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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197800131
Report Date: 03/20/2025
Date Signed: 03/20/2025 04:06:58 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
03/11/2025 and conducted by Evaluator Lizeth Villegas
COMPLAINT CONTROL NUMBER: 11-AS-20250311082723
FACILITY NAME:CHATEAU LONG BEACHFACILITY NUMBER:
197800131
ADMINISTRATOR:ESPERANZA NAAKTGEBORENFACILITY TYPE:
740
ADDRESS:3100 E. ARTESIA BLVD.TELEPHONE:
(562) 428-5371
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY:184CENSUS: 93DATE:
03/20/2025
UNANNOUNCEDTIME BEGAN:
08:17 AM
MET WITH:Administrator Esperanza NaaktgeborenTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Facility staff are not preventing altercations between residents.
INVESTIGATION FINDINGS:
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On 03/20/25 Licensing Program Analyst (LPA) Villegas conducted a subsequent complaint visit regarding the allegation(s) above. LPA met with Administrator Esperanza Naaktgeboren as the purpose of the visit was explained.

The investigation consisted of the following: On 03/14/25 LPA obtained copies of the following: staff and resident roster, as well as the following documents for residents #1-2 (R1-R2), emergency ID form, physicians report, physicians orders, service plan, resident assessmnet form, and admission agreement.On 03/14/25 LPA obtain copies of in-services held on the following topics; synergy (hospice), proper body mechanics,medication, personal rights,team building, work place violience, how to disfuse altercations, and mandated reporting. On 03/14/25 from 9:30am- 12:25pm LPA conducted Interviews with residents #1-7 (R1-R7) , and between 12:45pm-1:40 pm LPA conducted interviews with staff #1-3 (S1-S3). On 03/20/25 LPA conducted interviews with staff #4-5 (S4-S5).
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025
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 2
Control Number 11-AS-20250311082723
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: 03/20/2025
NARRATIVE
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The investigation revealed the following:
Allegation: Facility staff are not preventing altercations between residents.

It is being alleged that facility staff are not preventing altercations between residents. On 03/14/25 from 9:30am- 12:25pm LPA conducted Interviews with R1-R7, 7 of 7 residents interviewed denied the allegation above and reported staff assist when needed. On 03/14/25 and 03/20/25 LPA conducted interviews with S1-S5, 5 of 5 staff interviewed denied the allegation above and reported that when am altercation is observed staff will separate residents involved, assess residents, call 911 as needed, and submit report to CCLD. On 03/20/25 LPA conducted a review of R1s and R2's physicians report and service plans, LPA did not observe any documentation on aggressive or inappropriate behaviors. On 03/20/25 LPA conducted a file review and did not observe an unusual incident reports regarding R1 and R2 submitted to CCLD.

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: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2