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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701578
Report Date: 07/23/2026
Date Signed: 07/23/2026 03:18:03 PM

Unsubstantiated


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
02/11/2026 and conducted by Evaluator Arvin Villanueva
COMPLAINT CONTROL NUMBER: 27-AS-20260211113932
FACILITY NAME:LOVING LEGACY SENIOR CARE IIFACILITY NUMBER:
342701578
ADMINISTRATOR:BANUVE, VENIANAFACILITY TYPE:
740
ADDRESS:6532 RANCHO GRANDE WAYTELEPHONE:
(279) 229-7719
CITY:SACRAMENTOSTATE: CAZIP CODE:
95828
CAPACITY:6CENSUS: 6DATE:
07/23/2026
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Anese Warfield, ManagerTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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The facility allowed excluded individuals to work in the facility.
Staff are forging resident documents.
INVESTIGATION FINDINGS:
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On July 23, 2026, at approximately 9 am, Licensing Program Analyst, Arvin Villanueva (LPA), arrived at this facility unannounced to conduct a follow-up investigation visit regarding the allegations noted above. LPA initially met with Anese Warfield (S4) and stated the purpose of the visit. S4 stated that the administrator, Veniana Banuve (AD), cannot be here at the moment.

Present upon arrival were 4 residents in care with one staff on duty, Eparama Musuvanua (S5). According to S5, 2 residents are out in the community. At approximately 10am, another staff arrived who identified himself as Serupepeli Tuidekei (S6).
Per review of Guardian, S4, S5, and S6 are currently associated to this facility.

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Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026
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-20260211113932
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 II
FACILITY NUMBER: 342701578
VISIT DATE: 07/23/2026
NARRATIVE
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Allegation - The facility allowed excluded individuals (E1 and E2) to work in the facility:
The investigation into this allegation consisted of interviews, record reviews and observations.
During interviews, staff said they had not seen the excluded individuals at the facility. Some staff said they did not know who the excluded individuals were. Residents were also interviewed and said they had not seen the excluded individuals at the facility. Residents were not familiar with the excluded individuals when shown their photos and when their names were mentioned.
A review of the Personnel Rosters (LIC500), dated 2/4/2026, 4/8/2026, and 7/13/2026, showed that the excluded individuals were not listed as employees.
During observations made on 1/22/2026, 2/18/2026, 4/8/2026, 4/23/2026, 4/24/2026, 7/10/2026, and 7/23/2026, there were no reports or observations of the excluded individuals, E1 and E2, being present at the facility.
Based on interviews, record review, and observations, there was not enough evidence to show that the facility allowed excluded individuals to work in the facility. Therefore, the allegation is unsubstantiated.

Allegation - Staff are forging resident documents:
The investigation into this allegation consisted of interviews and record reviews.
LPA Villanueva contacted the doctor's office for 5 residents to verify whether the residents had been seen by the physicians who completed their Medical Assessment (LIC 602A) forms. LPA attempted to verify the records for four of the five residents, but the doctor's offices were unable to confirm the information because of their privacy policies.
Staff were also interviewed and could not confirm that the administrator, licensee, or management staff had falsified or forged resident documents. Staff said they had not been asked by management to alter or forge any resident documents.
Based on the information gathered during the investigation, there was not enough evidence to show that staff were forging resident documents. Therefore, the allegation is 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.
AD authorized S6 to conduct the exit interview and sign this report. A copy of this report and appeal rights were provided.
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SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026
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
02/11/2026 and conducted by Evaluator Arvin Villanueva
COMPLAINT CONTROL NUMBER: 27-AS-20260211113932

