197610162-8-3-2022-31-AS-NMAN-CHKSGY-20220823135240

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610162
Report Date: 08/03/2022
Date Signed: 08/03/2022 02:17:27 PM

Unsubstantiated

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 R		FACILITY TYPE:	740
ADDRESS:	17710 MARTHA STREET		TELEPHONE:	(818) 585-0063
CITY:	ENCINO	STATE: CA	ZIP CODE:	91316
CAPACITY:	6	CENSUS: 5	DATE:	08/03/2022
		UNANNOUNCED	TIME BEGAN:	09:37 AM
MET WITH:	Dinah Pasco		TIME COMPLETED:	02:25 PM

ALLEGATION(S):

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Facility does not provide comfortable temperature for resident's in care.
Facility does not have adequate food supply.
Facility does not provide adequate food service.
Facility refrigerator/freezer is in disrepair.
Facility staff left residents unattended.
Staff did not ensure that resident received timely incidental medical care.
Uncleared adult(s) providing care and supervision to residents.
Adult at the facility engaged in a verbal altercation with resident.

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. From 10:30 AM – 11:30 AM LPA interviewed one additional staff, the Administrator, one additional resident and attempted to contact both the complainant and resident #1 (R1) who is no longer living at the facility, but to no avail. Upon entry, LPA was offered sanitizer, screened for COVID 19 and signed in.

--- Facility does not provide comfortable temperature for resident's in care.

It was alleged that the A/C was not working. To investigate the allegation, on 06/27/2022 at 10:15 AM, LPA conducted a physical plant tour and from 11:15 AM – 2:30 PM, LPA conducted interviews with one staff and one resident.

(CONT. on LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2022

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 5

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
	VISIT DATE: 08/03/2022

NARRATIVE

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On 08/03/2022 at 10:00 AM. LPA conducted a physical plant tour. During the tour on 06/27/2022, the A/C was observed to be operational, the facility maintained a comfortable temperature at 78 degrees and there were fans in different parts of the facility. Interviews revealed that the A/C was not working at full capacity for a period of one week, but during that time it never went above 84 degrees, fans were placed in each room and resident #2 (R2) and resident #3 (R3) stated that they never felt uncomfortable or that it was never too hot. During LPA’s physical plant tour on 08/03/2022, LPA checked the thermostat which read 83 degrees. LPA asked if the A/C was working and the Administrator replied, no. Administrator stated that it has not worked for the past two weeks, due to residents frequently breaking the control unit, and that they are waiting for it to be fixed later today. However, Administrator purchased a portable unit for the resident that requested it and fans for the other residents that felt comfortable. Although the A/C is not currently working, the Administrator took steps to have the A/C repaired and ensured that the residents are comfortable with the facility’s temperature which remains below 84 degrees. Therefore, based on interviews and observation, the allegation is UNSUBSTANTIATED at this time.

---Facility does not have adequate food supply.

It was alleged that the refrigerator was also very sparse with food. To investigate the allegation, on 06/27/2022 at 10:15 AM, LPA conducted a physical plant tour and from 11:15 AM – 2:30 PM, LPA conducted interviews with one staff and one resident. During the tour, the refrigerator and freezer were observed to be full and the pantry was well stocked. Interviews revealed that groceries are done frequently or as needed. Based on the interviews and observation, there is not enough information to verify the allegation, therefore, the allegation is UNSUBSTANTIATED at this time.

---Facility does not provide adequate food service.

It was alleged that the facility does not provide food that is sufficient in nutrition as well as considerate of resident preferences. To investigate the allegation, on 06/27/2022 at 10:15 AM, LPA conducted a physical plant tour and from 11:15 AM – 2:30 PM and, at 3:00 PM, LPA requested documents. During the tour, LPA observed a well-balanced menu and plenty of nutritional food items stored in the refrigerator, freezer and pantry.
(CONT. on LIC9099-C)

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 5

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
	VISIT DATE: 08/03/2022

NARRATIVE

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An interview with the Administrator revealed that the facility follows dietary restrictions based on their physicians’ directives and furthermore, residents stated that they are satisfied with the facility’s food service. Based on the interviews, record review and observation, there is not enough information to verify the allegation, therefore, the allegation is UNSUBSTANTIATED at this time.

---Facility refrigerator/freezer is in disrepair.

