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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 075601208
Report Date: 05/05/2026
Date Signed: 05/05/2026 04:17:02 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/27/2026 and conducted by Evaluator Alicia Delmundo
COMPLAINT CONTROL NUMBER: 15-AS-20260427120706
FACILITY NAME:HM LOVE & CARE HOMEFACILITY NUMBER:
075601208
ADMINISTRATOR:RIFORMO, MARIAFACILITY TYPE:
740
ADDRESS:508 KAYANN COURTTELEPHONE:
(510) 222-1406
CITY:EL SOBRANTESTATE: CAZIP CODE:
94803
CAPACITY:6CENSUS: 3DATE:
05/05/2026
UNANNOUNCEDTIME BEGAN:
10:55 AM
MET WITH:Maria Riformo/Licensee-AdministratorTIME COMPLETED:
04:20 PM
ALLEGATION(S):
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Illegal eviction.

Staff increased resident's rates without 90 day written notice.
INVESTIGATION FINDINGS:
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On this day, May 5, 2026. at 10:55 am, Licensing Program Analyst (LPA) Delmundo arrived unannounced to investigate the above allegations. LPA was granted entry by staff, Manolo Boado. LPA spoke over the phone with Maria Riformo, licensee-administrator (LIC-ADM), who arrived after about 15 minutes.

LPA reviewed residents' records and obtained copies of following documents: LIC601 Identification and Emergency Contact Information; Admission Agreement; LIC602A Physician's Report; rate increase notification. LPA conducted interviews:


....continued on 9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Alicia Delmundo
LICENSING EVALUATOR SIGNATURE:

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

DATE: 05/05/2026
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 3
Control Number 15-AS-20260427120706
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: HM LOVE & CARE HOME
FACILITY NUMBER: 075601208
VISIT DATE: 05/05/2026
NARRATIVE
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Allegation: Illegal eviction.
Allegation: Staff increased resident's rates without 90 day written notice.
R1 stated the licensee gave R1 written notification for rate increase dated April 15, 2026 that if R1 cannot add the amount of increase to the rent, a 60 days notice to relocate to another place is included on the written notification.

The licensee-administrator (LIC-ADM) confirmed what R1 stated. LIC-ADM also stated she gave written notification on May 1, 2026. Review of the written notification showed it was dated April 15, 2026 with effective date July 15, 2026 with reason for increase is due to cost of living getting more expensive but does not include description of the additional costs.

Based on review of records and interviews, the above allegations are substantiated. A finding that a complaint is substantiated means that the allegations are valid because the preponderance of the evidence standard has been met.

Deficiencies are cited from Title 22 California Code of Regulations and listed on 9099D. Failure to submit proof of corrections (POCs) by plan of correction due dates and any repeat violation within 12 month period may result in civil penalty.

Deficiencies and plan and proof corrections were discussed with LIC-ADM.

Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form, and copy of this report provided.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Alicia Delmundo
LICENSING EVALUATOR SIGNATURE:

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

DATE: 05/05/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 15-AS-20260427120706
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: HM LOVE & CARE HOME
FACILITY NUMBER: 075601208
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/05/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/19/2026
Section Cited
CCR
87224(a)(1)
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87224 Eviction Procedures
(a) The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident..... (1) Nonpayment of the rate for basic services within ten days of the due date.
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Licensee-administrator to read the Regulations and self-certify full understanding. Proof to be submitted by 5/19/26.
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-This requirement is not met as evidence by:
-Based on interviews and record review, the licensee did not comply with the section above in incorporating eviction for non-payment to the rate increase notification which poses a potential rights risks to persons in care.
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Type B
05/19/2026
Section Cited
HSC
1569.655(a)
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§1569.655 Increase in fee rates for elderly residents; 90 days’ written notice...
(a) .... the licensee shall provide no less than 90 days’ prior written notice to the residents or the residents’representatives setting forth the amount of the increase and the reason or reasons for the increase, including a ......
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Licensee-administrator stated she will correct and rewrite the notification. Copy to be submitted by 5/19/26.
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....description of the additional costs....
-This requirement is not met as evidence by:
-Based on interviews and record review, the licensee did not comply with the section above in giving a written notification for increase to R1 16 days after the date on the letter and does not include description of the addtional costs for increase.
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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.
SUPERVISOR'S NAME: Bennett Fong
LICENSING EVALUATOR NAME: Alicia Delmundo
LICENSING EVALUATOR SIGNATURE:

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

DATE: 05/05/2026
LIC9099 (FAS) - (06/04)
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