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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374700363
Report Date: 11/18/2025
Date Signed: 11/18/2025 12:11:20 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
09/29/2025 and conducted by Evaluator Adrian L Mangina
PUBLIC
COMPLAINT CONTROL NUMBER: 47-HC-20250929130425
FACILITY NAME:INTERIM HEALTHCARE OF LA JOLLAFACILITY NUMBER:
374700363
ADMINISTRATOR:MALLER, KIMFACILITY TYPE:
300
ADDRESS:5440 MOREHOUSE DR. SUITE 2700TELEPHONE:
(858) 336-9934
CITY:SAN DIEGOSTATE: CAZIP CODE:
92121
CAPACITY:CENSUS: DATE:
11/18/2025
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Joey and Kim MallerTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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9
Home Care Aide has not completed the required training hours
INVESTIGATION FINDINGS:
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Home Care Services Branch, Enforcement Analyst (EA), Adrian Mangina conducted an complaint visit to the Home Care Organization (HCO) for the purpose of delivering the complaint findings regarding the above allegation. EA met with Designees Joey and Kim Maller.

EA interviewed Kim and Joey Maller who stated that the Home Care Organization provides the required five hour entry-level training to all Home Care Aides. Licensees provided training records for Home Care Aides currently employed, including HCS500 training logs as well as thrid party vendor records. EA reviewed the training records provided and found in a sampling of records, nine of nine HCAs did not complete the required five hour safety training prior to client contact as required by Statute. Based on EA’s interview with thedesignees and record review, the following violations are being cited in accordance with Health and Safety Code Health and Safety Code, Division 2, Chapter 13, Sections 1796.44(b)(1) and 1796.44(b)(2). See HCS 809D.
A copy of this report and appeals rights were provided to the licensee via email.

but stated that they had recently changed training vendors. to all Home Care Aides during which they stress that administration of medications is prohibited. Joey Maller provided a copy of the orientation deck that links to the Department's Home Care Services Fact Sheet which outlines that HCAs are not allowed to adminster medication but may provide medication reminders. EA also reviewed client service agreements and employee handbook and found no evidence that supports this allegation. Based on the EA's observation, interview and records review, there was insufficient evidence to prove the allegation did occur as the preponderance of evidence standard was not met. Although the allegation may have happened or is valid, the allegation is unsubstantiated.
An exit interview was conducted. A copy of this report was emailed to the designee,
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
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-20250929130425
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: INTERIM HEALTHCARE OF LA JOLLA
FACILITY NUMBER: 374700363
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/18/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/19/2025
Section Cited
1796.44(b)(1)
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TRAINING REQUIRMENTS :An affiliated home care aide shall complete a minimum of five hours of entry-level training prior to presence with a client, as follows: Two hours of orientation training regarding his or her role as caregiver and the applicable terms of employment.
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Licensee will immediately remove reference #1 and all other HCAs with clients from contact until they have completed two-hour orientation and will email proof of completion to adrian.mangina@dss.ca.gov no later than11/21/25. In addition, Licensee acknowledges that they will ensure that in the future all home care aides have required basic safety training before they are allowed any client contact.
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This requirement was not met as evidenced by: During the review of documents provided by Licensee via email, there was no record that Reference #1 completed entry-level 2-hour orientation training and no proof of completion priot to client contact for three of eight HCAs whose records were reviewed, a finding which poses an immediate health and safety risk to persons in care.
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Type A
11/19/2025
Section Cited
1796.44(b)(2)
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TRAINING REQUIREMENTS: An affiliated home care aide shall complete a minimum of five hours of entry-level training prior to presence with a client, as follows: three hours of safety training, including basic safety precautions, emergency procedures, and infection control.
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Licensee will immediately remove reference #1 and all HCAs who have client contact and have not completed three-hour safety training including basic safety precautions, emergency procedures, and infection control until proof of completed is emailed to adrian.mangina@dss.ca.gov no later than11/21/25. In addition, Licensee acknowledges that they will ensure that in the future all home care aides have required basic safety training before they are allowed any client contact.
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This requirements was not met as evidenced by: Licensee did not provide proof that reference #1 complete 3 hour safety training and seven of nine sampled HCA files showed that HCAs did not complete safety training before client contact a finding poses an immediate health and safety risk to persons 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: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
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
09/29/2025 and conducted by Evaluator Adrian L Mangina
COMPLAINT CONTROL NUMBER: 47-HC-20250929130425

FACILITY NAME:INTERIM HEALTHCARE OF LA JOLLAFACILITY NUMBER:
374700363
ADMINISTRATOR:MALLER, KIMFACILITY TYPE:
300
ADDRESS:5440 MOREHOUSE DR. SUITE 2700TELEPHONE:
(858) 336-9934
CITY:SAN DIEGOSTATE: CAZIP CODE:
92121
CAPACITY:CENSUS: DATE:
11/18/2025
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Joey and Kim MallerTIME COMPLETED:
10:30 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Home Care Aide administered medication to client
INVESTIGATION FINDINGS:
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3
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5
6
7
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9
10
11
12
13
Home Care Services Branch, Enforcement Analyst (EA), Adrian Mangina conducted complaint visit to the Home Care Organization (HCO) above or the purpose of delivering the complaint findings regarding the above allegation. EA met with and interviewed designees Joey and Kim Maller.

Both Designees attested that the Home Care Organization informs Home Care Aides (HCAs) during orientation that administration of medications is prohibited. Designees provided the orientation deck provided to all HCAs that links to the Department's Home Care Services Fact Sheet which outlines that medication may not be administered. No evidence was submitted that HCAs were administering medication. EA reviewed relevant documents and found no evidence HCAs were administering medication. Based on the EA's interviews and record review, there was not a preponderance of evidence to support allegation. Although the allegation may have happened or is valid, the allegation is unsubstantiated.

A copy of this report and HCS9098 Appeals form was emailed to the designees.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 3