Loving Legacy Senior Care

Allegation investigated: The Administrator is not present at the facility for a sufficient amount of time.

On July 29, 2026, at approximately 9:30am, Licensing Program Analyst, Arvin Villanueva (LPA), arrived at this facility unannounced to conduct a follow-up investigation visit and deliver findings of the allegations noted above. LPA initially met with one of the staff on duty, Aisake (James) Jemesa, and stated the purpose of the visit. The administrator was notified by James. Per James the administrator is not coming today. Present upon arrival were 5 residents in care with 2 staff on duty. The assistant administrator, Anese Warfield was also present, along with an individual who was identified as Yelena Bigelow. Allegation - The Administrator is not present at the facility for a sufficient amount of time. The investigation into this allegation consisted of record reviews, interviews, and observation. {1 of 2} Substantiated Based on a review of past visits to the facility, the administrator was not at the facility during visits on 12/17/2025, 1/15/2026, and 7/23/2026. The administrator was present during visits on 2/20/2026 and 1/5/2026. Review of the Personnel Report (LIC 500), dated 1/4/2026, shows that the administrator is scheduled to work or be present at the facility every Monday through Friday from 10:00 a.m. to 12:00 p.m. During interviews conducted on 7/23/2026, both staff members working that day stated that the administrator usually comes to the facility, on average, one or two times each week and stays for about two to three hours each visit. Additionally, staff and resident interviews revealed inconsistent statements regarding how often the administrator was present at the facility. Some reported the administrator visited periodically, while others were unable to state how frequently the administrator was on-site Further, records reviewed from the non-compliance (NCC) office meeting held on 4/15/2026 with Administrator/Licensee Veniana Banuve documented the administrator's agreement to be physically present at the facility for at least 40 hours per week, conduct unannounced nighttime health and safety checks at both licensed facilities, and maintain a written administrator presence log documenting the date, time, staff on duty, resident census, and observations made during each visit. LPA spoke with Veniana over the phone on 7/23/2026 where she stated that she has not been doing this agreement. During follow-up visit on 7/23/2026, the LPA requested this required documentation; however, facility staff were unable to produce any administrator presence log or other documentation verifying compliance with the agreed corrective actions. Based on the observations, record reviews and staff interviews, it is determined that there is a preponderance of evidence that the administrator is not present at the facility a sufficient amount of time needed to provide regular oversight and supervision of the facility's daily operations, therefore, this allegation is substantiated. A finding that the complaint allegation is substantiated means that the allegation is valid because the preponderance of evidence standard has been met. This facility is hereby cited per California Code of Regulations, Title 22, Division 6, Chapter 8. Plan of correction and appeal process were discussed during the exit interview with Anese Warfield. A copy of this report and appeal rights were provided. {2 of 2} On 7/29/2026, LPA was able to interview 2 residents. After showing photos of E1 and E2 and identifying them by their names, residents stated that E1 and E2 were not seen working at the facility. Note that the other residents were not able to be interviewed due to not being present at the facility during this visit and/or communication issues. A review of the Personnel Report (LIC 500), dated 1/4/2026, showed that neither E1 nor E2 is listed as a facility employee. During Department visits conducted on 1/5/2026, 1/15/2026, 2/20/2026, 7/23/2026, and 7/29/2026, there were no observations or reports of E1 or E2 being present or working at the facility. Based on the information gathered through interviews, record reviews, and observations, there is not enough evidence to support the allegation that the facility allowed excluded individuals to work in the facility. ************************************************************************************************** Allegation – Staff are forging resident documents: The investigation into this allegation consisted of interviews and record reviews. LPA Villanueva contacted the doctor's offices listed on the residents' Medical Assessments (LIC 602A) to verify whether the residents had been seen by the physicians. LPA was able to reach three of the five phone numbers. However, the doctor's office staff stated they could not provide or verify patient information. On 7/23/2026, LPA interviewed both staff members who were working at the facility. Both staff members stated that they had never been asked by the administrator, management, or any other staff member to change, falsify, or forge resident documents. Furthermore, staff denied seeing or knowing any facility staff forging, falsifying, or altering resident documents. Based on the information gathered during the investigation, there is not enough evidence to support the allegation that staff are forging resident documents, therefore, the allegation that staff are forging resident documents was unsubstantiated. A finding of unsubstantiated means that although the allegation may have happened the preponderance of evidence does not prove it. No deficiencies were cited as a result of this visit. Appeal process was discussed during the exit interview with Anese Warfield. A copy of this report and appeal rights were provided. {2 of 2}the state’s words, verbatim · CDSS document, Jul 29, 2026 · control 27-AS-20260211151007

