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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 365530191
Report Date: 03/03/2026
Date Signed: 03/03/2026 01:51:03 PM

Document Has Been Signed on 03/03/2026 01:51 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:ALL-LOVING SENIOR CAREFACILITY NUMBER:
365530191
ADMINISTRATOR/
DIRECTOR:		RODRIGUEZ, IRMA AFACILITY TYPE:
740
ADDRESS:1597 WEST MCWETHY STREETTELEPHONE:
(909) 560-9456
CITY:RIALTOSTATE: CAZIP CODE:
92376
CAPACITY: 6CENSUS: 4DATE:
03/03/2026
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:31 PM
MET WITH:Irma Rodriguez, LicenseeTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
NARRATIVE
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On March 3, 2026, at 9:55 AM, Licensing Program Analysts (LPAs), LaVette Farlow and Andrew Martinez, conducted a Case Management - Deficiencies inspections. LPAs met with Licensee, Irma Rodriguez, who accompanied LPAs on facility inspection. Licensee confirmed two (2) additional staff and four (4) residents were present at the facility.

At 11:25 AM, LPAs interviewed staff member, Sandra Romero, who stated they hold the job title as Caregiver and has been working various shift times, mainly during the day, at the facility for the past five (5) months. Sandra stated she assists with everything at the facility including assisting residents with going to the bathroom. Upon LPAs staff file reviews, Licensee was unable to provide a staff file on Caregiver Sandra Romero.

LPAs inquired with Licensee the job duties of Sandra Romero and Licensee stated that she was mainly here to assist with cleaning the facility and periodically help with meals a couple days out of the week, but has now become more frequent to at least 5 days a week. Licensee stated that she provides a service to the facility. LPAs informed Licensee that based on the duties being performed, Sandra is required to have been fingerprinted and obtained a criminal record clearance prior to working at the facility. LPAs informed Licensee of the deficiency and that a civil penalty will be assessed.

*** Continued on LIC809-C ***
NAME OF LICENSING PROGRAM MANAGER: Nedra Brown
NAME OF LICENSING PROGRAM ANALYST: Lavette Farlow
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/03/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 03/03/2026 01:51 PM - It Cannot Be Edited


Created By: Lavette Farlow On 03/03/2026 at 12:38 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: ALL-LOVING SENIOR CARE
FACILITY NUMBER: 365530191

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/03/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/03/2026
Section Cited
CCR
87355(e)(2)

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87355(e) All individuals... shall prior to working... (2)Obtain a California clearance or a criminal record exemption as required by the Department...
This requirement is not met as evidenced by:
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Licensee agreed to removed Staff three (S3) from the facility immediately and will not be allowed to work until the background clearance is completed.
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Licensee did not comply with section cited by having individual working at facility for past 5 months without prior criminal record clearance posing immediate health and safety risks to persons 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.
Nedra Brown
NAME OF LICENSING PROGRAM MANAGER:
Lavette Farlow
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 03/03/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/03/2026


LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: ALL-LOVING SENIOR CARE
FACILITY NUMBER: 365530191
VISIT DATE: 03/03/2026
NARRATIVE
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Based on interviews and observations during today's visit, an immediate civil penalty is being assessed at the rate of $100.00 per day, for a maximum of 5 days, totaling $500.00. Civil penalties may continue to accrue until the deficiency is corrected in accordance with Health and Safety Code regulation 1522(c)(1), 1568.09(c), 1569.17(c), and 1596.871(c). An exit interview was conducted, and a Plan of Correction was developed and discussed with Licensee. A copy of this report LIC 809, LIC 809C, LIC 809D, LIC 421BG, and letter of Appeal Rights were provided and discussed with Licensee whose signature is on this form confirms receipt of stated documents.
NAME OF LICENSING PROGRAM MANAGER: Nedra Brown
NAME OF LICENSING PROGRAM ANALYST: Lavette Farlow
LICENSING PROGRAM ANALYST SIGNATURE:

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

DATE: 03/03/2026
LIC809 (FAS) - (06/04)
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