197608029-5-12-2026-11-AS-SCIS-DU92UV-20260519174258

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608029
Report Date: 05/12/2026
Date Signed: 05/12/2026 03:43:49 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
03/25/2026 and conducted by Evaluator Lizeth Villegas

COMPLAINT CONTROL NUMBER: 11-AS-20260325122703

FACILITY NAME:	VISTA DEL MAR SENIOR LIVING		FACILITY NUMBER:	197608029
ADMINISTRATOR:	SUZETTE JOHNSON		FACILITY TYPE:	740
ADDRESS:	3360 MAGNOLIA AVENUE		TELEPHONE:	(562) 595-1559
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90806
CAPACITY:	300	CENSUS: 245	DATE:	05/12/2026
		UNANNOUNCED	TIME BEGAN:	01:39 PM
MET WITH:	Executive Director SuzetteJohnson		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Staff did not keep facility free of vermin.

INVESTIGATION FINDINGS:

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THIS REPORT SUPERSEEDS THE REPORT DATED 04/09/2026 TO CHANGE COMPLAINT INVESTIGATION FINDING(S).

On 04/09/26 Licensing Program Analyst (LPA) Villegas conducted a subsequent complaint visit regarding the allegation(s) above. LPA met with Executive Director as the purpose of today’s visit was explained.
The investigation consisted of the following: On 04/01/26 LPA Villegas obtained copies of the staff and resident roster, and copies of the following documents for Resident #1 (R1) Emergency ID form, pre placement appraisal dated: 02/20/25, Admission agreement dated: 02/18/25 , resident assessment dated: 03/05/25, Physicians report dated: 02/13/25, service plan dated: 06/17/25, updated service plan dated 03/26, shower schedule, facility notes dated: 03/2026, facilities laundry schedule, pest control service logs dated: On 01/2026-04/2026. On 04/01/26 from 10:00 am- 12pm LPA conducted Interviews with Residents #2-10 (R2-R10). On 04/01/26 LPA was unable to interview R1 as R1 was out of the

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20260325122703

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: 05/12/2026

NARRATIVE

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facility at the time of visit. On 04/01/26 LPA conducted interviews with staff #1-3 (S1-S3) and conducted a tour of the facility. On 04/09/26 LPA conducted interviews with staff #4-6 (S4-S6). On 04/09/26 at 2pm LPA conducted interview with R1.

The investigation revealed the following:

Allegation: Staff did not keep facility free of vermin.

It is alleged that the facility has a rat problem as rat feces have been observed at the facility. On 04/01/26 and 04/09/26 LPA conducted Interviews with R1-R10 regarding the allegation above. 8 of the 10 residents interviewed denied the allegation above, 2 of the 10 residents interviewed confirmed the allegation above. 10 of 10 residents interviewed confirmed that the facility is being treated by pest control. On 04/01/26 and 04/09/26 LPA conducted interviews with S1-S6. 4 of the 6 staff interviewed denied the allegation above, 2 of 6 staff interviewed confirmed the allegation above and reported seeing mice at the facility. 5 of the 6 staff confirmed that pest control services are coming out to service the facility. 1 of the 6 staff interviewed reported having no knowledge of pest control services at the facility. On 04/01/26 LPA observed pest control to be servicing the facility at the time of the visit. On 04/01/26 LPA conducted a review of pest control service report dated: 3/25/26. Per the report, 20 rooms were serviced, interior and exterior inspected and baited, no activity found, EZ snaps are inspected each time facility is serviced, sanitation conditions listed as Fair.

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: 05/12/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

LIC9099 (FAS) - (06/04)

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