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87405(a) · Plan of correction due date: Aug 6, 2026

The administrator…shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility as specified in this section. This requirement is not met as evidenced by: Based on interveiws, record reviews and observations, the administrator was not present during 4 of 6 unannounced LPA visits. The facility also did not provide the required administrator presence log as agreed during the 4/15/2026 Non-Compliance Conference, and the inconsistencies of staff statements. This poses a potential health, safety or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Jul 29, 2026

Plan of correction: Per discussion, the administrator will start documenting their presence at the facility including the date, arrival time, departure time, and duties completed during each visit as per NCC agreement; may title it Administrator Visit Log. Administrator Visit Log from 7/29/26 to 8/05/26 will be submitted to the Department by POC due date.

Type of visit: Case Management - Other

On July 29, 2026, at approximately 9:30am, Licensing Program Analyst, Arvin Villanueva (LPA), arrived at this facility unannounced to conduct a case management visit. LPA initially met with one of the staff on duty, Aisake (James) Jemesa, and stated the purpose of the visit. The administrator was notified by James. Per James the administrator is not coming today. This visit is being conducted concurrently with the complaint visit (complaint #27-AS-20260211151007) Present upon arrival were 5 residents in care with 2 staff on duty. The assistant administrator, Anese Warfield was also present, along with an individual who was identified as Yelena Bigelow. Per Anese, she is being trained by Yelena and stated that Yelena just started today. Staff Aisake stated this is the first time he seen Yelena at this facility. Upon LPA's arrival, Yelena was seen at the kitchen area, by the medication cabinet and residents' documents were accessible to Yelena. Yelena left the facility at around 9:35am. During this visit, LPA reviewed Guardian at around 9:30am, Yelena’s name was not in the list that were associated to this facility. At around 10:03am, Anese showed from Guardian website that Yelena was associated with this facility on 7/27/2026. LPA rechecked Guardian and confirmed Yelana’s associated on 7/272026. However, there were inconsistencies with Yelena’s documents in Guardian. Yelena's documents were dated 7/29/2026 and LPA sent an email to Care Provider Management Bureau (Guardian) to verify the inconsistencies. Also during this visit, LPA observed the fire door leading to bedrooms #1,2,3,4 was observed to be propped open with a door stopper throughout this visit (photo taken). At this time, this case management will need continuation, pending verification from Guardian. Base on today's visit, this facility is hereby cited per California Code of Regulations, Title 22, Division 6, Chapter 8. Plan of correction and appeal process were discussed during the exit interview with Anese Warfield. A copy of this report and appeal rights were providedthe state’s words, verbatim · CDSS document, Jul 29, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87203 · Plan of correction due date: Jul 30, 2026

Fire Safety: All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. This requirement is not met as evidenced by: Based on observation, 1 of 2 fire doors was propped open with a a door stopper throughout this visit. This poses an immediate health, safety, and personal rights risks to persons in care.the state’s words, verbatim · CDSS document, Jul 29, 2026

Plan of correction: Corrected on site: after consulting with the assistant administrator, she removed the door stopper Additional corrective action was discussed with the assistant admin. Per discussioin, they agreed to conduct in-service training with staff and residents to discuss fire safety, including the requirements relating to fire doors. Proof on training shall be submitted to the Department by 7/30/2026.

