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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 032701486
Report Date: 09/18/2025
Date Signed: 09/18/2025 04:25:42 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
09/04/2025 and conducted by Evaluator Arvin Villanueva
COMPLAINT CONTROL NUMBER: 27-AS-20250904170001

FACILITY NAME:LIVEWELL CARE HOME LLCFACILITY NUMBER:
032701486
ADMINISTRATOR:JONATHAN LIFACILITY TYPE:
735
ADDRESS:290 GOLD STRIKE CTTELEPHONE:
(302) 893-3498
CITY:SUTTER CREEKSTATE: CAZIP CODE:
95685
CAPACITY:4CENSUS: 4DATE:
09/18/2025
UNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Jonathan "Jon" LiTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Facility does not have phone on premises.
INVESTIGATION FINDINGS:
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On 9/18/2025, Licensing Program Analyst, Arvin Villanueva (LPA) arrived at this facility to conduct a follow up complaint visit regarding the allegation noted above. LPA met with Jon Li and stated the purpose of the visit.

Allegation – facility does not have phone on premises:
The investigation into this allegation consisted of interviews with residents and staff.

Resident interviews confirmed that there is no house phone available at the care home. However, residents stated that they have their own personal cellphone and that family members or parents can reach them via their cellphone or through the staff's phone.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2025
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 8
Control Number 27-AS-20250904170001
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: 09/18/2025
NARRATIVE
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Licensee/Administrator, Jon, acknowledged that there is no facility phone—either landline or mobile—available on the premises at all times. However, Jon confirmed that he provides a phone for each of the residents, covering a portion of their phone bills while residents contribute the remainder. Jon stated that callers can reach him directly through his personal cellphone.

Based on the interviews and the information gathered, it was found that the facility does not have a dedicated landline or facility phone. Therefore, the allegation that the facility does not have a phone on premises is SUBSTANTIATED.

A finding that the complaint is substantiated means that the allegations are valid because the preponderance of the standard has been met.

Deficiencies cited, per Title 22 Regulations. An exit interview was conducted with ___ and plan of correction was discuss. A copy of this report and appeal rights were provided to facility.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 8
Control Number 27-AS-20250904170001
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: 09/18/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/25/2025
Section Cited
CCR
80073(a)
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All facilities shall have telephone service on the premises.

This requirement is not met as evidenced by:
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Corrected prior to visit: as discussed, the licensee purchased a facility phone on 9/4/25 that will remain on-site at all times.
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Based on interviews, the licensee did not comply with the regulation cited above. Facility do not have dedicated phone on the premises at all times. This pose a potential health, safety,and personal 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: 09/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 8