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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 494700028
Report Date: 08/20/2024
Date Signed: 08/20/2024 12:26:37 PM

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
07/22/2024 and conducted by Evaluator Todd Borcher
PUBLIC
COMPLAINT CONTROL NUMBER: 47-HC-20240722150300
FACILITY NAME:THEKEY OF CALIFORNIA, LLCFACILITY NUMBER:
494700028
ADMINISTRATOR:CHEN XIEFACILITY TYPE:
300
ADDRESS:170 FARMERS LANE, SUITE 11TELEPHONE:
(707) 539-9000
CITY:SANTA ROSASTATE: CAZIP CODE:
95405
CAPACITY:CENSUS: DATE:
08/20/2024
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Designee - Kim ScottTIME COMPLETED:
12:15 PM
ALLEGATION(S):
1
2
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5
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8
9
Home care aide is not showing up for shifts.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Home Care Services Branch (HCSB) Analyst, Todd Borcher, arrived at the business address to meet with Kim Scott, designee for TheKey of California, LLC located at 170 Farmers Lane, Suite 11, Santa Rosa, CA 95405 to discuss the above complaint allegation. Designee, Kim Scott, greeted the analyst and showed him to an area where interviews and documents could be reviewed. 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, and corrective action policies set forth by the company, and payroll documentation.

Analyst concluded that there was not conclusive evidence to substantiate the above allegation. The analyst delivered the findings to designee Kim Scott. Based on the preponderance of evidence gathered through interviews conducted, evidence obtained and observations, the above allegation was found to be UNSUBSTANTIATED. An exit interview was conducted, and the licensing reports as well as the appeal rights documents were provided to the designee.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wendy Scott
LICENSING EVALUATOR NAME: Todd Borcher
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024
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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