9
10
11
12
13
14
Licensee did not maintain the required training logs for the Home Care Aide's in the personnel file. This poses a potential health and safety risk to clients in care.
8
9
10
11
12
13
14
Type B
11/30/2023
Section Cited
1796.42 (e)
1
2
3
4
5
6
7
..Report any suspected or known dependent adult or elder abuse as required by Section 15630... A copy of each suspected abuse report shall be maintained and available for review by the department during normal business hours.
1
2
3
4
5
6
7
Scan completed SOC 341A form(s) for all employees and email to HCO Analyst by 11.30.23.
8
9
10
11
12
13
14
Licensee did not have a signed copy of the SOC341A form in Home Care Aide's in the personnel file. This poses a potential health and safety risk to clients in care.
8
9
10
11
12
13
14
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: Wendy Scott
LICENSING EVALUATOR NAME: Megan Vigil
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 4