Type of visit: Case Management - Legal/Non-compliance

An Non-Compliance Conference (NCC) meeting was held on 04.15.2026 in-person at the Sacramento Regional Office. The purpose of this meeting was to discuss concerns regarding both facilities. Participants in the meeting included: Regional Manager-Stephenie Doub, Licensing Program Manager LPM- Stephen Richardson, Licensing Program Analyst LPA- Shakaricka Hughes, Licensee/ Administrator- Veniana Banuve. During the meeting, an incident which occurred in the facility on 01/24/2026 was discussed, in which a resident eloped from the facility without facility staff being aware. Hospice resident care including repositioning schedules, staff working hours and schedules. Administrator presence in the facility. Facility and staff required training. The facility has stated they will agree to do the following: Administrator’s presence in facility 40 hrs. per week, including unannounced night- time health and safety checks in both facilities. The facility will maintain a record of administrator presence, this document will remain at the facility, including date and time, staff present, census, and other pertinent details related to the visit and observations. Submit Personnel Report (LIC500) any time changes are made. Submit Designation of Administrative Responsibility (LIC308) for both facilities and any time changes are made. Continuation 809-C Submit a copy of the Daily Health Check Log by close of business and any time changes are made.The log is to be overseen by Administrator/Designee once every week and/or any time changes occur to include updated re-assessments and communication of such changes by a call to Community Care Licensing (CCL), Conservators and/or responsible parties along with submitting in writing using the Incident report (LIC624). Administrator will conduct vendor training for both on the job training, and annual training. Documentation of the training, including who was present. Administrator will calendar schedule on what dates the training will conducted. The Regional Office (RO) will continue to monitor the facilities’ progress. The RO will continue increased monitoring to verify compliance with issues discussed The RO will revisit compliance in 12 months and begin the legal process if facility is not in compliance. The licensee was Informed that an additional civil penalty was pending review and may be assessed according to Health and Safety code 1569.49(e). Once a civil penalty has been determined, the department will return at a future date to assess civil penalty. A Non-Compliance Conference Summary (LIC 9111) was generated to document this office meeting. A copy of this report and the LIC 9111 was provided to the licensee.the state’s words, verbatim · CDSS document, Apr 15, 2026

Type of visit: Case Management - Deficiencies

On 02-20-2026, Licensing Program Analyst, Arvin Villanueva (LPA), arrived unannounced at this facility to conduct case management visit. This visit is being conducted concurrently with a complaint visit for a complaint 27-AS-20260211151007. LPA intiially met with staff on duty, Rupeni Nakanuciri (S1) and Apimeleki Niumataiwalu (S2), and stated the purpose of the visit. The Administrator, Veniana Banuve (AD) was notified and arrived later. Present were 4 residents in care with 2 staff on duty. Upon arrival, LPA observed 5 medication cups on top of a desk located in the kitchen, below the medication cabinet, 4 were filled with medication pills and one with a clear liquid. Per interview with S1, he stated these medications belong to residents in care for their PM medication. These medication were accessible to residents in care. Based on today's case management, deficiencies were being cited. Exit interview conducted with AD, and a copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Feb 20, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(h)(2) · Plan of correction due date: Feb 21, 2026

Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the regulation cited above. During inspection of the kitchen, LPA found a packet of Tylenol inside the first aid kit that was located in a kitchen drawer. These were not locked and were accessible to residents. This poses an immediate safety, health, personal rights risks to persons in care.the state’s words, verbatim · CDSS document, Feb 20, 2026

Plan of correction: Corrected on site: Staff-1 put away the medications inside the medication cabinet and locked it. Per discussion, Administrator agreed to submit a written plan on how they will comply with the regulation cited above. The written plan shall be submitted by POC due date.

Type of visit: Office

An informal meeting was held on 2/20/2026 at the Sacramento Regional Office via Microsoft Teams. The purpose of this meeting was to discuss concerns regarding both facilities. Participants in the meeting included: Licensing Program Manager LPM- Stephen Richardson, Licensing Program Analyst LPA- Arvin Villanueva, Licensing Program Analyst LPA- Shakaricka Hughes, Licensee/ Administrator- Veniana Banuve. During the meeting, the informal conference process, including the administrative process, was explained to the licensee: The current areas of concern were identified as follows: · Incident Reporting · Suspected rough handling · Aware of family’s concern and allowed cameras · Mandated Reporter Training-additional training · Meeting Resident Needs without Impeding on Personal Rights · Any additional oversight · TSP offered Continuation 809-C The facilities will do the following to achieve compliance: · Personal Rights training for all staff, licensee will retrain facility staff on proper handling, supervision, support, and meeting residents’ needs without infringing on personal rights. · Review regulation for incident reporting, licensee will retrain facility staff with training regarding Reporting Requirements. Licensee stated that training for reporting requirements was completed 2/13/2026. · Hire additional facility staff for Loving Legacy Senior Care II 342701698. · Increase Administrator oversight at both facilities. · Review Technical Assistance Program (TSP) resources and request additional assistance when needed. The facilities will provide the following documentation to the regional office: · Reporting requirement training curriculum including staff sign-in sheet and trainer will be provided to the Department by 03/02/2026. · Personal Rights and Resident Care training. Licensee has completed training with resources from a Hospice agency. Training curriculum including staff sign-sheet and trainer will be provided to the Department by 03/02/2026. · Licensee will submit an updated LIC 500/ LIC 308 for both facilities by 03/02/2026. The regional office will do the following: · Continue to collaborate and provide assistance to licensee as needed · Offer TSP services · A link to a list of approved CEU Vendors from the CDSS website was provided to the licensee to research and find vendor-based training for their facilities. Per California Code of Regulations (CCR) - Title 22 - no deficiencies are being cited. An exit interview was held, and a copy of the report was sent via email.the state’s words, verbatim · CDSS document, Feb 20, 2026

