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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374700276
Report Date: 06/12/2024
Date Signed: 07/25/2024 12:07:09 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
03/28/2024 and conducted by Evaluator Ruben Perez
COMPLAINT CONTROL NUMBER: 47-HC-20240328073751
FACILITY NAME:PRIORITY HOME CARE LLCFACILITY NUMBER:
374700276
ADMINISTRATOR:MONTIEL, ERIKAFACILITY TYPE:
300
ADDRESS:441 BLACKSHAW LNTELEPHONE:
(619) 991-2702
CITY:SAN DIEGOSTATE: CAZIP CODE:
92173
CAPACITY:CENSUS: DATE:
06/12/2024
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Erika MontielTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Employees/HCAs do not have fingerprint clearance

HCAs do not have TB clearance

HCAs do not have registration
INVESTIGATION FINDINGS:
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Home Care Services Branch (HCSB) Analysts Adrian Mangina and Ruben Perez arrived at the address provided for Priority Home Care LLC. Analysts met with Licensee Erika Montiel to discuss the above complaint allegation.

It was alleged that Employees/HCAs do not have fingerprint clearance, HCAs do not have TB clearance, and HCAs do not have registration. Analysts requested to review employee files, which Ms. Montiel provided. Analysts reviewed payroll records for all employees working between January 2024 and present. Analysts reviewed the files for all employees which revealed that one Home Care Aide was allowed to provide care to clients without fingerprint clearances and without Home Care Aide Registry, as required. In addition, In addition, analysts discovered through file review that three of 20 Home Care Aides working in March 2024 did not meet the TB requirement.

Based on the information HCSB Analyst obtained during the file review and interview of Licensee with Ms. Montiel along with documents obtained and evidence collected, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. Health and safety code is being cited on the attached HCS 9099D. The 9099 and 9099-D reports along with appeal rights were provided to the Licensee, Erika Montiel.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wendy Scott
LICENSING EVALUATOR NAME: Ruben Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2024
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-20240328073751
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: PRIORITY HOME CARE LLC
FACILITY NUMBER: 374700276
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/12/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/12/2024
Section Cited
1796.43 (a)
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1796.43 (a)
“Home care organizations that employ affiliated home care aides shall ensure the affiliated home care aides are cleared on the home care aide registry before placing the individual in direct contact with clients...”

Licensee understands that these HCAs need to be taken off assignment(s) immediately and complete the registration process until they receive a “registered” status in Guardian. Otherwise, they need to be dissociated from the organization and taken off all shifts.
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Licensee already started the background check and is "pending" in Guardian Licensee understands that these HCAs need to be taken off assignment(s) immediately and complete the registration process until they receive a “registered” status in Guardian.
Type A
06/26/2024
Section Cited
1796.45
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(a) Affiliated home care aides hired on or after January 1, 2016, shall submit to an examination 90 days prior to employment, or within seven days after employment, to determine that the individual is free of active tuberculosis disease.
(b) For purposes of this section, “examination” means a test for tuberculosis infection that is recommended by the federal Centers for Disease Control and Prevention (CDC) and is licensed by the federal Food and Drug Administration (FDA) and, if that test is positive, an X-ray of the lungs. The aide shall not work as an affiliated home care aide unless the licensee obtains documentation from a licensed medical professional that there is no risk of spreading the disease.
(c) After submitting to an examination, an affiliated home care aide whose test for tuberculosis infection shall be required to undergo an examination at least once every two years. Once an affiliated home care aide has a documented positive test for tuberculosis infection that has been followed by an X-ray, the examination is no longer required.
(d) After each examination, an affiliated home care aide shall submit, and the home care organization shall keep on file, a certificate from the examining practitioner showing that the affiliated home care aide was examined and found free from active tuberculosis disease.
(e) The examination is a condition of initial and continuing employment with the home care organization.
(f) An affiliated home care aide who transfers employment from one home care organization to another shall be deemed to meet the requirements of subdivision (a) or (c) if the affiliated home care aide can produce a certificate showing that he or she submitted to the examination within the past two years and was found to be free of active tuberculosis disease, or if it is verified by the home care organization previously employing him or her that it has a certificate on file that contains that showing and a copy of the certificate provided to the new home care organization prior to the affiliated home care aide beginning employment.

This requirement is not met as evidenced by:
Based on file review, the analyst identifed missing tuberculosis test for HCA's selected in sample size. This poses a potential safety risk to the people in care.
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HCO will provide tuberculis test documentation for HCA via email to gabriela.chavez@dss.ca.gov on or before due date.
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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: Wendy Scott
LICENSING EVALUATOR NAME: Ruben Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2