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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 414700045
Report Date: 12/19/2024
Date Signed: 12/26/2024 10:18:15 AM

Unsubstantiated


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
12/02/2024 and conducted by Evaluator Ruben Perez
PUBLIC
COMPLAINT CONTROL NUMBER: 47-HC-20241202151334
FACILITY NAME:AT HOME SUPPORT SENIOR CARE, LLCFACILITY NUMBER:
414700045
ADMINISTRATOR:J JUSTIN TUVILLAFACILITY TYPE:
300
ADDRESS:1590 EL CAMINO REAL STE KTELEPHONE:
(650) 585-4447
CITY:SAN BRUNOSTATE: CAZIP CODE:
94066
CAPACITY:CENSUS: DATE:
12/19/2024
UNANNOUNCEDTIME BEGAN:
12:34 PM
MET WITH:Victoria TuvillaTIME COMPLETED:
03:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
HCA is not showing up for shifts.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 12/19/2024, Enforcement Analyst (EA) Ruben Perez arrived at the business address for At Home Support Senior Care. EA Perez introduced himself and was greeted by Victoria Tuvilla. EA explained that he was there to investigate the above complaint allegation(s). EA Perez interviewed Victoria regarding the company’s onboarding process for caregivers including background check and registration on the Home Care Aide (HCA) Registry. EA Perez also reviewed personnel files and payroll to ensure licensing requirements were met. EA Perez interviewed Designee about their policy pertaining to Home Care Aides not showing up for scheduled shifts. Designee was able to provide the following documentation: client service agreement, which included agreed upon policies in the event of service interruption, employee handbook that covers attendance and punctuality requirements set forth by the company.

Based on EA's observations and interviews, the EA concluded that there was not enough evidence to show that the organization violated the allegation(s) listed above, therefore, the above allegation(s) is found to be UNSUBSTANTIATED.

Analyst Perez concluded the visit with an exit interview and provided a copy of the HCS 9099 investigation report along with appeal rights.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wendy Scott
LICENSING EVALUATOR NAME: Ruben Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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