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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304700008
Report Date: 06/04/2025
Date Signed: 06/04/2025 12:11:07 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
05/16/2025 and conducted by Evaluator Mila Quinto
COMPLAINT CONTROL NUMBER: 47-HC-20250516093841
FACILITY NAME:SMITH'S HOME CARE, INCFACILITY NUMBER:
304700008
ADMINISTRATOR:PAULINE PAGUNSANFACILITY TYPE:
300
ADDRESS:530 TECHNOLOGY DR. #100TELEPHONE:
(949) 273-5006
CITY:IRVINESTATE: CAZIP CODE:
92618
CAPACITY:CENSUS: DATE:
06/04/2025
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Sarah Smith, LicenseeTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
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9
HCO is operating out of an office not licensed by the department.
INVESTIGATION FINDINGS:
1
2
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5
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13
Enforcement Analyst (EA), Mila Quinto conducted a complaint inspection visit regarding the above complaint allegation. EA met with the licensee, Sarah Smith.

EA conducted an interview with the licensee. According to the licensee, they only operate at this address. Licensee confirmed the address on the website will need to be updated as it does not have the current information. The licensee have updated the website during the visit.

Based on the EA's observations, interviews 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, the allegation is unsubstantiated.

An exit interview was conducted. A copy of this report was emailed to the licensee, Sarah Smith.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Mila Quinto
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2025
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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