197603601-5-19-2026-11-AS-UCOL-DVZTFR-20260715144155

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197603601
Report Date: 05/19/2026
Date Signed: 05/19/2026 11:22:32 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
04/13/2026 and conducted by Evaluator Zina Brown

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20260413125505

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: 85	DATE:	05/19/2026
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Lida Zarafshan (Administrator)		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Staff do not provide residents with medication as prescribed.
Staff do not ensure that the facility is kept clean.

INVESTIGATION FINDINGS:

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On 05/19/2026 at 9:00am, the Department conducted an subsequent visit at this facility deliver the complaint investigation findings. During today's visit, the Department met with Lida Zarafshan (Administrator) and explained the purpose of the visit.

The investigation consisted of the following: On 04/15/2026, the Department conducted interviews between the hours of 8:49am - 1:41pm with Administrator (A1), Staff (S1- S9), Resident (R2 - R9) and on 05/19/2026 between the hours of 9:46am - 9:51am interview was conducted with R1. The Department requested copies of the staff roster (dated 04/09/2026) and resident roster (dated 03/02/2026, 04/08/2026, 04/14/2026). 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 September 2025 - May 19, 2026), LIC 624 Unusual Incident Injury Report (dated 04/09/2026), Admission Agreement (dated 02/04/2026) and Discharge Summary (dated 04/30/2026)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 05/19/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2026

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 5

Control Number 11-AS-20260413125505

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: 05/19/2026

NARRATIVE

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The investigation revealed the following:

Allegation: Staff do not provide residents with medication as prescribed.
It was alleged that a resident has had scabies since on or around 10/20/2025 and that facility staff have not been applying the medicated cream prescribed for treatment of the condition. It was further alleged that despite the ongoing nature of the condition, no improvement has been observed, raising concerns that the prescribed topical treatment has not been consistently administered as ordered.

On 04/15/2026 between 10:42am – 11:01am, the Department interviewed A1. A1, who denied the allegation, stated that the resident received treatment for suspected scabies; however, no biopsy confirming scabies were present for R1. A1 reported that a medicated cream was prescribed and administered by the medtech, and that topical treatments are documented on daily communication logs. A1 stated the resident had been transported to Cedars Sinai Hospital on 04/08/2026 for an abscess near the armpit, and an incident report was filed to the Department on 04/09/2026.

On 04/15/2026, between 8:49am – 11:32am, the Department interviewed 9 staff regarding the allegation. 6 of 9 denied the allegation and stated that they were responsible for medication administration. These six (6) staff reported verifying topical treatments through labels, physician orders, and the MAR, and stated they had never skipped a prescribed topical treatment. Staff mentioned awareness of residents receiving scabies treatment and stated treatments were applied as ordered. 3 out of 9 staff were unaware of the allegation and did not know about any failure to administer prescribed medication.

On 04/15/2026, between 11:43am – 1:41pm, and on 05/19/2026, between the hours of 9:46am - 9:51am, the Department interviewed 9 Residents (R1–R9) regarding the allegation. 9 out of 9 residents denied the allegation. Residents consistently stated that staff provide medications on time and as prescribed, and none reported missed doses.

On 04/27/2026, between 10:00am – 10:30am the Department conducted a records review and observed that according to the LIC 624 (dated 04/08/2026), R1 was transferred to Cedars Sinai Medical Center per physician direction due to the discovery of a lump on the left armpit area. A review of the LIC 602 Medical Assessment for Residential Care Facilities for the Elderly (dated 01/30/2026) showed that on page 4 of 9, under Section I: Overall Physical Health, item M. “History of Skin Condition or Breakdown” was marked No, indicating no documented history of skin breakdown or chronic skin conditions at the time of assessment.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 05/19/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 11-AS-20260413125505

