Loving Home Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced annual inspection of the facility. Upon arrival, LPA was greeted by caregiver staff and granted entry. The purpose of the visit was explained. Administrator (AD) Tin Le was contacted by phone and stated he was unable to be physically present. He designated lead staff, Patricia Cano Castolo, to assist with the inspection. The facility is licensed for a total capacity of six residents, including two ambulatory and four non-ambulatory residents, with a hospice waiver for four residents. At the time of the visit, the facility was operating at full capacity with six residents, and none were receiving hospice care. LPA began by reviewing records, including six resident files and two staff files. Some resident files were missing complete physician’s reports. Staff files generally contained the required documentation; however, one staff member had a health screening on file but did not have documentation of a TB screening. The Administrator’s certificate is current and valid through November 28, 2026. LPA then toured the facility with staff. The home consists of five resident bedrooms, including one shared room, three full bathrooms, a living room, kitchen, laundry room, attached garage, and a designated resting area for caregivers. Throughout the inspection, the facility was observed to be clean, organized, and free of hazards, with clear and unobstructed pathways. Smoke detectors and carbon monoxide detectors were operational in both common areas and bedrooms. The fire extinguisher in the kitchen was fully charged, and records indicated that the last disaster drill was conducted on March 3, 2026. Resident bedrooms were properly furnished with appropriate beds, linens, and adequate storage space. Bathrooms were clean and in good condition, with working toilets and faucets, secure grab bars, and (Annual Inspection continued on LIC809C) showers free of mold or mildew. The water temperature measured approximately 117.1 degrees Fahrenheit. Towels, toiletries, and personal hygiene supplies were sufficiently stocked. The kitchen was inspected and had an adequate supply of perishable and non-perishable food. However, LPA observed that the stove burners were not functioning and did not ignite. Sharps were secured in a kitchen drawer and under the sink. Cleaning supplies and other toxic substances were properly locked and stored in the kitchen, laundry room, and garage, making them inaccessible to residents. Emergency food and water supplies were observed in the garage. The first aid kit was complete and contained all required items. The outdoor areas were also inspected and found to be safe and accessible. There was ample shaded seating for residents, and exit gates on both sides of the house were self-latching and operational. The facility provides activities based on residents’ preferences, needs, and abilities. Staff reported that residents participate in activities such as coloring, painting, walking, and exercising. During the visit, LPA observed residents watching television. Medication storage and administration practices were reviewed. Medications were securely stored in a locked cabinet in the kitchen and were being administered according to physician orders. LPA interviewed residents regarding their quality of care and spoke with staff about the services provided. Feedback indicated that residents’ needs were being met. Based on observations and records reviewed during the inspection, deficiencies were identified and cited in accordance with Title 22, Division 6 of the California Code of Regulations. An exit interview was conducted with Administrator Tin Le by phone. Copies of LIC 809, LIC 809-C, LIC 858, LIC 859, LIC 9102TV, LIC 809D, and Appeal Rights were reviewed and provided to the facility. Additionally, a Legionnaires’ Disease Fact Sheet was given for informational and preventive purposes.the state’s words, verbatim · CDSS document, Apr 17, 2026

