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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701485
Report Date: 01/05/2026
Date Signed: 01/05/2026 12:49:35 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/15/2025 and conducted by Evaluator Shakaricka Hughes
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20251215085701
FACILITY NAME:LOVING LEGACY SENIOR CAREFACILITY NUMBER:
342701485
ADMINISTRATOR:BANUVE, VENIANAFACILITY TYPE:
740
ADDRESS:8216 COTTON BALL WAYTELEPHONE:
(279) 229-7719
CITY:SACRAMENTOSTATE: CAZIP CODE:
95828
CAPACITY:6CENSUS: 6DATE:
01/05/2026
UNANNOUNCEDTIME BEGAN:
10:27 AM
MET WITH:Facility Administrator: Veniana BanuveTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff member physically abuses resident in care.
Staff member handles resident in a rough manner while in care.
INVESTIGATION FINDINGS:
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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
Estimated Days of Completion:
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Shakaricka Hughes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2026
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 5
Control Number 27-AS-20251215085701
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: LOVING LEGACY SENIOR CARE
FACILITY NUMBER: 342701485
VISIT DATE: 01/05/2026
NARRATIVE
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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.
 
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Shakaricka Hughes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/15/2025 and conducted by Evaluator Shakaricka Hughes
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20251215085701

FACILITY NAME:LOVING LEGACY SENIOR CAREFACILITY NUMBER:
342701485
ADMINISTRATOR:BANUVE, VENIANAFACILITY TYPE:
740
ADDRESS:8216 COTTON BALL WAYTELEPHONE:
(279) 229-7719
CITY:SACRAMENTOSTATE: CAZIP CODE:
95828
CAPACITY:6CENSUS: 6DATE:
01/05/2026
UNANNOUNCEDTIME BEGAN:
10:27 AM
MET WITH:Facility Administrator: Veniana BanuveTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff member speaks inappropriately to resident in care.
Staff did not adequately supervise resident in care.
INVESTIGATION FINDINGS:
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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 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. A brief interview with conducted with Veniana.

Allegation: Staff member speaks inappropriately to resident in care.
It was alleged that a staff member speaks inappropriately to a resident in care. This investigation consisted of interviews with facility staff and residents in care. On 12/17/2025 LPA Hughes conducted a visit to the facility, during the visit LPA spoke with 2 out of 3 residents in care who did not express concerns about facility staff speaking to them inappropriately. Interview with resident (R2) expressed concern about facility staff speaking inappropriately stating that facility staff oftentimes use profane language when speaking with residents in care. Interview with 2 out of 2 facility staff denied allegations of speaking inappropriately to residents in care. There is not enough evidence to corroborate this allegation, therefore the allegation is unsubstantiated.
Continuation 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Shakaricka Hughes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 27-AS-20251215085701
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: LOVING LEGACY SENIOR CARE
FACILITY NUMBER: 342701485
VISIT DATE: 01/05/2026
NARRATIVE
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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.


SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Shakaricka Hughes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 27-AS-20251215085701
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: LOVING LEGACY SENIOR CARE
FACILITY NUMBER: 342701485
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/05/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/06/2026
Section Cited
CCR
87468.1(a)(3)
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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.


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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...
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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.
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disassociation in Guardian to LPA Hughes by 1/6/2026 via email.
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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: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Shakaricka Hughes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/05/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5