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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304700431
Report Date: 01/24/2025
Date Signed: 01/24/2025 03:37:30 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
01/21/2025 and conducted by Evaluator Mila Quinto
COMPLAINT CONTROL NUMBER: 47-HC-20250121154753
FACILITY NAME:LOVED ONE COMFORT CAREFACILITY NUMBER:
304700431
ADMINISTRATOR:VIVIEN E. QUINTANA-FLORESFACILITY TYPE:
300
ADDRESS:1408 EL ENCANTO DRTELEPHONE:
(714) 749-6989
CITY:BREASTATE: CAZIP CODE:
92821
CAPACITY:CENSUS: DATE:
01/24/2025
UNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Vivien Quintana and Doreen DyTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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HCO is using unregistered home care aides to provide care to clients.
INVESTIGATION FINDINGS:
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Enforcement Analyst (EA), Mila Quinto conducted an investigation visit regarding the above complaint allegation. Upon arrival, EA met with Vivien Quintana Flores and Doreen Dy.

During today’s visit, EA interviewed Ms. Quintana Flores and Ms. Dy. Both stated they currently have 2 clients and 3 active HCAs. Ms. Dy stated 1 of 3 HCA is currently working on the criminal background while the other 2 HCA have clearance.
EA reviewed the 3 HCA background status and found 1 HCA does not have the criminal background and 2 HCA do not have an active home care registry.

Based on interviews conducted and file review, the complaint alleging HCO is using unregistered home care aides to provide care to clients is found to be substantiated.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Mila Quinto
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2025
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-20250121154753
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: LOVED ONE COMFORT CARE
FACILITY NUMBER: 304700431
VISIT DATE: 01/24/2025
NARRATIVE
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Page 1 of 2


Based on EAs interview with Ms. Quintana-Flores and Ms. Dy and file review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Health and safety code is being cited on the attached HCS 9099D.

Exit interview was conducted and reports with appeal rights was provided to the licensee, Vivien Quintana-Flores via email.
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Mila Quinto
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 47-HC-20250121154753
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: LOVED ONE COMFORT CARE
FACILITY NUMBER: 304700431
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/24/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/31/2025
Section Cited
1796.23(a)
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1796.23 Fingerprint Requirements
(a) Each person initiating a background examination to be a registered home care aide shall submit their fingerprints to the Department of Justice by electronic transmission in a manner approved by the department, unless exempt under subdivision (d).
This requirement is not met as evidenced by:
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The licensee stated will have HCA3 submit the live scan today and will provide proof of correction along with home care registry to analyst, M. Chavarin at
misael.chavarin@dss.ca.gov by 1/31/2025. Licensee undertands HCA3 cannot meet with clients until live scan and registry have been completed.
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Based on interview with licensee, HCA 3 did not have criminal background clearance. This poses an immidiate health and safety risk to clients in care.
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Type A
01/31/2025
Section Cited
1796.14(b)
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1796.14 Scope of Requirements for HCAs
(b) An affiliated home care aide shall be listed on the home care aide registry prior to providing home care services to a client.
This requirement is not met as evidenced by:
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Licensee stated will register HCA1 and HCA 2 and will provide proof of correction to analyst, M. Chavarin by January 31, 2024 at
misael.chavarin@dss.ca.gov
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Based on interview and file review, HCA 1 and HCA 2 did not have a current home care registry.
This poses an immediate health and safety risk to clients 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: Susan Du
LICENSING EVALUATOR NAME: Mila Quinto
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3