Allegation investigated: Staff illegally evicted a resident in care.

On 01/15/2026 at 9:00 AM, Licensing Program Analyst (LPA) Shakaricka Hughes arrived unannounced to this facility to conduct a complaint visit. LPA met with facility staff Aisake Jemesa and explained the purpose of the visit. The purpose of this visit is to deliver complaint findings for the allegation above. The current census is 5. A brief interview with conducted with Aisake. Allegation: Staff illegally evicted a resident in care. It was alleged that staff illegally evicted a resident in care. This investigation consisted of interviews with staff, and records reviewed. On 01/15/2026 LPA Hughes conducted a visit to the facility. LPA interviewed 2 out of 3 facility staff, who stated that resident (R1) was hospitalized and that the facility refused (R1) readmittance to the facility due to R1’s ongoing health care needs, which staff stated exceeded the facilities scope of care. Interview with facility staff (S1) stated that a written eviction notice was not issued to (R1) prior to refusing readmittance. Continuation 9099-C Substantiated Additional interview with facility staff (S2) stated that an eviction notice was requested from the admitting hospital care coordination team, but the facility was unable to provide the eviction notice issued by the licensee. LPA reviewed facility reports submitted to the Dept, however no written eviction notice for resident (R1) was received or on file with the Dept. This allegation was observed not in compliance with Title 22 regulation 87224(a) Eviction Procedures as the licensee did not ensure a written lawful eviction notice was provided to the resident. As a result, this allegation is SUBSTANTIATED. A finding that the complaint is substantiated means that the allegations are valid because the preponderance of the evidence standard has been met. Deficiencies cited on the LIC 9099-D, per Title 22 Regulations. An exit interview was conducted with Aisake and a copy of the LIC 9099, LIC 9099-D pages and appeal rights were provided to facility. LPA attempted to speak with resident (R1) but was unable as the resident was hospitalized at the time of the visit. LPA spoke with (R1) Home Health nurse, who stated that they are unsure that meals provided to resident in the facility is a direct result of an increased concern for R1’s on-going health needs. LPA reviewed R1’s discharge summary for resident (R1) dated 12/08/2025, which indicated that the resident’s diagnosis, however no dietary orders were indicated. There is not enough evidence to corroborate this allegation, therefore the allegation is unsubstantiated. The investigation revealed the preponderance of evidence standards have not been met; therefore, the above allegation are found to be UNSUBSTANTIATED. A finding that the complaint allegations are UNSUBSTANTIATED means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.the state’s words, verbatim · CDSS document, Jan 15, 2026 · control 27-AS-20260114152118

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87224(a) · Plan of correction due date: Jan 15, 2026

87224 Eviction Procedures(a)The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required except as otherwise specified in paragraph (5) This requirement was not met as evidenced by: The facility refused resident (R1) readmittance following hospitalization without issuing a written eviction as required by Title 22 regulation. This posed a potential health, safety, and resident rights risk to residents in care.the state’s words, verbatim · CDSS document, Jan 15, 2026

Plan of correction: Licensee will ensure the facility is in compliance with Title 22 regulation 87224 at all times. Additionally, licensee agrees that all evictions will be issued through a timely written lawful eviction notice in accordance with Title 22 Eviction Procedures.

Allegation investigated: Staff member physically abuses resident in care. Staff member handles resident in a rough manner while in care.

