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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336423972
Report Date: 05/27/2025
Date Signed: 05/27/2025 03:53:51 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/06/2024 and conducted by Evaluator Janira Arreola
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20240306094623
FACILITY NAME:WHITE'S LOVE & CARE RESIDENTIAL ELDERLY HOME INCIIFACILITY NUMBER:
336423972
ADMINISTRATOR:JACQUELYN J. WHITEFACILITY TYPE:
740
ADDRESS:24068 RISTRAS LANETELEPHONE:
(951) 319-6622
CITY:MURRIETASTATE: CAZIP CODE:
92562
CAPACITY:6CENSUS: 3DATE:
05/27/2025
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Staff, Krista HaganTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Facility staff misued resident fianances.
Facility staff are making medical decisions on behalf of the resident.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Janira Arreola, conducted an unannounced visit to the facility in order to investigate the above allegations. LPA met with Staff, Krista Hagan and met with Administrator, Armond Hagan over the phone who were informed of the purpose of the visit. During the visit, LPA conducted interviews, conducted a walk through, and records review.

It was alleged “Facility staff misused resident finances.” It was alleged the licensee became the Power of Attorney (POA) for Resident #1 (R1) and was in charge of R1’s finances such as their social security income (SSI).
The department attempted to conduct an interview with R1 who was not alert or oriented during the interview. LPA attempted to interview the licensee who was not available at the time of the visit.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2025
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 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/06/2024 and conducted by Evaluator Janira Arreola
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20240306094623

FACILITY NAME:WHITE'S LOVE & CARE RESIDENTIAL ELDERLY HOME INCIIFACILITY NUMBER:
336423972
ADMINISTRATOR:JACQUELYN J. WHITEFACILITY TYPE:
740
ADDRESS:24068 RISTRAS LANETELEPHONE:
(951) 319-6622
CITY:MURRIETASTATE: CAZIP CODE:
92562
CAPACITY:6CENSUS: 3DATE:
05/27/2025
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Staff, Krista HaganTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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9
Resident documents are altered and incomplete.
INVESTIGATION FINDINGS:
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13
*This report has been amended an the updated finding and deficiency can be found on LIC9099 dated 7/24/2025.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 18-AS-20240306094623
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: WHITE'S LOVE & CARE RESIDENTIAL ELDERLY HOME INCII
FACILITY NUMBER: 336423972
VISIT DATE: 05/27/2025
NARRATIVE
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*This report has been amended an the updated finding and deficiency can be found on LIC9099 dated 7/24/2025.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 18-AS-20240306094623
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: WHITE'S LOVE & CARE RESIDENTIAL ELDERLY HOME INCII
FACILITY NUMBER: 336423972
VISIT DATE: 05/27/2025
NARRATIVE
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(2) staff interviews revealed the licensee is the POA for R1 for Financial Management and receives R1’s SSI. (1) administrative staff revealed the licensee currently manages R1’s finances, has access to R1’s bank account, and pays R1’s rent. (1) administrative staff revealed the facility does not have a surety bond or ledger for finances managed for R1.

Per California Code of Regulations (CCR) Title 22, the licensee of a facility cannot be designated as a resident’s Power of Attorney. The licensee can be designated by the social security administration as a resident’s payee and must document and account for the funds received. Therefore, based on interviews and records reviews the allegation that the licensee was misusing the resident’s finances is substantiated at this time.

It was alleged “Facility staff are making medical decisions on behalf of the resident.” It was alleged the licensee was providing medical consent for R1 for medical procedures. It was alleged R1 was unable to provide consent and that the licensee was R1’s POA.

The department attempted to conduct an interview with R1 who was not alert or oriented during the interview. LPA attempted to interview the licensee who was not available at the time of the visit.

Interview with (1) administrative staff revealed the licensee was making medical decisions for R1, until they designated another staff member as R1’s POA over Health Care. Interview with (1) confidential witness revealed the licensee provided medical consent and signed medical consent forms for R1. File review revealed POA documents dated 05/07/2024 signed by the licensee designating a staff member as the POA for Health Care. Therefore, based on interviews and records review the allegation that the licensee is providing medical consent for R1 is substantiated at this time.

The preponderance of evidence standard has been met, therefore the above allegations are substantiated. California Code of Regulations Title 22 is being cited on the attached LIC 9099 D. An exit interview was conducted, and a copy of this report LIC 9099D, and appeal rights were reviewed and provided.

SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 18-AS-20240306094623
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: WHITE'S LOVE & CARE RESIDENTIAL ELDERLY HOME INCII
FACILITY NUMBER: 336423972
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/27/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/28/2025
Section Cited
CCR
87217(c)
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87217 Safeguards for Resident Cash, Personal Property, and Valuables (c) Every facility shall account for any cash resources entrusted to the care or control of the licensee… This requirement was not met as evidenced by:
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The licensee is to call Adult Protective Services (APS) and initate the process to assist R1 in finding a new POA who is not affiliated with the facility. The licensee is to submit proof of this by the POC due date.
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Based on interview and record review the licensee appointed themselves to be R1's POA over financial management and does not have a surety bond or ledger of finances management. This poses an immediate health saftey or personal rights risk to residents in care.
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Type A
05/28/2025
Section Cited
CCR
87468.2(a)(7)
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87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (a)...residents in privately operated...facilities...shall have all of the following personal rights: (7) To fully participate in planning their care...according to Health and Safety Code section 1569.80 and involve persons of their choice in this planning. The licensee shall provide necessary information and support...
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The licensee is to call Adult Protective Services (APS) and initate the process to assist R1 in finding a new POA who is not affiliated with the facility. The licensee is to submit proof of this by the POC due date.
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This requirement was not met as evidenced by: Based on interview and record review the licensee appointed themselves as the POA for R1 and appointed a staff as R1's POA for Health care. This poses an immediate health, saftey or personal rights risk to residents in care.
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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: Anthony Perez
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5