197603601-5-20-2026-11-AS-PMAA-DUHU5T-20260528151718

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197603601
Report Date: 05/20/2026
Date Signed: 05/20/2026 05:17:10 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/11/2026 and conducted by Evaluator Wendy Gibbs

COMPLAINT CONTROL NUMBER: 11-AS-20260511095526

FACILITY NAME:	BEVERLY HILLS LOVING CARE		FACILITY NUMBER:	197603601
ADMINISTRATOR:	LIDA ZARAFSHAN		FACILITY TYPE:	740
ADDRESS:	1019 S. WOOSTER STREET		TELEPHONE:	(310) 652-3555
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90035
CAPACITY:	176	CENSUS:	DATE:	05/20/2026
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:			TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Staff did not maintain the facility hallways free of obstructions
Staff are not properly trained
Staff retained expired food at the facility
Staff did not practice proper hand hygiene when handling foods

INVESTIGATION FINDINGS:

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On 05/20/2026, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced Complaint Visit to the facility listed above. LPA met with Administrator Controller, Ilana Yazdi, and the purpose of today’s visit was explained. LPA was granted entry into the facility.
The investigation consisted of the following:
During today’s visit, LPA inspected the facility, observed lunch being served, interviewed Staff S1-S8, interviewed Residents R1-R9, and received and reviewed documents pertinent to the investigation. The following documents were received and reviewed Staff Roster, Resident Roster, Medication Technician Training, California Board of Registered Nursing Licensing Details, kitchen staff California Food Handler Certificate and receipts from West Pico Distributor (dated 05/05/26), Good Quality Produce Inc (dated 05/21/2026), Pacific Fresh Fish Co (dated 05/20/2026), and Dairy King (dated 05/20/26).

The investigation revealed the following:

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026

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 4

Control Number 11-AS-20260511095526

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: BEVERLY HILLS LOVING CARE	FACILITY NUMBER: 197603601
	VISIT DATE: 05/20/2026

NARRATIVE

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Allegation: Staff did not maintain the hallway facility free of obstructions
The allegation alleges that staff have placed tables in the hallways which is a hazard in case of an emergency.
During the facility inspection, LPA and S1 walked all hallways in the facility. LPA observed all walkways and hallways were clean, clear, and free of debris, hazards, and obstructions. LPA did observe, while residents were participating in activities and having meals, staff were placing walkers in the hallway, outside the door. LPA observed that with the walkers lined up against the walls, there was still ample space for residents, residents with a walker or wheelchair, and staff, to pass through safely. Additionally, LPA observed that hallways have small trash cans and fans pressed up against the walls, not obstructing hallways.
During interviews with Staff S1-S8, were asked if the walkways and hallways were kept clear and free of obstructions, eight (8) out of eight (8) stated yes, the hallways and walkways are kept clear.
During interviews with Residents R1-R9, were asked if staff keep the hallways clear of obstructions, nine (9) out of nine (9) stated yes, staff ensure hallways are kept clear. Additionally, Residents R1-R9 were asked if staff have placed items such as a table, chairs, or cabinet in the hallway that limits their access to get through, nine (9) out of nine (9) stated no, there are not items like that placed in the hallways.

Allegation: Staff are not properly trained

The allegation alleges that caregivers have been assigned to be med techs but have not been fully trained.
During record review, LPA received and reviewed the medication technician training records and observed medication technicians have received the 24-hours initial training, including 16- hours of shadowing. Medication Technicians received the following training regarding medications, Medication Pass Fundamental Video Training that consists of Preparation, Errors, Safety Security and Controlled Substances, Route Specific Administration and Common Errors: Oral, Ophthalmic, Otic, Nasal, Enteral, Topical, Inhaled, Subcutaneous and Suppositories. Additional training includes Personal Rights of the Resident, personal and Direct care, Medication Management, Psychosocial Needs of the Elderly, Occupational Health, Resident Health, Surveillance and Disease Reporting, Hand Hygiene, Standard and Transmission Based Precautions, Respiratory Hygiene and Source Control, Injection Safety, and Environmental Cleaning. Med Techs additionally receive training from Omnicell Nurse Training including Cycle Counting Module, Basic Workflow Training, Restocking Module, Super User Task Module, and Overview Training.
During interviews with Staff S1-S6, were asked if they received the required 24-hours of training for assisting residents with self-administration of medications, six (6) out of six (6) stated yes, they initially received 8-hours of instruction and 16-hours of shadowing for a total of 24-hours.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 11-AS-20260511095526

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: BEVERLY HILLS LOVING CARE	FACILITY NUMBER: 197603601
	VISIT DATE: 05/20/2026

NARRATIVE

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During interviews with Residents R1-R9, were asked if they have any concerns regarding the medication technicians training, nine (9) out of nine (9) stated no, they have no concerns regarding medication technician’s training.

Allegation: Staff retained expired food at the facility

The allegation alleges that expired milk was observed in the refrigerator in the kitchen.
During the facility inspection, LPA reviewed the dates on perishable foods and non-perishable foods. LPA observed fresh produce in the refrigerator properly stored and dated when delivered and opened. LPA checked the dates on the dairy products, eggs, grains, and meats and observed the best before dates have not passed. During record review, LPA received and reviewed receipts for food purchased for the month of May 2026. The receipts are from the following West Pico Distributor (dated 05/05/26), Good Quality Produce Inc (dated 05/21/2026), Pacific Fresh Fish Co (dated 05/20/2026), and Dairy King (dated 05/20/26).
During interviews with staff S1-S8, were asked if expired food is retained by staff and served to the residents, eight (8) out of eight (8) stated no, to their knowledge expired food is not retained or served to residents. Additionally, Staff S1-S8 were asked if there has been any complaint about the food being spoiled, one (1) out of eight (8) stated there was once a while ago that a resident complained their food smelled rancid.
During interviews with Resident R1-R8 were asked if they had been served expired or spoiled food, eight (8) out of eight (8) stated no, they have not been served expired or spoiled food.

Allegation: Staff did not practice proper hand hygiene when handling foods

During record review, LPA received and reviewed the kitchen staff’s Certificate of Achievement California Food Handler. LPA observed all California Food Handlers Certificates are valid till various dates in 2027.
During the facility inspection, LPA observed kitchen staff preparing plates for lunch service. LPA observed staff had gloves on their hands, and were using spoons, spatulas, and tongs to serve food. LPA observed a kitchen staff assist a caregiver in the dining room, and when he returned to the kitchen, he washed his hands and put on a new pair of gloves.
During interviews with Staff S1-S8, were asked if kitchen staff practice proper hand hygiene when handling food, five (5) out of eight (8) stated yes, staff practice proper hand hygiene when handling foods. Two (2) out of the eight (8) stated they are trained to practice proper hand hygiene and believe the kitchen staff are practicing proper hand hygiene. Additionally, Staff S1-S8 were asked if kitchen staff use gloves while preparing and serving food eight (8) out of eight (8) stated they see staff using gloves while serving food.
During interview with Resident R1-R9, were asked if kitchen staff practice proper hand hygiene when handling food, nine (9) out of nine (9) stated yes, staff practice proper hand hygiene when handling food

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 11-AS-20260511095526

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: BEVERLY HILLS LOVING CARE	FACILITY NUMBER: 197603601
	VISIT DATE: 05/20/2026

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32	During the course of the investigation, LPA was unable to find evidence to support the allegation(s). Although the allegation(s) may have happened or is valid, there is no preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation(s) is/are unsubstantiated. An exit interview was conducted and a copy of this report was provided.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026

LIC9099 (FAS) - (06/04)

Page: 4 of 4