On 01/05/2026 at 9:00 AM, Licensing Program Analyst (LPA) Shakaricka Hughes arrived unannounced to this facility to conduct a complaint visit. LPA met with the facility administratorVeniana Banuve and explained the purpose of the visit. The purpose of this visit is to deliver complaint findings for the allegations above. The current census is 6. Allegation: Staff member physically abuses resident in care and Staff member handles resident in a rough manner while in care. It was alleged that staff member physically abused a resident in care and staff member handles resident in a rough manner. This investigation consisted of interviews with residents and facility staff, and review of video camera footage. On 12/17/2025 LPA Hughes conducted a visit to the facility, during the visit LPA spoke with 2 out of 3 residents who stated that they have no issue with facility staff physically harming them and have not observed facility staff harm other residents in care. Interview with resident (R1) stated that they have been physically harmed by facility staff (S2) almost daily. Continuation 9099-C Substantiated Interview 2 out of 2 facility staff stated that they have never observed other facility staff harm any residents in care or caused harm to residents. LPA reviewed camera footage provided by an outside party, which revealed that facility staff handled the resident in a rough manner on 3 separate occasions, despite the residents attempts to stop the facility staff (S2) from assisting the resident (R1) with grooming needs. This was observed not in compliance with Title 22 regulation 87468.1(a)(3) Personal Rights of Residents in All Facilities. As the facility did not ensure that a resident in care was free from being abused in the facility. As a result, the allegations are SUBSTANTIATED. A finding that the complaint is substantiated means that the allegations are valid because the preponderance of the evidence standard has been met. Deficiencies cited on the LIC 9099-D, per Title 22 Regulations. An exit interview was conducted with Veniana and a copy of the LIC 9099, LIC 9099-D pages and appeal rights were provided to facility. Allegation: Staff did not adequately supervise resident in care. It was alleged that staff did not adequately supervise a resident in care. This investigation consisted of interviews with facility staff and residents. On 12/17/2025 LPA Hughes conducted a visit to the facility. LPA spoke with 2 out of 2 facility staff who stated that residents are supervised and check on every two hours. Interview with Resident (R1) stated that they have no concerns about facility staff not checking on them regularly. Additional, Interviews with 2 out of 3 residents revealed that they have no concerns about facility staff not adequately supervising residents, stating that residents are checked on frequently. There was not enough information to corroborate this allegation, therefore this allegation is unsubstantiated. The investigation revealed the preponderance of evidence standards have not been met; therefore, the above allegations are found to be UNSUBSTANTIATED. A finding that the complaint allegations are UNSUBSTANTIATED means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.the state’s words, verbatim · CDSS document, Jan 5, 2026 · control 27-AS-20251215085701

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(3) · Plan of correction due date: Jan 6, 2026

87468.1 Personal Rights of Residents in All Facilities(a)Residents in all residential care facilities for the elderly shall have all of the following personal rights(3)To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination. This requirement was not met as evidenced by: The licensee did not ensure that a resident in care was kept free from abuse, and other actions of a punitive nature. Facility staff (S2) were observed on camera assaulting resident (R1) on multiple occassions.the state’s words, verbatim · CDSS document, Jan 5, 2026

Plan of correction: The licensee agrees to remain in compliance with Title 22 regulation 87468.1 at all times. Additionally, the licensee agrees to terminate facility staff (S2). As of 1/5/2026 facility staff (S2) no longer works in the facility. The licensee agrees to disassociate the former staff in guardian and send proof of... disassociation in Guardian to LPA Hughes by 1/6/2026 via email.

Allegation investigated: Staff are not ensuring that resident's diabetic needs are met. Staff are not ensuring that skilled professionals are taking resident's blood pressure.

