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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006729
Report Date: 04/01/2026
Date Signed: 04/01/2026 03:56:03 PM

Unsubstantiated


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
03/25/2026 and conducted by Evaluator Jenifer Tirre
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20260325115352
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: 2DATE:
04/01/2026
UNANNOUNCEDTIME BEGAN:
07:24 AM
MET WITH:Administrator Suha AbdallaTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Staff do not ensure medication records are properly maintained
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced visit to conduct complaint investigation. LPA Tirre was greeted and granted entry into the facility by staff and explained reason for visit with Administrator Suha Abdalla.

During the course of investigation, LPA reviewed records and conducted interviews. Department requested pertinent documentation such as Physician’s Reports, Medication Administration record,Medication Training and Centrally Stored Medication and Destruction Record. The investigation conducted revealed the following:
On March 25, 2026 the department received a complaint alleging Staff do not ensure medication records are properly maintained.
Regarding Allegation Staff do not ensure medication records are properly maintained, Record Review was conducted and Department reviewed Medication Administration Records for current residents (Residents 3 and 4) and previous residents (Residents 1 and 2). Facility provided records for four individuals
CONTINUED ON 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jenifer Tirre
LICENSING EVALUATOR SIGNATURE:

DATE: 04/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/01/2026
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 2
Control Number 22-AS-20260325115352
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: 04/01/2026
NARRATIVE
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Two of four resident records (R3-R4) Medication Administration Records (MAR’s) revealed to be current and complete. Records for R2 were completed by facility staff and Hospice staff. MAR’s for R1 were provided for December 13, 2025 to February 23, 2026 and LPA observed that medications for R1 for December 13, 2025 to December 31, 2025 were initialed and signed off by Staff1. A as needed PRN MAR for same dates of December 13-31st was also provided with three PRN (as needed meds) for R1. LPA observed the PRN MAR had signatures for one medication by staff 1. LPA observed that it was unclear what PRN medication was signed off by Staff 1 due to signature was signed on a line that was in between two medications (Lactulose and Olanzapine). R1’s MAR for month of January 2026 was signed off by two different staff members (S2 & S6). One medication for R1 (Nitrofurantoin) was missing signatures from January 7-19, 2026. R1’s MAR for the month of February 1-23rd was signed off by two staff members (Staff 2 and 5). R1’s MAR for February was missing signatures for three PM medications (Levothyroxine, Synthroid, and pantoprazole) on February 23rd.

Medication Training verification was provided for four of six staff members of which four staff administered meds to R1.

Interviews conducted with staff revealed that staff stated they verify one by one medications for AM, NOON and PM medications before dispensing to each resident one by one. Staff interviews stated that once medications are dispensed to residents and they visually see that Residents have swallowed medications, Staff sign off MAR for given meds. Staff interviews stated that if Resident refuses medications or are out of facility in example if they are out at hospital, MAR should not be signed off if medications are not dispensed. Interviews with three staff members stated they had Medication Training. Interview with Staff 1, stated that due to S1 no longer working at facility, S1 could not recall and wished not to disclose information regarding medications given to residents.

Interviews with two residents R3-R4 stated that they receive their medications timely and have no issues regarding medications or staff. Interview with Witness 1 revealed that staff members were incorrectly filling out Resident MAR’s and stated that medication was listed that Resident was not supposed to be given.

Based on information provided in investigation, the preponderance of evidence has not been met, deeming the allegations Staff do not ensure medication records are properly maintained to be Unsubstantiated meaning 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 as reported.

An exit interview was conducted with Administrator Abalia and copy of report was discussed and provided.

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jenifer Tirre
LICENSING EVALUATOR SIGNATURE:

DATE: 04/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/01/2026
LIC9099 (FAS) - (06/04)
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