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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304700351
Report Date: 01/14/2025
Date Signed: 01/14/2025 10:46:33 AM

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
11/25/2024 and conducted by Evaluator Mila Quinto
COMPLAINT CONTROL NUMBER: 47-HC-20241125130412
FACILITY NAME:FIRST LIGHT HOME CARE OF IRVINEFACILITY NUMBER:
304700351
ADMINISTRATOR:CHARITH WEERASURIYAFACILITY TYPE:
300
ADDRESS:2400 BARRANCA PKWY # 1205TELEPHONE:
(949) 302-1047
CITY:IRVINESTATE: CAZIP CODE:
92606
CAPACITY:CENSUS: DATE:
01/14/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Charith Weerasuriya, LicenseeTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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HCO is financially abusing client.
INVESTIGATION FINDINGS:
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Enforcement Analysts (EAs), Mila Quinto and Jane Cong-Huyen, with the Home Care Services Branch (HCSB) conducted a follow-up onsite inspection for the purpose of delivering the finding of a Complaint Investigation. The EAs met with the HCO representative, Charith Weerasuriya and Dak Perusinghe and discussed the above allegation.

During the course of the investigation, EA conducted interviews and reviewed records including but not limited to, service agreement, duty service rates and invoices. The licensee stated, as a franchisee, the rates are all the same. Licensee denied the allegation of financial abuse as all rates are included on the client’s agreement. Licensee also stated they use an application called Welsky of which clients have access to check and HCA to clock in and out as well as enter notes.


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Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Mila Quinto
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025
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-20241125130412
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: FIRST LIGHT HOME CARE OF IRVINE
FACILITY NUMBER: 304700351
VISIT DATE: 01/14/2025
NARRATIVE
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Based on interviews conducted and file review, the complaint alleging HCO is financially abusing client is found to be unsubstantiated. Although the allegation may have happened or is valid, there is not enough preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.


An exit interview was conducted. A copy of this report was also provided via email to the licensee.
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Mila Quinto
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2