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: 05/19/2026

NARRATIVE

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On 05/18/2026, between 3:15pm– 3:25pm, the Department reviewed the discharge packet provided by the Administrator. Records showed that R1 was hospitalized at Cedars Sinai from 04/08/2026 - 04/20/2026, and subsequently admitted to Beachwood Post Acute & Rehab from 04/20/2026 - 04/30/2026. The admission record documented multiple diagnoses, including cutaneous abscess of limb, cutaneous abscess of chest wall, and MRSA infection. The discharge summary dated 04/30/2026 indicated that R1 received nursing care, physical therapy, occupational therapy, and speech therapy during the rehab stay. The clinical recap documented that R1’s skin was clear at discharge, R1 was alert, and no concerns were noted regarding medication administration. The discharge packet included a reconciled medication list provided to the resident representative and confirmed that medications and treatments were reconciled by the physician and prior to discharge. The discharge summary further documented that R1 was discharged home with home health services and that the family initiated the immediate discharge to an assisted living facility. No documentation in the rehab records indicated missed, delayed, or improperly administered medications, and no records referenced scabies treatment or a confirmed scabies diagnosis during the rehab stay.

On 05/19/2026, between 9:15am – 9:45am, the Department conducted a medication records review for R1 (September 2025 - April 2026) and for six residents including R1 (for May 2026 medication). For the month of May 2026, beginning with the new medication cycle on 05/09/2026, the Department observed that residents in Rooms 100, 102, 116, 124, and 134 were administered all medications as prescribed by their primary physicians from 05/09/2026 to the date of review 05/19/2026. No discrepancies, missed doses, or irregularities were observed in theMARs reviewed.

Based on information gathered through 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.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 05/19/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 11-AS-20260413125505

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: 05/19/2026

NARRATIVE

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Allegation : Staff do not ensure that the facility is kept clean.
It was alleged that the facility is not maintained in a clean condition and that staff are engaging in cross-contamination practices. It was further alleged that the overall cleanliness of the facility is inadequate, posing a potential health and safety risk to residents.

On 04/15/2026 between 10:42am – 11:01am, the Department interviewed A1. A1 denied the allegation. A1 stated that housekeeping cleans the facility daily, infection control procedures include PPE, handwashing, and quarantining residents with rashes, and no complaints regarding cleanliness had been received.

On 04/15/2026, between 8:49am – 11:32am, the Department interviewed 9 staff regarding the allegation. 9 out of 9 staff denied the allegation. Staff reported that housekeeping performs daily cleaning and that caregivers assist only as needed, such as when linens or clothing are soiled. Staff stated they follow infection control procedures, including glove use, handwashing, and PPE removal before exiting resident rooms. Housekeeping staff confirmed daily cleaning routines, including linen changes, bathroom sanitation, dusting, sweeping, mopping, and towel replacement. No staff reported concerns regarding cleanliness or cross-contamination.

On 04/15/2026, between 11:43am – 1:41pm and on 05/19/2026, between the hours of 9:46am - 9:51am, the Department interviewed 9 Residents (R1–R9) regarding the allegation. 9 out of 9 residents denied the allegation. Residents consistently described the facility as clean, reported that their rooms are cleaned daily, and stated they observe staff changing gloves or washing hands between assisting residents. No residents reported concerns regarding cleanliness or cross - contamination.

04/15/2026, between the hours of 1:43pm - 1:53pm and on 05/19/2026 between the hours of 9:41am - 9:43am, the Department conducted a walk-through of the facility and observed the following: In Rooms 100, 102, 116, 124, 134, and 228 were observed to be clean, with beds made, linens in place, and no visible debris or odors. Floors were free of spills or clutter, and trash receptacles were not overflowing. Resident bathrooms observed during the walk through were clean, with stocked supplies and no visible sanitation concerns. Staff were observed wearing gloves while assisting residents and removing gloves before exiting resident rooms. No cross contamination concerns were observed during the walk through.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 05/19/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2026

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 11-AS-20260413125505

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: 05/19/2026

NARRATIVE

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Based on information gathered through 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: 05/19/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2026

LIC9099 (FAS) - (06/04)

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