Loving Heart Care Home

Type of visit: Required - 1 Year

On 10/30/25 at 2:40 PM, Licensing Program Analyst (LPA) D Panlilio arrived unannounced to conduct an annual required inspection. LPA met with administrator (ADM) and explained the purpose of the visit. LPA observed ADM has current RCFE administrator certificate# 6070341740 which expires 06/27/26. At 2:50PM, LPA toured the facility including but not limited to the front entrance, screening station, kitchen, bathrooms, bedrooms and common areas. There is one central entry point for universal screening for staff, residents and visitors. A sign-in policy, visitor’s logs, no touch thermometer, additional face masks and hand sanitizers were observed at the screening station. Emergency Disaster Plan, Complaint poster, Personal rights, Cough/sneeze etiquette, proper hand-washing signs were observed posted in common areas. Facility has a sufficient 2-day perishable and 7-day non-perishable food supply. Facility has a 30-day supply of PPEs, paper, medications locked in cabinets. Comfortable temperature is maintained at 75 deg F. Hot water temperature was measured at 114 deg F. Facility has a mitigation plan in place and the infection control leader is the administrator. Inside and outside pathways were free of obstruction and fire hazards. Smoke and Carbon monoxide detectors were operational. Fire extinguisher was observed fully charged and purchased on 10/30/25. LPA reviewed 4 staff and 5 resident files. Updated copies of the following documents were collected for facility file:  LIC500- Personnel Report  Resident Roster  LIC308- Designation of Facility Responsibility  LIC610E- Emergency/Disaster Plan including infection control plans  Evidence of Liability Insurance No deficiencies observed during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Oct 30, 2025

Allegation investigated: Resident developed pressure injuries while in care Resident developed an infection requiring resident to be hospitalized

On 04/10/25 at 12:30PM, Licensing Program Analyst (LPA) D Panlilio conducted a subsequent visit and met with administrator (ADM) to deliver the findings of above allegations. LPA explained the purpose of the visit with ADM. During investigation, the department obtained the following documents from administrator – personnel record, residents’ roster, admission agreement, physicians report, Needs & services plans, centrally stored medication logs, hospital discharge summary reports. Continued on next page, LIC 9099-C Substantiated Allegation: Resident developed pressure injuries while in care Investigation Finding: Substantiated During investigation, the department conducted interviews of facility staff & responsible parties and reviewed resident (R1) documents. Review of R1’s records showed she was first admitted at the facility on 06/06/22 with no pressure injuries. On 07/22/22, R1 was admitted to the hospital for generalized weakness. Review of hospital records show R1 had an unstageable pressure injury on her right buttock, a stage 2 pressure injury on her left heel, an inactive pressure injury on her right heel and an unstageable pressure injury on her coccyx. Hospital nurses provided wound care to R1’s pressure injuries. Interviews of facility staff and responsible parties and reviews of facility documents show R1 was neglected while residing at the facility. Staff (ADM, S1) gave inconsistent statements about R1’s pressure injuries. Staff denied having knowledge about the stages of R1’s pressure injuries but acknowledged that R1 did have a skin condition in the areas where the pressure injuries were located. Based on the department’s observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) that resident developed pressure injuries while in care was found to be substantiated. Allegation: Resident developed an infection requiring resident to be hospitalized Investigation Finding: Substantiated During investigation, the department reviewed resident’s (R1) medical records which showed R1 was hospitalized on 07/22/22 and diagnosed with various stages (stage 2, unstageable and inactive) of pressure injuries on R1. Interviews with facility staff and responsible parties, and review of facility documents showed facility failed to know about R1’s sustaining pressure injuries while in care. Facility staff failed to conduct body checks, document any changes in condition and provide proper care to R1. Based on the department’s observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) that resident developed an infection requiring resident to be hospitalized was found to be substantiated. Continued on next page, LIC 9099-C pg2 Immediate civil penalty of $500 assessed during visit for staff failing to provide adequate care and supervision to resident resulting in hospitalization and sustaining pressure injuries while in care. Additional civil penalty determination is pending relating to serious bodily injuries. Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of corrections (POC) by plan of correction due dates and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted, appeal rights and copy of report provided. Allegation: Resident’ s medication is missing Investigation Finding: Unsubstantiated During investigation, staff (S2) stated resident’s (R1) authorized representative was claiming she left a prescribed medication for R1 at the facility in July 2022. Staff denied receiving any prescribed medication from POA. S2 stated POA has the habit of taking R1’s medications, creams without letting staff know that she has taken them. S2 stated that POA was looking for R1’s cream on 07/23 -07/24, Triamcinolone Acetonide. Staff looked all over for it and could not find it. POA brought the cream back on 07/25/22. Based on records review, interviews conducted, and observations made, the department has investigated the above allegation that resident’s medication is missing and found it to be unsubstantiated. A finding that the complaint allegation is unsubstantiated means that although the allegation may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation that resident’s medication is missing is unsubstantiated. Allegation: Facility did not ensure resident had an adequate amount of diapers Investigation Finding: Unsubstantiated During investigation, the department conducted interviews of facility staff & responsible parties and reviewed resident (R1) documents. Review of R1’s admission agreement show basic services do not include incontinent supplies. ADM stated R1 had an adequate amount of diapers and that they billed POA for R1’s incontinent supplies. Based on records review, interviews conducted, and observations made, the department has investigated the above allegation that facility did not ensure resident had an adequate amount of diapers and found it to be unsubstantiated. A finding that the complaint allegation is unsubstantiated means that although the allegation may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation that facility did not ensure resident had an adequate amount of diapers is unsubstantiated. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Apr 10, 2025 · control 15-AS-20220823112003

