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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608029
Report Date: 02/09/2026
Date Signed: 02/09/2026 03:27:02 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/01/2026 and conducted by Evaluator Lizeth Villegas
COMPLAINT CONTROL NUMBER: 11-AS-20260201205407
FACILITY NAME:VISTA DEL MAR SENIOR LIVINGFACILITY NUMBER:
197608029
ADMINISTRATOR:SUZETTE JOHNSONFACILITY TYPE:
740
ADDRESS:3360 MAGNOLIA AVENUETELEPHONE:
(562) 595-1559
CITY:LONG BEACHSTATE: CAZIP CODE:
90806
CAPACITY:300CENSUS: 240DATE:
02/09/2026
UNANNOUNCEDTIME BEGAN:
09:04 AM
MET WITH:Collene Rosatti/Interim Executive Director DirectorTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff mishandled a resident's medications.
INVESTIGATION FINDINGS:
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On 02/09/26 at 9:00 am Licensing Program Analyst (LPA) Villegas conducted a initial/subsequent complaint visit regarding the allegation(s) above. LPA met with Collene Rosatti as the purpose of today’s visit was explained.

The investigation consisted of the following: On 02/09/26 LPA Villegas obtained copies of the staff and resident roster, and copies of the following documents for Resident #1 (R1) Emergency ID form, pre-appraisal dated:06/08/25, Physicians report dated: 03/01/23, current physicians orders, service plan dated:04/26/25, and the Medication Administration Record (MAR) for December 2025- February 2026. On 02/09/26 from 10:00 am- 12pm LPA conducted Interviews with residents# 1-10 (R1-R10), and from 1pm- 2:15 pm LPA conducted interviews with staff #1-4 (S1-S4). On 02/09/26 LPA conducted a review of R1's file including medications review, and conducted an interview with witness #1 (W1).

The investigation revealed the following:
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 02/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2026
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 2
Control Number 11-AS-20260201205407
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: VISTA DEL MAR SENIOR LIVING
FACILITY NUMBER: 197608029
VISIT DATE: 02/09/2026
NARRATIVE
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Allegation: Staff mishandled a resident's medications.

It is being alleged that medications were left sitting alone on a cluttered counter rather than being safely administered by facility staff. On 02/09/26 from 10:00 am- 12pm LPA conducted Interviews with R1-R10 regarding the allegation above. 8 of the 10 residents interviewed denied the allegation above and reported that staff watch them take their medications before exiting their bedroom. 1 of 10 residents interviewed reported handling their own medications and do not require staff to watch them take their medications. 1 of 10 residents interviewed confirmed the allegation above and reported they have found medications left in their bedroom, and reported that there have been times where staff will hand over the medication and walk away. On 02/09/26 from 1pm- 2:15 pm LPA conducted interviews with S1-S4 regarding the allegation above, 4 of 4 staff interviewed denied the allegation above and reported they watch the residents take their medications before leaving the room. On 02/09/26 LPA conducted an interview with W1 regarding the allegation above, per W1 there have not been any concerns with the care and assistance R1 is receiving. On 02/09/26 LPA conducted a review of R1's file, per the pre-appraisal dated:06/08/25, Physicians report dated: 03/01/23, and Service plan dated: 04/26/25 R1 requires assistance with medication administration. On 02/09/26 LPA and S1 conducted a review of R1's medications and Medication Administration Record (MAR) for December 2025- February 2026, during the review it was determined all medications were administered.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

Exit interview conducted, and a copy of this report was provided.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 02/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2