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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197800131
Report Date: 12/04/2024
Date Signed: 03/05/2025 11:44:07 AM

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
06/19/2024 and conducted by Evaluator Antonine Richard
COMPLAINT CONTROL NUMBER: 11-AS-20240619103658
FACILITY NAME:CHATEAU LONG BEACHFACILITY NUMBER:
197800131
ADMINISTRATOR:KHATERA BAHADORYFACILITY TYPE:
740
ADDRESS:3100 E. ARTESIA BLVD.TELEPHONE:
(562) 428-5371
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY:184CENSUS: 91DATE:
12/04/2024
UNANNOUNCEDTIME BEGAN:
08:18 AM
MET WITH:Esperanza NaaktgeborenTIME COMPLETED:
11:10 AM
ALLEGATION(S):
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Staff locked resident out of his room.
Staff comitted resident to a mental health facility without cause.
staff handled resident in a rough manner.
Staff facility is in disrepair (heater).
Staff refused to provide resident records upon request.
Staff did not safeguard resident funds.
INVESTIGATION FINDINGS:
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The purpose of the amendment is to clarify the narrative on the LIC9099 and LIC9099-Cs and it does not change the investigation findings. On 03/05/2025 Licensing Program Analyst (LPA) Antonine Richard conducted a subsequent complaint visit at the above mentioned facility. LPA met with the Administrator Esperanza Naaktgeboren and explained the purpose of the visit. LPA and Administrator toured the faiclity.

On 12/04/2024, the department conducted a subsequent complaint investigation and met with the administrator Cindy Nicolson-Bolong to deliver findings. The investigation consisted of the following:
During the investigation on 06/20/2024, the department conducted a complaint investigation at the above facility to address the following allegation(s). The department met with Administrator Khatera Bahadory and Assistant Administrator Jennifer Rivas and explained the purpose of the visit. The investigation consisted of the following: During today's investigation, the department conducted a record review, interviewed 8 residents and 6 staff members, and obtained documents.

See Continued LIC9099-C

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2025
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 6
Control Number 11-AS-20240619103658
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: CHATEAU LONG BEACH
FACILITY NUMBER: 197800131
VISIT DATE: 12/04/2024
NARRATIVE
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Allegation #1: Staff locked the resident out of his room.

It is alleged that the staff changed the locks on the resident's bedroom door and required police assistance to enter the room. Interviewed with Administrator #1 (A1), and the staff denied the allegation. An interview with A1 stated that all residents have keys to access their rooms. The staff accessed the rooms to clean and deliver food to residents. In the case that they were sick and could not go downstairs to the dining room. The department interviewed eight residents (R1-R8) and 7 out of 8 residents stated that the facility provided them with a key. (R1-R8) 7 out of 8 residents also stated that the facility never locked them out of their rooms. The records reviewed showed that the facility called the police on 11/28/2023 not on 11/29/23. The department interviewed six staff (S1-S6), and all 6 stated that the residents had keys to their rooms while the staff were only allowed to go in the residents’ rooms to change bed sheets, clean, and check heaters and ventilators.


Although the allegation may have happened or is valid, there is no preponderance of evidence to prove that the alleged violation(s) did or did not occur; therefore, the allegation is Unsubstantiated.

Allegation #2: Staff committed the resident to a mental health facility without cause.

It is alleged that the staff illegally committed the resident to a mental health hospital without cause or seen as a threat to anyone. On 06/20/2024 the department interviewed administrator #1 (A1) who stated that they were concerned about the resident on the morning of 11/31/2023 due to R1’s yelling. The department records reviewed on 12/01/2023 revealed the resident (R1) was seen by a psychiatric team who recommended that the resident be admitted to the mental health because of the danger they pose to others and self. The administrator stated that the facility psychiatrist and the resident (R1) were communicated about what needed to be done about R1’s state of mind before agreeing voluntarily to treatment. The records also showed communication between the facility and the Los Angeles Downtown Medical Center about R1’s treatment plan for admission to mental health. On 06/20/2024, the department interviewed six staff (S1-S6) 4 out of 6 stated that no one can force any resident to be admitted to a mental health hospital other than the psychiatrist's approval.

See continued LIC9099-C

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 11-AS-20240619103658
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: CHATEAU LONG BEACH
FACILITY NUMBER: 197800131
VISIT DATE: 12/04/2024
NARRATIVE
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See continued LIC9099-C

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.

Allegation #3: Staff roughly handled the resident.

It is alleged that the staff handled the resident in a rough manner that caused the resident to be agitated. The department interviewed administrator #1 (A1) who stated that they did not receive any reports that residents had been handled roughly. The department reviewed the staff roster and found that the staff named in the complaint was the administrator who denied the allegation. The department interviewed eight residents (R1-R8), and 7 out of 8 residents denied the staff roughly handling them. Within that same group (R1-R8), 4 out of 8 stated that the staff have been disrespectful, pushing, and physically abused by the residents. The department interviewed six staff (S1-S6) with all of the staff denying the allegations, while also stating that staff members do not handle residents roughly nor do they ever see any staff roughly handling a resident. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation(s) did or did not occur, therefore the allegation is Unsubstantiated.

