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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304700431
Report Date: 03/20/2025
Date Signed: 03/20/2025 10:31:34 AM

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
03/13/2025 and conducted by Evaluator Mila Quinto
COMPLAINT CONTROL NUMBER: 47-HC-20250313170917
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:
03/20/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Vivien Quintanilla-FloresTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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HCO is using independent contractors as caregivers.
INVESTIGATION FINDINGS:
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Enforcement Analyst (EA), Mila Quinto, with the Home Care Services Branch (HCSB) conducted a complaint inspection visit regarding the above complaint allegation.

EA met with licensee, Vivien Quintanilla-Flores. According to the licensee, they currently have 1 active HCA. In the beginning, they had 3 HCAs and they issued payments by checks and zelle. However, as of January 2025, they started issuing W2 payments to the HCAs.


Based on EA’s interview with the licensee and record review, the following violation is being cited in accordance with Health and Safety Code Health and Safety Code, Division 2, Chapter 13, Section 1796.42 (b). See HCS 809D.
A copy of this report was emailed to the licensee.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Mila Quinto
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025
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-20250313170917
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: 03/20/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/27/2025
Section Cited
1796.42(b)
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1796.42(b) Maintain and abide by a valid workers’ compensation policy covering its affiliated home care aides.
This requirement is not met as evidenced by:
Based on interview with the licensee and record review, the HCAs were not recieving payment via W2. However, licensee have started to issue payments via W2 as of January 2025.
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LIcensee will provide a written plan to indicate that all caregivers are paid by W2 payments. The written plan will be submitted to the assigned analyst via email by due date of 3/27/25 to
misael.chavarin@dss.ca.gov
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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: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2