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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610162
Report Date: 06/27/2022
Date Signed: 06/27/2022 03:44:54 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/23/2022 and conducted by Evaluator Abeye Duguma
COMPLAINT CONTROL NUMBER: 31-AS-20220623111852
FACILITY NAME:LOVE & CARE SENIOR LIVING, INC.FACILITY NUMBER:
197610162
ADMINISTRATOR:PASCO, DINAH RFACILITY TYPE:
740
ADDRESS:17710 MARTHA STREETTELEPHONE:
(818) 585-0063
CITY:ENCINOSTATE: CAZIP CODE:
91316
CAPACITY:6CENSUS: 6DATE:
06/27/2022
UNANNOUNCEDTIME BEGAN:
10:11 AM
MET WITH:Dinah PascoTIME COMPLETED:
03:40 PM
ALLEGATION(S):
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Resident's do not have access to wifi.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced subsequent complaint visit to the facility. LPA arrived at 10:00am and met with the administrator, Dinah Pasco. Upon entry, LPA was offered sanitizer, screened for COVID 19 and signed in.

--- Resident's do not have access to wifi.
It was alleged that the facility has a low wifi signal which restricts internet access for the residents in care. To investigate these allegations, on 06/27/2022 at 11:15am, LPA interviewed the Administrator and made observations. During the interview the Administrator stated that the “wifi is not working” and that the “licensee was notified and will have the wifi repaired or installed upon return from out of town”. LPA also requested to join wifi and observed that wifi is not available at the facility. Based on the interview and observation, the allegation is substantiated at this time.
Exit interview conducted, a copy of the report was issued and pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 9099-D):

Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye DugumaTELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2022
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 3
Control Number 31-AS-20220623111852
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: LOVE & CARE SENIOR LIVING, INC.
FACILITY NUMBER: 197610162
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/27/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/04/2022
Section Cited
CCR
87468.2(a)(1)
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(a) In addition to the rights listed in Section 87468.1... residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (1) To have a reasonable level of personal privacy in accommodations,... use of the Internet...
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Administrator will have third party installations completed to accomodate internet access for residents and ensure that residents have a reasonable level of personal privacy when using the internet. The administrator will notify CCL in writing upon installation.
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This requirement is not met as evidenced by;
Based on the interview and observation, residents do not have a reasonable level of personal privacy in accomodation for internet use as the facility does not have wifi available for resident use.
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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.
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye DugumaTELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3