On 01/05/2026 at 9:00 AM, Licensing Program Analyst (LPA) Shakaricka Hughes arrived unannounced to this facility to conduct a complaint visit. LPA met with the facility administrator Veniana and explained the purpose of the visit. The purpose of this visit is to deliver complaint findings for the allegations above. The current census is 6. Allegation: Staff are not ensuring that resident's diabetic needs are met It was alleged that staff are not ensuring that residents diabetic needs are met. This investigation consisted of interviews with facility staff, reporting party, resident (R1) Home Health Nurse. On 12/17/2025 LPA Hughes conducted a visit to the facility and spoke with 2 out of 2 facility staff. Facility staff (S1) stated that they primarily ensure that (R1) diabetic needs are met. Stating that the facility are aware of R1’s diabetic needs and that the facility assists the resident in the facility with glucose monitoring and regularly observes the residents for changes in condition following the facilities protocol to assist the resident whenever their glucose levels are elevated. Continuation 9099-C Substantiated An interview with the reporting party reflected that the resident (R1) requires a higher level of care than what the facility can provide, however resident (R1) has denied the need for a higher level of care. The resident requires diabetic care, including injectable insulin administration, which exceeds the facilities scope of care. The facility does not employ licensed medical staff authorized to administer injectable medications. An interview with R1’s Home Health nurse confirmed that facility staff lack the skill and authorization to properly meet the resident’s diabetic needs. Resident (R1) has been hospitalized on multiple occasions due to complications related to diabetes management. Despite glucose monitoring by facility staff, the facility is unable to ensure care and supervision appropriate to the resident’s identified health care needs, as required by Title 22 regulation 87628(a), therefore the allegation is substantiated. Allegation: Staff are not ensuring that skilled professionals are taking resident's blood pressure It was alleged that Staff are not ensuring that skilled professionals are taking resident's blood pressure. This investigation consisted of interviews with facility staff, the reporting party, and resident (R1) Home Health nurse. On 12/17/2025 LPA Hughes conducted a visit to the facility and spoke with 2 facility staff. Facility staff (S1) stated that they are responsible for assisting resident (R1) with glucometer testing and reported having received additional training related to glucose monitoring. Despite training, staff remain unauthorized to administer injections. An interview with the reporting party indicated that (R1) requires a higher level of care than the facility can provide due to additional health concerns contributing to elevated glucose levels. An interview with resident (R1) Home Health nurse indicated that facility staff are unable to perform injectable medications and are limited in providing skilled medical care due to the facilities scope of care limitations. The Home Health nurse further stated that resident (R1) is legally blind and unable to self administer diabetic injections. Based on the investigation, the resident is legally blind and requires diabetic injections the facility does not employ licensed or trained medical professionals to administer injectable medications. This was observed not in compliance with Title 22 regulation Diabetes 87628(a). The citation was previously cited to the facility, Therefore, the citation will not be reissued at this time. As a result, the allegations are SUBSTANTIATED. A finding that the complaint is substantiated means that the allegations are valid because the preponderance of the evidence standard has been met. Deficiencies cited on the LIC 9099-D, per Title 22 Regulations. An exit interview was conducted with Veniana and a copy of the LIC 9099, LIC 9099-D pages and appeal rights were provided to facility. Interview with facility staff (S1) and (S2) reported that residents have freshly prepared meals. Interview with residents 2 out of 2 residents in care stated that they have no concerns about meals being prepared and served in the facility. LPA attempted to speak with resident (R1) but was unable as the resident was hospitalized at the time of the visit. LPA spoke with (R1) Home Health nurse, who stated that they are unsure of meals provided to resident is a direct result of an increased concern for (R1) health needs. There is not enough evidence to corroborate this allegation, therefore the allegation is unsubstantiated. The investigation revealed the preponderance of evidence standards have not been met; therefore, the above allegations are found to be UNSUBSTANTIATED. A finding that the complaint allegations are UNSUBSTANTIATED means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.the state’s words, verbatim · CDSS document, Jan 5, 2026 · control 27-AS-20251215084937

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87628(a) · Plan of correction due date: Jan 6, 2026

87628 Diabetes(a)The licensee shall be permitted to accept or retain a resident who has diabetes if the resident is able to perform his/her own glucose testing... and is able to administer his/her own medication including medication administered orally or through injection, or has it administered by an appropriately skilled professional. This requirement was not met as evidenced by: The facility did not ensure that resident (R1) identified diabetic care needs were met through self-administration or by an appropriately skilled professional.the state’s words, verbatim · CDSS document, Jan 5, 2026

Plan of correction: The licensee agrees to remain in compliance with Title 22 regulation 87628 at all times. The licensee agrees to stop accepting and retaining residents whose medical care exceed the facilities scope of care. The licensee agrees to ensure all residents care needs which fall outside of the facilities scope of care... are referred to appropriate services when necessary. The licensee review RCFE Prohibited Health Conditions and send LPA Hughes a statement of acknowledgement of review of the policy by 1/6/2025.