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.2(a)(4) · Plan of correction due date: Apr 12, 2025

Residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs… This requirement was not met as evidenced by staff failing to provide adequate care & supervision which posed an immediate health & safety risk to residents in care.the state’s words, verbatim · CDSS document, Apr 10, 2025

Plan of correction: By POC due date, administrator agreed to complete and submit in-service staff retraining certifications by a CCL approved vender on proper care and supervision of residents in compliance with Title 22 Section 87468. Immediate civil penalty of $500 assessed during visit for serious bodily injury. Additional civil penalty determination is pending relating to this serious bodily injury.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87466 · Plan of correction due date: Apr 12, 2025

When changes such as unusual weight gains or losses or deterioration of mental ability or a physical health condition are observed, the licensee shall ensure that such changes are documented and brought to the attention of the resident's physician and the resident's responsible person… This requirement was not met as evidenced by staff failing to address resident’s change in condition which posed an immediate health & safety risk to residents in care.the state’s words, verbatim · CDSS document, Apr 10, 2025

Plan of correction: By POC due date, administrator agreed to complete and submit in-service staff retraining certifications by a CCL approved vender on proper care and supervision of residents in compliance with Title 22 Section 87466.

Type of visit: Required - 1 Year

On 11/22/24 at 1:40 PM, Licensing Program Analyst (LPA) D Panlilio arrived unannounced to conduct an annual required inspection. LPA met with administrator (ADM) and explained the purpose of the visit. At 2PM, LPA toured the facility including but not limited to the front entrance, screening station, kitchen, bathrooms, bedrooms and common areas. There is one central entry point for universal screening for staff, residents and visitors. A sign-in policy, visitor’s logs, no touch thermometer, additional face masks and hand sanitizers were observed at the screening station. Emergency Disaster Plan, Complaint poster, Personal rights, Cough/sneeze etiquette, proper hand-washing signs were observed posted in common areas. Facility has a sufficient 2-day perishable and 7-day non-perishable food supply. Facility has a 30-day supply of PPEs, paper, medications locked in cabinets. Comfortable temperature is maintained at 74 deg F. Hot water temperature was measured at 117 deg F. Facility has a mitigation plan in place and the infection control leader is the administrator. Inside and outside pathways were free of obstruction and fire hazards. Smoke and Carbon monoxide detectors were operational. Fire extinguisher was observed fully charged. LPA reviewed 5 staff and 4 resident files. Updated copies of the following documents were collected for facility file:  LIC500- Personnel Report  Resident Roster  LIC308- Designation of Facility Responsibility  LIC610E- Emergency/Disaster Plan including infection control plans  Evidence of Liability Insurance No deficiencies observed during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Nov 22, 2024

Type of visit: Required - 1 Year

On 11/16/23 at 3:10 PM, Licensing Program Analyst (LPA) D Panlilio arrived unannounced to conduct an annual required inspection. LPA met with administrator (ADM) and explained the purpose of the visit. LPA toured the facility including but not limited to the front entrance, screening station, kitchen, bathrooms, bedrooms and common areas. There is one central entry point for universal screening for staff, residents and visitors. A sign-in policy, visitor’s logs, no touch thermometer, additional face masks and hand sanitizers were observed at the screening station. Emergency Disaster Plan, Complaint poster, Personal rights, Cough/sneeze etiquette, proper hand-washing signs were observed posted in common areas. Facility has a sufficient 2-day perishable and 7-day non-perishable food supply. Facility has a 30-day supply of PPEs, paper, medications locked in cabinets. Comfortable temperature is maintained at 74 deg F. Hot water temperature was measured at 117 deg F. Facility has a mitigation plan in place and the infection control leader is the administrator. Inside and outside pathways were free of obstruction and fire hazards. Smoke and Carbon monoxide detectors were operational. Fire extinguisher was observed fully charged. LPA reviewed 5 staff and 5 resident files. LPA also conducted 2 staff and 2 resident interviews during visit. Updated copies of the following documents were collected for facility file:  LIC500- Personnel Report  Resident Roster  LIC308- Designation of Facility Responsibility  LIC610E- Emergency/Disaster Plan including infection control plans  Evidence of Liability Insurance No deficiencies observed during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Nov 16, 2023