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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 214700042
Report Date: 07/08/2024
Date Signed: 07/10/2024 09:53:41 AM

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
04/24/2024 and conducted by Evaluator Todd Borcher
PUBLIC
COMPLAINT CONTROL NUMBER: 47-HC-20240424164151
FACILITY NAME:SENIOR HEART AT HOMEFACILITY NUMBER:
214700042
ADMINISTRATOR:ARES, SUSANFACILITY TYPE:
300
ADDRESS:7595 REDWOOD BLVD #107TELEPHONE:
(415) 233-3262
CITY:NOVATOSTATE: CAZIP CODE:
94945
CAPACITY:CENSUS: DATE:
07/08/2024
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Licensee - Susan AresTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Home Care Organization is operating without a license.
INVESTIGATION FINDINGS:
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On July 8, 2024, Home Care Services Branch (HCSB) Analyst, Todd Borcher, arrived at the business office of Senior Heart at Home, located at 7595 Redwood Blvd #107, Novato, CA. Analyst Borcher met with Licensee Susan Ares to discuss the above complaint allegation.
Analyst Borcher met with Licensee and conducted an interview to discuss the operations of the Home Care Organization (HCO). Licensee admitted to providing and arranging for services before proper licensure. Licensee Ares has submitted an HCO application with the Home Care Services Bureau and wants to be in compliance with proper licensing requirements.
Based on the analyst'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. Health and Safety Code. Article 11. Section 1796.55, are being cited on the attached HCS 9099D.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wendy Scott
LICENSING EVALUATOR NAME: Todd Borcher
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2024
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 2
Control Number 47-HC-20240424164151
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: SENIOR HEART AT HOME
FACILITY NUMBER: 214700042
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/08/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/08/2024
Section Cited
1796.55
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...(a) A home care organization that operates in violation of any requirement or obligation imposed by this chapter or any rule or regulation promulgated pursuant to this chapter may be subject to the fines levied or licensure action taken by the department as specified in this chapter...
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Licensee understands to operate the Home Care Organization (HCO), Licensee must obtain the HCO Licensee to organize and provide care services to the public. Licensee understands they cannot advertise or operate the Organization until their pending HCO application is approved.
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Licenese Susan Ares admitted to operating a Home Care Organization (HCO) without the License. This poses an immediate Health and Safety risk to persons 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: Wendy Scott
LICENSING EVALUATOR NAME: Todd Borcher
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2024
LIC9099 (FAS) - (06/04)
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