Type of visit: Case Management - Other

On 01/05/2026 at 1:00 PM Licensing Program Analyst (LPA) Shakaricka Hughes arrived at the facility to conduct a case management visit to deliver an Order to Licensee/Facility of Immediate Exclusion from Facility. LPA met with licensee/administrator Veniana Banuve and explained the purpose of today's visit. LPA Hughes handed the Order to Licensee/Facility of Immediate Exclusion from Facility letter to Veniana and explained that facility staff (S1), if present in the facility needed to leave immediately. Facility staff (S1) is to be removed from all shifts and disassociated from the facility in Guardian. An exit interview was held with Veniana and a copy of this report was provided.the state’s words, verbatim · CDSS document, Jan 5, 2026

Type of visit: Required - 1 Year

On 10/29/2025 at 9:15 am, Licensing Program Analyst (LPA) Shakaricka Hughes arrived at the facility to conduct an unannounced annual inspection. LPA Hughes met with the facility designated administrator Veniana. The current census is 6 with 2 facility staff. This facility is a single story building licensed to serve six (6) non-ambulatory residents. LPA inspected the physical plant including but not limited to the common area, kitchen, dining area, resident bedrooms, resident bathrooms, laundry room and outside courtyards of the facility to ensure compliance with Title 22 regulations. LPA observed the facility to be free of odor, clean and in good repair. LPA observed bedrooms to be properly furnished with appropriate bedding and lighting. There are no bodies of water present. LPA toured the kitchen and observed sufficient seven-day non-perishable and two-day perishable food supplies. Hot water temperature was measured at 115.5 degrees Fahrenheit in resident bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. Grab bars and non-slip mat were observed to be stable and in good repair at this time. Smoke and carbon monoxide detectors are in compliance with fire safety. The fire extinguisher is located in the kitchen area and was last serviced on 05/01/2025. LPA observed the facility has a public telephone in the kitchen area and the facility has the required posters posted. Facility thermostat was observed at 71 degrees Fahrenheit. LPA observed toxins located in the laundry area kept locked and inaccessible to residents. LPA observed sharp knives kept locked in the kitchen and inaccessible to residents. Continuation 809-C LPA checked medication storage and found medication to be locked away and inaccessible to residents. LPA reviewed 4 out of 6 residents medications and the medication administration record (MAR) was complete. The first aid kit was checked and contained the required components. LPA requested resident and staff files for review. LPA reviewed 6 out of 6 resident files and they were complete. LPA reviewed 3 staff files, and it was complete. LPA reviewed staff criminal record clearances, and a review of staff records indicates that all facility staff or other individuals who require caregiver background checks are fingerprint cleared. The following documents will be email to LPA by 10/31/2025 end of day 5:00 PM: (1) LIC 308 Designation of Administrative Responsibility (2) Copy of Administrator Certificate (3) LIC 610 Current Emergency Disaster Plan (4) Proof of Current Liability Insurance (5) LIC 500 Current Personnel Report As a result of this annual visit, the facility is in compliance with Title 22 Regulations, and a copy of these LIC 809 reports, were provided to the facility.the state’s words, verbatim · CDSS document, Oct 29, 2025

Type of visit: Prelicensing

On 10/9/24 at 9:00am Licensing Program Analyst (LPA) Kevin Gould arrived at Loving Legacy Senior Care for the purpose of conducting a pre-licensing inspection. LPA met with applicant, Veniana Banuve and together conducted a tour of the home. Applicant is applying for an RCFE with a capacity for six (6) non-ambulatory residents. LPA and applicant evaluated the physical plant to ensure the health and safety of the residents in care. Areas inspected are including but not limited to the kitchen, resident bedrooms; resident bathrooms, living and dining room and outdoor areas. LPA observed the facility to be free of odor, clean and in good repair. LPA observed that all rooms are equipped with the required furniture and sufficient lighting throughout the facility. LPA measured the water temperature, temperature measured at 109 degrees F which meets the 105-120 degree Fahrenheit regulation. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Fire extinguishers and smoke detectors are current and in compliance with fire safety. LPA notes the facility had the required carbon monoxide detectors. First aid kit was checked and is complete. LPA observed centrally stored medications area secure from residents. LPA and applicant conducted Component III orientation. At the time of inspection, the applicant has met all requirements to obtain a license. LPA has no objections to the facility being licensed. LPA will contact CAB and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Oct 9, 2024