The state marks this report as 6 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. At around 1:00 PM, LPA Tea was greeted and granted entry into the facility by caregiver staff and explained the reason for the visit. Administrator (AD) Tin Le arrived shortly to assist with the visit. The facility is licensed for a capacity of six, which two are ambulatory and four are non-ambulatory, with a hospice waiver for four. Currently there are six residents, and there are none on hospice during today's visit. At 1:29 PM, LPA Tea reviewed six resident files and two staff files. Resident files and staff files contained all required documentation. The administrator certificate expires on November 28, 2026. LPA Tea along with AD Le toured the facility at 2:14 PM. LPA toured the physical plant, checked food service, and the first aid kit. The home consists of 5 resident bedrooms, which one is shared, 3 full bathrooms, living room, kitchen, laundry room and attached garage and resting area for caregivers. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms are operational. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 117.3 Fahrenheit degrees and 119.6 Fahrenheit degrees. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, doorways were free of obstructions. First aid kit had all the required elements including dressing, bandages, tweezers, thermometer, and scissors. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPA observed sharps secured in a kitchen drawer. LPA also observed toxin substances to be secured and locked and inaccessible to clients underneath the kitchen sink and Annual Inspection continued LIC809C garage. The fire extinguisher in the kitchen is fully charged. The facility’s last fire drill was conducted on March 1, 2025. Kitchen appliances are operational during today's visit. LPA observed emergency food and water supply in the garage. LPA toured the outside grounds and there is ample seating with shade and exit gates are on both sides of the house that are self-latching and operational. Facility provides activities based on resident’s personal preference and health condition and limitations. The residents do puzzles, some go out for walks and do exercise. At the time of the visit, LPA observed residents watching TV and enjoying their meals. At 2:36 PM LPA reviewed medication storage and administration. Medications are stored in a locked cabinet in the kitchen. Medications are being administered per physician order. LPA interviewed clients regarding their quality of care and spoke to staff present regarding care provided. Based on the observation made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with Administrator Tin Le and a copy of this report LIC809, 809-C, LIC858, LIC859, was read and provided to the facility.the state’s words, verbatim · CDSS document, Apr 21, 2025

Allegation investigated: Staff neglect resulting in resident developing pressure injuries. Resident developed a septic infection while in care. Staff did not properly clean resident

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of delivering findings into the investigation of the three allegations listed above. LPA was greeted and granted entry by facility staff after introducing himself and stating the purpose of the visit. Administrator Tin Le was notified via telephone and arrived later to assist with the visit. The initial complaint investigation visit took place on July 7, 2021. Staff interview conducted by the Department. Additional follow-up visits was conducted on December 19, 2023. During this visit, the administrator, primary caregiver and two additional staff members were interviewed along with four facility residents admitted at the time. Records for resident R1 could not be reviewed at that time as they had allegedly been taken by R1’s responsible party at the time of a hospitalization occurring in June 2021. None of the residents interviewed during the follow-up were admitted to the facility at the time of the allegations. CONTINUED ON FORM LIC9099-C Unsubstantiated CONTINUED FROM FORM LIC9099 An additional follow-up visit took place on January 22, 2025. Administrator Tin Le was interviewed at that time and confirmed that records were not available for review. Additional witness interviews were attempted via email and telephone. R1’s responsible party reached via telephone did not provide any additional evidence that would corroborate the allegations. Resident R1 was admitted to the facility on June 22, 2021, and was the first admitted person once the license was obtained. Approximately 11 days after R1’s admission, R1 was taken to Orange Coast Memorial Emergency Department for decreased responsiveness and leg swelling. An Unusual Incident/Injury Report as submitted by the licensee on June 25, 2021 indicating that R1 was behaving aggressively towards staff members and displayed resistance to being provided with toileting care and having their diaper changed. The form submitted additionally states that “resident is not cooperative” and that R1’s responsible party was notified of the issue and requested to acquire “an air topper mattress that help to prevent [pressure injuries]”. Caregivers are reported to be using Calmoseptine and to be encouraging R1 to get out of bed. Email correspondence with R1’s responsible party was provided and indicates a diagnosis of gout which would be consistent with the leg swelling reported. Regarding the allegations that Staff neglect resulting in resident developing pressure injuries, Resident developed a septic infection while in care and that Staff did not properly clean resident, the following has been concluded: Based on records reviewed and interviews conducted, the presence of pressure injuries upon R1’s hospitalization is confirmed, however correspondence and reports reviewed show measures taken by facility staff to prevent or mitigate the occurrence were also in place. There is insufficient evidence to demonstrate whether staff negligence was or could have been a contributing factor in the septic infection reported. Finally, repeated attempts to provide toileting care were reported but could not be confirmed due to a lack of evidence. As a result, the three allegations are found to be Unsubstantiated, meaning that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. An exit interview was conducted and a copy of this report was provided to a facility representative.the state’s words, verbatim · CDSS document, Jan 31, 2025 · control 22-AS-20210701151949