See continued LIC9099-C
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 11-AS-20240619103658
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: CHATEAU LONG BEACH
FACILITY NUMBER: 197800131
VISIT DATE: 12/04/2024
NARRATIVE
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Allegation #4: The facility is in disrepair (heater).

It is alleged that the facility is in disrepair and that the heater does not work. The resident stated that the heater in disrepair resulted in the staff providing the resident with a space heater that was labeled can causing cancer. The department and Administrator #1 (A1) toured the facility and inspected ten resident rooms (10) out of the (76) rooms inspected with heaters. In all 10 rooms, the ventilators were found working properly with comfortable temperatures observed. The department did not observe that the facility was unkept or in disrepair condition. A1 stated that the facility has a maintenance crew that is on call for regular minor services. The facility has a staff on call 24/7 in case any repair is needed. The department inspected the resident’s electrical outlet for any short circuits, and none were observed. The department observed the facility has fully functioning central air and heating. A1 stated that the facility has procedures in place for beginning and ending work shift duties to clean the facility. A1 stated that no repairs are being conducted in the facility and that the facility is not in disrepair. The department interviewed eight residents (R1-R8) with 7 out of 8 stating that the heater in their room was working fine. The same group of residents also stated a portable heater was given to the residents in case the resident didn’t want to use the wall heater. The department was not able to inspect R1's room. The department interviewed six staff members (S1-S6) with all 6 stating that the facility is cleaned daily. The department toured the outside grounds, and no bodies of water were observed. All exits and walkways around the facility were free of debris and hazards.
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.


See continued LIC9099-C
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 11-AS-20240619103658
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: CHATEAU LONG BEACH
FACILITY NUMBER: 197800131
VISIT DATE: 12/04/2024
NARRATIVE
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See Continued LIC9099-C

Allegation #5: Staff refused to provide resident their records upon request.

It is alleged that the staff refused to provide the resident with records of video footage, police reports, and eviction documents upon request. The department interviewed administrator #1 (A1) who stated that if a resident wanted a copy of their records, the facility would provide it to them. Also stated that R1 requested a copy of a police report dated 11/29/23 however, the facility did not have any police report for that date. The facility then provided R1 with the identification card police left upon their arrival at the facility on 11/28/23. Administrator #1 also stated that the resident requested a 1 years’ worth of video footage and an eviction notice. The facility did provide R1 with the eviction notice documents, but the facility could not provide video footage from a year from 11/29/23, because after seven days the footage is no longer available. R1 did confirm received the eviction documents for court. The department interviewed eight residents (R1-R8) with 6 out of 8 stating that the facility does provide them with a copy of their records when requested. The residents also stated that they received a copy of their admission agreement. The department interviewed six staff (S1-S6) with 4 out of 6 stating that when residents request a copy of a record within their facility file, they typically provide said record to the resident. The department reviewed the facility video log along with seven days of footage. The records revealed that the facility has a process before giving a resident a 30-day eviction notice, with approval from the Community Care Licensing.
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.

Allegation #6: Staff did not safeguard resident funds.

It is alleged that staff did not safeguard the resident’s funds which resulted in the resident missing money. The department interviewed eight residents (R1-R8) with 7 out of 8 denying the allegation. The same group also stated that they all have keys to their rooms and that no staff are allowed to enter their rooms without notice. The department records revealed that the resident is mostly responsible for keeping their room locked when they are not in the room.

See continued LIC9099-C



SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 11-AS-20240619103658
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: CHATEAU LONG BEACH
FACILITY NUMBER: 197800131
VISIT DATE: 12/04/2024
NARRATIVE
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See continued LIC9099-C

The Department interviewed eight residents (R1-R8) with 7 out of 8 denying having any issues with their funds at the facility. (R3-R4) mentioned that their main income is Supplemental Security Income (SSI), and that the facility is the payee. The basic monthly fee (rent) is deducted each month, and the rest is their Personal and Incidental (P&I). (R2 and R4) verified that they do not have an issue with the facility handling their funds, and they have had no discrepancies with their (P&I) funds. The Department interviewed administrator #1 (A1) who stated that not all residents’ funds are being handled by the facility as some of the residents handle their funds. As a result of the Department reviewing (R1-R8) Admissions Agreement 2 out of 8 residents’ Records of Client’s/Resident’s Safeguarded Cash Resources (dated: 11-29-23 through 06-20-24), there are no records of residents reporting any missing money in 2023. The department interviewed six Staff (S1-S6) 6 out of 6 and eight residents (R1-R8) 6 out of 8 revealed they had not heard or observed any staff withholding residents’ money. 2 out of 8 residents admitted they did have some money missing but they didn’t report it, because they were not sure where they lost it.

Based on interviews conducted, there is no sufficient evidence to corroborate the above allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is Unsubstantiated.


No deficiencies cited. Exit interview conducted. A copy of the report was provided to the Administration Esperanza Naaktgeboren..



SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 6