FACILITY NAME:LOVING LEGACY SENIOR CARE IIFACILITY NUMBER:
342701578
ADMINISTRATOR:BANUVE, VENIANAFACILITY TYPE:
740
ADDRESS:6532 RANCHO GRANDE WAYTELEPHONE:
(279) 229-7719
CITY:SACRAMENTOSTATE:CAZIP CODE:
95828
CAPACITY:6CENSUS: 6DATE:
07/23/2026
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Anese Warfield, ManagerTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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The Administrator is not present at the facility for a sufficient amount of time.
INVESTIGATION FINDINGS:
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On July 23, 2026, at approximately 9 am, Licensing Program Analyst, Arvin Villanueva (LPA), arrived at this facility unannounced to conduct a follow-up investigation visit regarding the allegations noted above. LPA initially met with Anese Warfield (S4) and stated the purpose of the visit. S4 stated that the administrator, Veniana Banuve (AD), cannot be here at the moment.

Allegation - The Administrator is not present at the facility for a sufficient amount of time:
The investigation into this allegation consisted of interviews, record reviews and observations.
A review of Licensing Program Analyst (LPA) inspection records showed the administrator was not present during unannounced visits conducted on 1/22/2026, 2/18/2026, 4/8/2026, 4/23/2026, 4/24/2026, 7/10/2026, and 7/23/2026. The administrator was present during only one unannounced visit, conducted on 4/30/2026. The repeated absence of the administrator during multiple visits over a six-month period indicates the administrator was not consistently present to oversee the daily operation of the facility.
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Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026
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-20260211113932
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 II
FACILITY NUMBER: 342701578
VISIT DATE: 07/23/2026
NARRATIVE
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A review of the facility's LIC 500, Personnel Report, dated 2/4/2026 and 4/8/2026, showed the administrator was scheduled to work Fridays, Saturdays, and Sundays from 7:00 a.m. to 5:00 p.m. The most recent LIC 500, dated 7/13/2026, showed the administrator's schedule had changed to Mondays and Tuesdays from 7:00 a.m. to 7:00 p.m. Despite the documented work schedules, the administrator was not present during the majority of LPA visits.
Further, records reviewed from the non-compliance (NCC) office meeting held on 4/15/2026 with Administrator/Licensee Veniana Banuve documented the administrator's agreement to be physically present at the facility for at least 40 hours per week, conduct unannounced nighttime health and safety checks at both licensed facilities, and maintain a written administrator presence log documenting the date, time, staff on duty, resident census, and observations made during each visit. During the follow-up inspection on 7/23/2026, the LPA requested this required documentation; however, facility staff were unable to produce any administrator presence log or other documentation verifying compliance with the agreed corrective actions.
Additionally, staff interviews revealed inconsistent statements regarding how often the administrator was present at the facility. Some staff reported the administrator visited periodically, while others were unable to state how frequently the administrator was on-site. Several staff members were unable to identify who the facility administrator was.
Based on the administrator not being present during multiple LPA visits, the conflicting staff statements about how often the administrator is at the facility, and residents being unable to identify or recall seeing the administrator, the evidence supports that the administrator was not present at the facility for a sufficient amount of time. Therefore, the allegation is 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 immediate civil penalty is being assessed today due to repeat violation.
Plan of correction and appeal rights were discussed with AD via telephone. AD authorized staff S6 to conduct the exit interview and sign this report. A copy of this report and appeal rights were provided to facility.
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SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 27-AS-20260211113932
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 II
FACILITY NUMBER: 342701578
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/23/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/31/2026
Section Cited
CCR
87405(a)
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The administrator…shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility as specified in this section.
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Per discussion, the administrator will start documenting their presence at the facility including the date, arrival time, departure time, and duties completed during each visit as per NCC agreement; may title it Administrator Visit Log.
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This requirement is not met as evidenced by: Based on interveiws, record reviews and observations, the administrator was not present during 7 of 8 unannounced LPA visits. The facility also did not to provide the required administrator presence log as agreed during the 4/15/2026 Non-Compliance Conference, and the inconsistencies of staff statements. This poses a potential health, safety or personal rights risk to residents in care.
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Administrator Visit Log from 7/23/26 to 7/30/26 will be submitted to the Department by POC due date.
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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: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5