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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006729
Report Date: 03/26/2026
Date Signed: 03/26/2026 09:07:03 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/09/2026 and conducted by Evaluator William Vanegas
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20260209104718
FACILITY NAME:LOVELAND SENIOR LIVINGFACILITY NUMBER:
306006729
ADMINISTRATOR:ABDALLA, SUHAFACILITY TYPE:
740
ADDRESS:2443 E POWHATAN AVETELEPHONE:
(657) 201-3637
CITY:ANAHEIMSTATE: CAZIP CODE:
92806
CAPACITY:6CENSUS: 1DATE:
03/26/2026
UNANNOUNCEDTIME BEGAN:
08:13 AM
MET WITH:Suha Abdalla TIME COMPLETED:
09:00 AM
ALLEGATION(S):
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-Staff are not administering resident's medication
INVESTIGATION FINDINGS:
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On this day, Licensing Program Analyst (LPA) William Vanegas made an unannounced visit to the facility to deliver complaint findings for the allegation listed above. LPA was greeted and granted entry into the facility and explained the purpose for the visit. Administrator was on site and LPA began to explain the findings of the investigation and the following were discussed.
Regarding the allegation Staff are not administering resident’s medication, the following has been concluded: During the observations and reviews of the medication administration record, for R1 it was observed that all medications found at the facility were not documented on the medication administration record.
Furthermore, the following was observed; medications found in Resident 2 (R2) stored medications bubble pack medications were being dispensed on conflicting dates. It was observed that medications were dispensed from bubble packs as R2 was admitted to the hospital during the time periods of medications being dispensed.
CONTINUED ON LIC9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: William Vanegas
LICENSING EVALUATOR SIGNATURE:

DATE: 03/26/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2026
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 3
Control Number 22-AS-20260209104718
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: LOVELAND SENIOR LIVING
FACILITY NUMBER: 306006729
VISIT DATE: 03/26/2026
NARRATIVE
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CONTINUATION FROM LIC9099
Additionally, per LPA review one medication with a quantity of 60 pills 41 were not dispensed. A total of 19 pills were dispensed however the number of dispensed pills is not parallel to the number of Callander days that have passed in the month of March which is 18 days. Therefore, it is determined that medications were not administered per physicians’ orders.

on the evidence observed and gathered the department obtained sufficient evidence to substantiate the allegation mentioned above. The preponderance of evidence standard has been met; therefore, the allegation is Substantiated. See LIC9099D for cited deficiency per title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report along with appeal rights was provided to the facility.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: William Vanegas
LICENSING EVALUATOR SIGNATURE:

DATE: 03/26/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20260209104718
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: LOVELAND SENIOR LIVING
FACILITY NUMBER: 306006729
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/26/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/26/2026
Section Cited
CCR
87465(h)(6)(C)
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Incidental Medical and Dental Care
(h)The following requirements shall apply to medications which are centrally stored: (6)The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each
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Administrator will document all residents medications correctly in medication administration record, and will discard of any left over medication from previous months in order to not compromise the number of medications adminstered.
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resident is maintained for at least one year and includes: (C)The drug name, strength and quantity.
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Administrator will provide proof of correction via email to LPA.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: William Vanegas
LICENSING EVALUATOR SIGNATURE:

DATE: 03/26/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3