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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304700374
Report Date: 06/04/2025
Date Signed: 06/04/2025 03:33:02 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
05/16/2025 and conducted by Evaluator Mila Quinto
COMPLAINT CONTROL NUMBER: 47-HC-20250516140023
FACILITY NAME:ORANGE COUNTY SUPPORT SERVICES DBA HOME INSTEADFACILITY NUMBER:
304700374
ADMINISTRATOR:THOMAS, WILLIAMFACILITY TYPE:
300
ADDRESS:18 TECHNOLOGY DRIVE SUITE 205TELEPHONE:
(714) 624-2465
CITY:IRVINESTATE: CAZIP CODE:
92618
CAPACITY:CENSUS: DATE:
06/04/2025
UNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Michelle Thomas, LicenseeTIME COMPLETED:
04:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Home Care Aides are delivering tube feedings to clients
Home Care Aides are administering medications to clients
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Home Care Services Branch, Enforcement Analyst (EA), Mila Quinto conducted an investigation visit to deliver the complaint findings regarding the above allegations. EA met with the licensee, Michelle Thomas.

According to the interview with the licensees, the HCAs who provide services to the client understands they cannot provide medical assistance as this is part of the initial trainings to the HCAs. The licensee stated when reviewing the care log for the client, it was discovered that the HCAs were assisting the client with the feeding tube and also assisting with medication administration. However, due to the client’s health condition and lack of support system, the HCAs may have provided assistance beyond the scope of expectations. According to the licensee, after the discovery of the additional services being provided to the client, they came to the client’s home for further assessment.
Substantiated
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)
Page: 1 of 3
Control Number 47-HC-20250516140023
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: ORANGE COUNTY SUPPORT SERVICES DBA HOME INSTEAD
FACILITY NUMBER: 304700374
VISIT DATE: 06/04/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Page 2 of 2

Based on interview conducted and records reviewed, the preponderance of evidence standard has been met. Therefore, the above allegations are found to be SUBSTANTIATED. A substantiated finding means the allegations are valid because the preponderance of the evidence standard has been met. The following violation was revealed and is being cited in accordance with Health and Safety Code, California Code of Regulations, Title 22, Division 12, 1796.12(n) Please refer to attached 9099 (D).

A copy of this report and appeals rights were provided to the licensee, Michelle William via email.
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
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 47-HC-20250516140023
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: ORANGE COUNTY SUPPORT SERVICES DBA HOME INSTEAD
FACILITY NUMBER: 304700374
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/11/2025
Section Cited
1796.12(n)
1
2
3
4
5
6
7
1794.12(n)(n) “Home care services” means nonmedical services and assistance provided by a registered home care aide to a client who, because of advanced age or physical or mental disability, cannot perform these services. These services enable the client to remain in his or her residence and include, but are not limited to, assistance with the following: bathing, dressing, feeding, exercising, personal hygiene and grooming, transferring, ambulating, positioning, toileting and incontinence care, assisting with medication that the client self-administers, housekeeping, meal planning and preparation, laundry, transportation, correspondence, making telephone calls, shopping for personal care items or groceries, and companionship. This subdivision shall not authorize a registered home care aide to assist with medication that the client self-administers that would otherwise require administration or oversight by a licensed health care professional.
1
2
3
4
5
6
7
The licensee have conducted an additional client assessment to determine the required assistance. Licensee understants HCAs are not to provide medical assistance to clients. Licensee will submit a written plan of correction to prevent future deficieny. This plan will be submitted to EA, Quinto via email by due date.
8
9
10
11
12
13
14
This requirement is not met as evidenced by:
Based on interviews and record reviews, the HCAs were assisting the client by putting liquids in the feeding tube.
This poses a potential heal tha safety risk to clients in care.
8
9
10
11
12
13
14
Type B
06/11/2025
Section Cited
1794.12(n)
1
2
3
4
5
6
7
1794.12(n)(n) “Home care services” means nonmedical services and assistance provided by a registered home care aide to a client who, because of advanced age or physical or mental disability, cannot perform these services. These services enable the client to remain in his or her residence and include, but are not limited to, assistance with the following: bathing, dressing, feeding, exercising, personal hygiene and grooming, transferring, ambulating, positioning, toileting and incontinence care, assisting with medication that the client self-administers, housekeeping, meal planning and preparation, laundry, transportation, correspondence, making telephone calls, shopping for personal care items or groceries, and companionship. This subdivision shall not authorize a registered home care aide to assist with medication that the client self-administers that would otherwise require administration or oversight by a licensed health care professional.
1
2
3
4
5
6
7
The licensee have conducted an additional client assessment to determine the required assistance. Licensee understants HCAs are not to provide medical assistance to clients. Licensee will submit a written plan of correction to prevent future deficieny. This plan will be submitted to EA, Quinto via email by due date.
8
9
10
11
12
13
14
This requirement is not met as evidenced by:
Based on interviews and record reviews, the HCAs were assisting the client with medication administration and putting in the feeding tube.
This poses a potential heal tha 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: 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
LIC9099 (FAS) - (06/04)
Page: 3 of 3