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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304700292
Report Date: 08/11/2023
Date Signed: 09/20/2023 01:29:20 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
07/08/2022 and conducted by Evaluator Michael Drake
COMPLAINT CONTROL NUMBER: 47-HC-20220708172806
FACILITY NAME:INFINITE CARE SOLUTIONS, INC.FACILITY NUMBER:
304700292
ADMINISTRATOR:CARAIG, LOUELLA S.FACILITY TYPE:
300
ADDRESS:5120 E LA PALMA STE 201TELEPHONE:
(800) 603-9722
CITY:ANAHEIM HILLSSTATE: CAZIP CODE:
92807
CAPACITY:CENSUS: DATE:
08/11/2023
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:TIME COMPLETED:
10:30 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Home Care Aides administering medication to clients.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 8/11/2023, at 9:50am., Home Care Services Analyst (HCSA), Michael Drake, conducted a complaint phone interview and spoke with Licensees Jacqueline Stokes and Louella Caraig.

At 9:55am, HCSA Drake reviewed the Home Care Organization's (HCO) training plan and asked the licensees if Home Care Aides (HCA) working for their HCO were administering medications to clients. The licensees stated that they "didn't think so," but followed that by asking under what circumstances it would be allowed.

Based on the HCSA's interviews which was conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Health and Safety Code are being cited on the attached HCS 9099 D.

Exit interview was conducted. Copies of the HCS 9099, HCS 9099D, and appeal rights provided. Request that Licensee(s) sign and return HCS 9099 was made.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Chong Vang
LICENSING EVALUATOR NAME: Michael Drake
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023
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 2
Control Number 47-HC-20220708172806
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: INFINITE CARE SOLUTIONS, INC.
FACILITY NUMBER: 304700292
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/11/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/20/2023
Section Cited
1796.12(n)
1
2
3
4
5
6
7
1796.12(n) Home care services” means nonmedical services and assistance provided by a registered home care aide ... These services enable the client to remain in his or her residence and include, but are not limited to, ... assisting with medication that the client self-administers,... This subdivision shall not authorize a registered home care aide to assist with medication that the
1
2
3
4
5
6
7
Licensee stated that they will send updated training plan regarding the administration of medication by Home Care Aides
8
9
10
11
12
13
14
client self-administers that would otherwise require administration or oversight by a licensed health care professional.
This requirement is not met as evidenced by:

Based on interview and record review the licensee could not ensure that medications were not being administered by Home Care Aides.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Chong Vang
LICENSING EVALUATOR NAME: Michael Drake
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2