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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603775
Report Date: 07/22/2025
Date Signed: 07/23/2025 12:15:26 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/15/2025 and conducted by Evaluator Sanjay Vaid
COMPLAINT CONTROL NUMBER: 28-AS-20250115100620
FACILITY NAME:LOVE N'CARE VILLAFACILITY NUMBER:
198603775
ADMINISTRATOR:AXALAN, NICOLEFACILITY TYPE:
740
ADDRESS:5203 JOSIE AVENUETELEPHONE:
(720) 530-9218
CITY:LAKEWOODSTATE: CAZIP CODE:
90713
CAPACITY:6CENSUS: 5DATE:
07/22/2025
UNANNOUNCEDTIME BEGAN:
08:43 AM
MET WITH:Administrator- Nicole AxalanTIME COMPLETED:
10:00 AM
ALLEGATION(S):
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Staff financially abused resident in care.
Staff physically abused resident in care.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) S Vaid and E Mallet conducted a findings delivery visit to the facility. LPAs Vaid and Mallett were met by Cherly LaCambra and notified the administrator via phone. Administrator Nicole Axalan arrived shortly after. LPA’s conducted a tour with caregiver and did nor observe any health and safety concerns.

On 01/23/2025, Licensing Program Analyst (LPA) S Vaid conducted an initial 10-day complaint investigation visit for the above allegations. LPA met with Nicole Axalan, Administrator and purpose of the visit was discussed. Cheryl Lacambra assisted LPA with complaint. LPA did not observe any safety concerns during the facility tour. LPA Vaid requested, collected, and reviewed documents from R1's face sheet, physicians reports, admissions-health care directives, residential appraisal, and copies five current residents: face sheet, physician reports, admissions agreement, residential appraisals. Telephone contact information, hospice nurse, attorney information for 1 lawsuit settlement, and banker who opened account for R1. CONTINUED ON 9099C............
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Sanjay Vaid
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2025
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 2
Control Number 28-AS-20250115100620
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: LOVE N'CARE VILLA
FACILITY NUMBER: 198603775
VISIT DATE: 07/22/2025
NARRATIVE
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Regarding the allegation: Staff financially abused resident in care. It is alleged that the staff at the facility financial abused resident in care. Per the complaint, staff opened separate bank account for resident while family had fiduciary power of attorney. Four (4) out of four (4) staff interviewed deny this allegation. The investigation determined the resident was capable to managing their cash resources. Document review of the pre-placement information dated 6/01/2023, resident appraisal dated 6/01/2023, acknowledged by R1’s family and S4(former administrator) and LIC 602 Physician report for residential care facility for the elderly (RCFE) state R1 to manage own cash resources. According S1 and S3, they assisted R1 to the bank to open a new account on 6/26/2024. Upon R1’s death, S3 informed family and relinquished all R1’s personal and financial belonging to R1’s family, including California ID and debit card including pin number. Documents reviewed indicate the family only had Health Care power of attorney. Fiduciary power of attorney was not corroborated. R1 was able to manage their own cash resources. Five (5) out of six (6) residents interviewed could not corroborate this allegation. Facility residents have not been financially abused by the staff. Based upon record review and interviews conducted the findings indicate that, although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Regarding the allegation: Staff physically abused resident in care. It is alleged that the facility staff physically abused the resident in care. Four (4) out of four (4) staff interviewed deny this allegation. According to the staff they provide residents with living assistance, treat residents with respect and dignity, staff stated they have never physically abused any residents in their care, past nor present. Five (5) out of six (6) residents interviewed could not corroborate this allegation. Residents interviewed stated the facility staff attend to their needs and provide assistance when residents are in need. Two (2) out three (3) witnesses stated they have not observed physical abuse on R1’s body at any time during R1’s resident at the facility. Review of staffing records confirms staff person accused of physical abuse in the complaint worked at the facility between October 2022 and December 2022, R1 started their stay at the facility on 6/01/23. Based upon record review and interviews conducted the findings indicate that, although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the .

A copy of this report was given to Nicole Axalan, Administrator.

Due to printer issues, LPA Vaid will mail report to facility.
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Sanjay Vaid
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2025
LIC9099 (FAS) - (06/04)
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