It was alleged that there was frozen blood in the bottom of the freezer that appeared to be from meat that may have thawed, implying that the freezer is in disrepair, and that the icemaker does not work. To investigate the allegation, on 06/27/2022 at 10:15 AM, LPA conducted a physical plant tour and from 11:15 AM – 2:30 PM, LPA conducted interviews with one staff and one resident. During the tour, the freezer was observed to be operational, it was clean and the freezer’s ice trays were filled with ice. Interviews revealed that, although the refrigerator’s icemaker my not work, residents have never been denied ice and feel that, if requested, the facility would provide ice without delay. Based on the interviews and observation, there is not enough information to verify the allegation, therefore, the allegation is UNSUBSTANTIATED at this time.

---Facility staff left residents unattended.

It was alleged that residents were left unattended. To investigate the allegation, on 06/27/2022 at 10:15 AM, LPA conducted a physical plant tour and from 11:15 AM – 2:30 PM, LPA conducted interviews with one staff and one resident. On 08/03/2022 from 10:30 AM – 11:30 AM LPA interviewed one additional staff, the Administrator, one additional resident and attempted to contact both the complainant and resident #1 (R1) who is no longer living at the facility, but to no avail. During the unannounced visits on 06/27/2022 and 08/03/2022, there were three staff present during the duration of the visit. Interviews with residents and staff revealed that residents were never left unsupervised. Resident #2 (R2) stated, “There is always someone around, we’re never alone”. Also, resident #3 (R3) and all staff that were also interviewed confirmed that residents are never unattended. Based on the interviews and observation, there is not enough information to verify the allegation, therefore, the allegation is UNSUBSTANTIATED at this time.

(CONT. on LIC 9099-C)

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2022

LIC9099 (FAS) - (06/04)

Page: 3 of 5

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
	VISIT DATE: 08/03/2022

NARRATIVE

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---Staff did not ensure that resident received timely incidental medical care.

It was alleged that R1 requested medical assistance, R1 called 911 and their responsible party and then the Administrator arrived fifteen (15) mintes after. To investigate the allegation, on 06/27/2022 at 11:15 AM, LPA conducted interviews and on 08/03/2022 from 10:30 AM – 11:30 AM LPA interviewed one additional staff, the Administrator, one additional resident and attempted to contact both the complainant and resident #1 (R1), who is no longer living at the facility, but to no avail. Interviews confirmed that the time that elapsed between R1 requesting medical assistance and receiving medical assistance did not exceed thirty (30) minutes. It was later explained that the reason behind the delay was due to staff #1 (S1) forgetting his glasses at home and decided that it would be best to call his wife, the Administrator, who was close-by, to come and assist. Based on the interviews, there is not enough information to verify the allegation, therefore, the allegation is UNSUBSTANTIATED at this time.

---Uncleared adult(s) providing care and supervision to residents.

It was alleged that an uncleared adult, Mr. Pasco, was providing care to residents. To investigate the allegation, on 06/23/2022 at 4:00 PM, LPA reviewed Community Care Licensing records and on 06/27/2022 from 11:15 AM – 2:30 PM, LPA conducted interviews with one staff. The interview and record review revealed that the alleged uncleared adult, Mr. Pasco, husband of the administrator Dinah Pasco, is in fact cleared and goes by the name Eustaquio Guerina. Based on the interviews and file review, the allegation is UNSUBSTANTIATED at this time.

---Adult at the facility engaged in a verbal altercation with resident.

It was alleged that staff told resident to “go to bed” and “shut up”. To investigate the allegation, on 06/27/2022 from 11:15 AM – 2:30 PM, LPA conducted interviews with one staff and one resident. On 08/03/2022 from 10:30 AM – 11:30 AM LPA interviewed one additional staff, the Administrator, one additional resident and attempted to contact both the complainant and resident #1 (R1) who is no longer living at the facility, but to no avail.

(CONT. on LIC9099-C)

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2022

LIC9099 (FAS) - (06/04)

Page: 4 of 5

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
	VISIT DATE: 08/03/2022

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 interviews, both staff and residents stated that they neither heard nor witnessed any verbal altercation between staff and R1. Based on the interviews, there is not enough information to verify the allegation, therefore, the allegation is UNSUBSTANTIATED at this time.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2022

LIC9099 (FAS) - (06/04)

Page: 5 of 5