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Celine De Perio conducted an unannounced required annual. LPA De Perio explained reason for visit and was greeted and granted entry by staff on duty. During the visit, staff on duty contacted facility administrator (AD) Tin Le about visit, however was unable to be present during time of visit, and provided consent for staff on duty (S1) Patricia Cano to receive and sign report. LPA observed the Administrator's Certificate for Tin Le which expires on 11/28/24. LPA De Perio toured the interior and exterior portions of the facility with S1. The facility is a single level structure and is licensed for 6 residents, of which 4 may be non-ambulatory and 2 may be ambulatory. Facility has a hospice waiver for 4 residents. There are a total of 5 bedrooms, of which 4 are private resident rooms, and 1 shared resident room. LPA observed that the facility has a space in the garage designated for staff. LPA De Perio toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. There are a total of 3 restrooms and were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature in restrooms were measured to be at 111.1 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Fire extinguisher was charged, mounted and located in the kitchen. LPA De Perio observed the emergency disaster and evacuation plan, which is posted in the kitchen. Facility had back-up emergency food and water supply, located in the kitchen, garage and in a storage closet. LPA De Perio observed that First Aid Kit had all the required components. Medications and toxins were locked in a cabinet and made inaccessible to residents in care. For the exterior portion, LPA De Perio observed patio furniture under shading, and the grounds were free of any hazards. There are 2 gates in the backyard, which were self-closing and self-latching. No bodies of water were observed. For today's visit no deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. No citations were issued. An exit interview was conducted with S1 Cano. A copy of this report was explained, and provided.the state’s words, verbatim · CDSS document, Apr 13, 2024

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Case Management - Deficiencies

On today's date, LPA Quiroz conducted an unannounced Case Management-Deficiencies visit in conjunction to complaint investigation follow up for complaint control #22-AS-20210701151949. LPA Quiroz met with Licensee/Administrator (L/AD) Tin Le and discussed the purpose of today's visit. On today's date, to assist with complaint investigation for complaint control #22-AS-20210701151949, LPA Quiroz requested resident records for Resident 1 (R1). (L/AD) Tin Le indicated "I don't have the original documents, the resident was here only less than 2 weeks and the Family never returned the packet back to me, I only have the LIC 602 in an email." LPA Quiroz not able to review the following requested documents for (R1) during today's date: Admission Agreement, Pre- Appraisal, Needs and Services Plan, Identification Form due to R1 records not being available on site or in centralized location. (L/AD) Tin Le concluded "We don't have them." LPA Quiroz provided consultation on the following California Code of Regulation to (L/AD) Tin Le: Resident Records-87506(e): Original records or photographic reproductions shall be retained for a minimum of three (3) years following termination of service to the resident. Facility Cited during today's visit (See LIC 809-D). Plan of correction was cleared during today's visit. LPA Quiroz conducted an exit interview with (L/AD) Tin Le and provided a copy of this report, Appeal Rights, LIC 809-D, Cleared POC Letter and LIC 811- Confidential Names at exit.the state’s words, verbatim · CDSS document, Dec 19, 2023

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87506(e) · Plan of correction due date: Dec 22, 2023

Resident Records-87506(e): Original records or photographic reproductions shall be retained for a minimum of three (3) years following termination of service to the resident. This requirement was not met as evidenced by: Based on interview with (L/AD) Tin Le regarding investigation of complaint control #22-AS-20210701151949, LPA Quiroz requested resident records for Resident 1 (R1). (L/AD) Tin Le indicated "I don't have the original documents, the resident was here only CONTINUED...the state’s words, verbatim · CDSS document, Dec 19, 2023

Plan of correction: (L/AD) Tin Le agreed to read, review and understand CCR 87506 and maintain in compliance with resident records prior to admitting resident into facility. (L/AD) Tin Le submitted proof of understanding of CCR 87506 on today's date. CONT... less than 2 weeks and the Family never returned the packet back to me." LPA Quiroz not able to review R1s records during today's date. (L/AD) Tin Le concluded, "We don't have them." This poses a potential risk to residents in care.