197603601-7-6-2026-11-AS-PMAA-DVTSJ9-20260709135447

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197603601
Report Date: 07/06/2026
Date Signed: 07/06/2026 11:11:00 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/06/2026 and conducted by Evaluator Zina Brown

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20260706082126

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:	ZIP CODE:	90035
CAPACITY:	176	CENSUS: 92	DATE:	07/06/2026
		UNANNOUNCED	TIME BEGAN:	10:10 AM
MET WITH:	Lida Zarafshan (Adminstrator)		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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Facility staff did not seek timely medical attention for a resident who developed an abscess.

INVESTIGATION FINDINGS:

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On 07/06/2026 at 10:10 am, the Department conducted a initial visit at the facility to deliver the complaint investigation findings. During today’s visit, Licensing Program Analyst (LPA) Zina Brown met with Administrator Lida Zarafshan and explained the purpose of the visit.

The investigation consisted of the following: On 04/15/2026, the Department conducted interviews between 8:49am – 1:41pm with the Administrator (A1), Staff (S1–S9), and Residents (R2–R9). On 05/19/2026 between 9:46am – 9:51am, the Department interviewed R1. The Department contacted the W1 on 04/14/2026 at 2:05pm, 05/20/2026 at 10:10am, and 07/06/2026 at 8:26am, with no response. Additional attempts were made on 05/18/2026 at 1:38pm and 06/04/2026 at 4:19pm, to speak with W2 also with no response. LPA also reviewed the following records for R1: LIC 601 Identification & Emergency Information (dated 02/04/2025); LIC 602 Physician Report for RCFE (dated 01/30/2026), LIC 603A Preplacement Appraisal Information (dated 02/04/2025), LIC 625: Needs & Appraisal Service (dated 02/10/2026), Medication Administrator Record (MAR) (dated 09/2025 - 05/19/2026), LIC 624 Unusual Incident Injury Report (dated 04/09/2026), Admission Agreement (dated 02/04/2026) and the discharge packet from Beachwood Post Acute & Rehab (dated 04/30/2026).

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 07/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2026

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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Control Number 11-AS-20260706082126

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: BEVERLY HILLS LOVING CARE	FACILITY NUMBER: 197603601
	VISIT DATE: 07/06/2026

NARRATIVE

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On 04/27/2026 between 10:00am – 10:30am, the Department reviewed records and observed that the LIC 624 (dated 04/08/2026) documented R1’s transfer to Cedars Sinai Medical Center due to the discovery of a lump under the left armpit area. The LIC 602 (dated 01/30/2026) indicated “No” under Section I, item M: History of Skin Condition or Breakdown.

On 05/18/2026 between 3:15pm – 3:25pm, the Department reviewed the discharge packet from Beachwood Post Acute & Rehab. Records showed that R1 was hospitalized from 04/08/2026 – 04/20/2026 and admitted to rehab from 04/20/2026 – 04/30/2026. The admission record documented diagnoses including cutaneous abscess of limb, cutaneous abscess of chest wall, and MRSA infection. The discharge summary noted that R1 received nursing care and therapy services during the rehab stay.

Based on interviews and record reviews, there is not enough evidence to support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is UNSUBSTANTIATED.

Exit interview conducted with Lida Zarafshan (Administrator) and a copy of this report was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 07/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2026

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20260706082126

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: BEVERLY HILLS LOVING CARE	FACILITY NUMBER: 197603601
	VISIT DATE: 07/06/2026

NARRATIVE

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The investigation revealed the following:

Allegation: Staff did not seek timely medical attention for a resident who developed an abscess
It was alleged that a resident developed a lump under the left armpit area that required hospital evaluation, and concerns were raised about whether the condition had been identified and addressed in a timely manner

On 04/15/2026 between 10:42am – 11:01am, the Department interviewed A1 regarding the allegation. A1 denied the allegation. A1 stated that on 04/08/2026, when R1 was taking a shower, a caregiver observed swelling and an abscess under the resident’s left armpit. A1 reported that R1 and R1’s primary care physician were informed immediately, and a family member arrived at the facility and was present during transportation. A1 stated that R1 was transported to Cedars Sinai Hospital per physician order without delay, and an incident report was submitted to the Department on 04/09/2026.

On 06/16/2026 at 3:45 PM, the Department contacted A1 for further clarification. A1 reiterated that the caregiver discovered the swelling and abscess during R1’s shower on 04/08/2026, that the primary care physician and family were notified immediately, and that R1 was transported to the hospital per physician order.

On 04/15/2026 between 8:49am – 11:32am, the Department interviewed nine (9) staff. 9 out of 9 staff denied the allegation. Staff reported awareness that R1 had been transported to the hospital but did not report any concerns or delays related to the facility’s response to the abscess.

On 04/15/2026 between 11:43am – 1:41pm, and on 05/19/2026 between 9:46am – 9:51am, the Department interviewed nine (9) residents. 9 out of 9 residents denied the allegation. Residents did not report concerns regarding staff response to medical needs or delays in seeking medical attention.

Investigation continues on LIC 9099-C

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 07/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2026

LIC9099 (FAS) - (06/04)

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