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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 032701486
Report Date: 05/01/2025
Date Signed: 05/01/2025 03:37:35 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/01/2025 and conducted by Evaluator Arvin Villanueva
COMPLAINT CONTROL NUMBER: 27-AS-20250401153123
FACILITY NAME:LIVEWELL CARE HOME LLCFACILITY NUMBER:
032701486
ADMINISTRATOR:LI, JONATHANFACILITY TYPE:
735
ADDRESS:290 GOLD STRIKE CTTELEPHONE:
(302) 893-3498
CITY:SUTTER CREEKSTATE: CAZIP CODE:
95685
CAPACITY:4CENSUS: 4DATE:
05/01/2025
UNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Karen OrrTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff interacts with clients inappropriately.
INVESTIGATION FINDINGS:
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On 5/1/2025, Licensing Program Analyst Arvin Villanueva (LPA) arrived unannounced at this facility to conduct a follow-up complaint visit and deliver findings of the allegation noted above. LPA arrived at 2:15pm and no one was at the facility at this time. LPA contacted the administrator, Karen Orr (AD), to inform her of this visit and permitted LPA to wait at the back of the facility until AD arrives. At 3pm, AD arrived at the facility with 3 clients in care. LPA also spoke with the licensee, Jonathan Li over the phone and discuss the report with him.
The investigation into the above allegation consisted of interviews of residents, staff and outside parties.
Interviews with 4 clients (C1, C2, C3, C4) revealed that 3 of 4 clients , consistently expressed discomfort with the staff member identified as (S1 ). Clients reported that S1’s behavior, such as standing too close during activities and requiring clients to open their mouths to verify medication administration, made them feel uncomfortable and violated their personal space. Although no physical abuse or aggressive behavior was reported, the repeated accounts from several clients indicated that S1's conduct created an environment in which clients did not feel safe or at ease in their own home.
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Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2025
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 5
Control Number 27-AS-20250401153123
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: LIVEWELL CARE HOME LLC
FACILITY NUMBER: 032701486
VISIT DATE: 05/01/2025
NARRATIVE
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C1 statement revealed that C1 often chose to remain in their bedroom to avoid interaction with S1, highlighting how S1’s presence disrupted C1 daily living comfort. C2 similarly expressed distrust and discomfort with S1, particularly due to past negative experiences with former staff, and noted that even virtual appointments were uncomfortable with S1 present. C4 confirmed discomfort with S1’s proximity during medication and cleaning activities, further supporting the clients' claims.

Further client interviews also revealed that a meeting was held with the licensee, Jonathan Li, voicing their concerns but felt that their concerns were not heard and one client stated that they felt “bullied” into giving S1 a chance.

Staff member (S2) corroborated these concerns, stating that multiple clients expressed unease around S1, preferred not to be alone with S1, and required another resident to accompany them during medication administration.

With interview with S1, although S1 acknowledged the residents’ discomfort with S1’s presence and made efforts to be sensitive to clients in care, the majority and consistency of client and staff reports corroborated that S1’s methods and lack of experience working with individuals with developmental disabilities impacted the clients' sense of security.

Through interview, the licensee, Jonathan Li, admitted that concerns were raised by clients in care and acknowledged that a meeting was held, and that steps were taken to modify staffing arrangements due to client discomfort. However, Li noted that there is not documentation of this meeting.

Given the evidence gathered, including multiple corroborating statements from client and staff and the licensee's admission of corrective efforts had taken place, it is determined that S1’s interactions were inappropriate for the clients in care. Therefore, this allegation was SUBSTANTIATED.

A finding that the complaint allegation is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met.



Per California Code of Regulations (CCRs) - Title 22, Division 6, the following deficiencies are cited on the 9099D during this visit.

Exit interview was conducted with AD and a copy of this report and appeal rights were provided.
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SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/01/2025 and conducted by Evaluator Arvin Villanueva
COMPLAINT CONTROL NUMBER: 27-AS-20250401153123

FACILITY NAME:LIVEWELL CARE HOME LLCFACILITY NUMBER:
032701486
ADMINISTRATOR:LI, JONATHANFACILITY TYPE:
735
ADDRESS:290 GOLD STRIKE CTTELEPHONE:
(302) 893-3498
CITY:SUTTER CREEKSTATE: CAZIP CODE:
95685
CAPACITY:4CENSUS: 4DATE:
05/01/2025
UNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Karen OrrTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff is not adequately trained.
INVESTIGATION FINDINGS:
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On 5/1/2025, Licensing Program Analyst Arvin Villanueva (LPA) arrived unannounced at this facility to conduct a follow-up complaint visit and deliver findings of the allegation noted above. LPA arrived at 2:15pm and no one was at the facility at this time. LPA contacted the administrator, Karen Orr (AD), to inform her of this visit and permitted LPA to wait at the back of the facility until AD arrives. At 3pm, AD arrived at the facility. LPA also spoke with the licensee, Jonathan Li, over the phone and discussed the report with him.

The investigation into this allegation consisted of record reviews and interviews.

A review of staff training records for Staff 1 (S1) indicated that S1 completed the following orientation training on 3/11/2025, the date of hire, including Facility Program Design, Individual Program Plan, Client Rights Regulations, Medication Assistance, Health and Emergency Procedures, Special Incident Reporting, and Client Abuse Identification and Reporting.
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Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2025
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 5
Control Number 27-AS-20250401153123
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: LIVEWELL CARE HOME LLC
FACILITY NUMBER: 032701486
VISIT DATE: 05/01/2025
NARRATIVE
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It was documented that the training was provided by both the current Administrator Karen Orr and the Licensee Jonathan Li. However, interviews revealed that the Administrator was off on 3/11/2025, which contradicts the training document.

Similarly, Staff 2 (S2) completed the same required orientation training by 4/1/2025, with Jonathan Li listed as the trainer.

During interviews, S1 stated that they received informal training in addition to the formal orientation, including guidance from the Administrator, Karen Orr, and another staff member regarding daily responsibilities, medication management, food storage, and housekeeping procedures. S1 also confirmed the completion of DSP Year 1 training and reviewed residents' Individual Program Plans (IPPs) to familiarize S1 with clients’ care needs.

Although, though interviews, concerns about S1’s lack of prior experience and basic skills such as cooking, the documentation and interview evidence demonstrate that S1 received the training consistent with licensing regulations. Based on the gathered information, there is insufficient evidence to support the allegation that staff is not adequately trained. Therefore, this allegation is UNSUBSTANTIATED.

A finding of unsubstantiated means that although the allegation may have happened the preponderance of evidence does not prove it.



An exit interview was conducted with AD and a copy of this report was provided.

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SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 27-AS-20250401153123
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: LIVEWELL CARE HOME LLC
FACILITY NUMBER: 032701486
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/01/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type B
05/08/2025
Section Cited
CCR
80072(a)(2)
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Personal Rights: each client shall have personal rights which include: To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
This requirement is not met as evidenced by:
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Per discussion, Licensee will submit a written plan in place as it relates to the deficiency.
Written plan to be submitted to the Department by POC due date.
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Based on interviews, the licensee did not ensure clients in care were accorded comfortable accommodations as demonstrated by the continued presence of staff with whom they felt uncomfortable. This poses a potential health, safety, and personal rights risks 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: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5