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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 564700090
Report Date: 04/09/2024
Date Signed: 04/09/2024 12:43:48 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
11/07/2023 and conducted by Evaluator Mila Quinto
COMPLAINT CONTROL NUMBER: 47-HC-20231107160302
FACILITY NAME:DIVINE AGAPE HEALTH CARE AGENCYFACILITY NUMBER:
564700090
ADMINISTRATOR:DOMINGO, ARNOLDFACILITY TYPE:
300
ADDRESS:300 EAST ESPLANADE DR,9TH FLTELEPHONE:
(805) 980-8021
CITY:OXNARDSTATE: CAZIP CODE:
93036
CAPACITY:CENSUS: DATE:
04/09/2024
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Laura Martinez, ManagerTIME COMPLETED:
11:00 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Unregistered caregivers
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On April 9, 2024, Home Care Services Analysts (HCSA), Mila Quinto conducted an investigation visit regarding the above complaint allegation. Upon arrival, HCSA met with Manager, Laura Martinez.
The complainant alleged there are unregistered caregivers working for the HCO.

During today’s visit, HCSA interviewed Ms. Martinez. According to Ms. Martinez, all Home Care Aids (HCA) have the requirements prior to hire. Ms. Martinez explained prior to hire date, all HCA must have background clearance and registered.
HCSA also reviewed 10 files and based on the review, all HCA has background clearance with registry.
Based on interviews conducted and file review, the complaint alleging unregistered caregivers working for the HCO is found to be unsubstantiated. Although the allegation may have happened or is valid, there is not enough preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Mila Quinto
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024
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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