Complaint Investigation Report

364700157-5-21-2026-47-HC-SDUU-DUBVJK-20260522162852

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

HOME CARE SERVICES , 744 P STREET, MS 09-14-90

This is an official report of an unannounced visit/investigation of a complaint received in our office on

04/17/2026 and conducted by Evaluator Jane Cong-Huyen

COMPLAINT CONTROL NUMBER: 47-HC-20260417091034

Justin Larsen - Licensee (Unavailable to Meet)

Home Care Aides are providing medical services to clients

On 5/19/2026, Home Care Services Branch Enforcement Analyst (EA), Jane Cong-Huyen completed the complaint investigation regarding the above complaint allegation. The home care organization is no longer operating at the address listed above as of 5/11/26. No staff are present at this location.

During the investigation, EA confirmed with staff and observed documentation on the care logs showing the home care aides (HCAs) administered medication to client(s) in care daily.

Based on record reviews and interviews conducted, the preponderance of evidence standard has been met, therefore, the above allegation is found to be SUBSTANTIATED. Health and Safety Code, Division 2, Chapter 13, Section 1796.12(n) is cited on the attached LIC9099D.

EA Cong-Huyen provided copy of this report along with appeal rights to the licensee, Justin Larsen, via email for signature on each report page. The licensee will send the report pages back to HCSB for the records.