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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197800131
Report Date: 07/23/2025
Date Signed: 07/23/2025 03:46:00 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
07/11/2025 and conducted by Evaluator Lizeth Villegas
COMPLAINT CONTROL NUMBER: 11-AS-20250711095008
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: 103DATE:
07/23/2025
UNANNOUNCEDTIME BEGAN:
10:33 AM
MET WITH:Olivia AlvaradoTIME COMPLETED:
03:43 PM
ALLEGATION(S):
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Staff do not ensure that resident's dietary needs are met.
INVESTIGATION FINDINGS:
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On 7/23/25 at 10:45 am Licensing Program Analyst (LPA) Villegas conducted a subsequent complaint visit regarding the allegation(s) above. LPA met with Olivia Alvarado as the purpose of today’s visit was explained.

The investigation consisted of the following: On 7/17/25 LPA Villegas obtained copies of the staff and resident roster, and copies of the following documents for Resident #1 (R1) face sheet, Physicians report dated:3/27/25, service plan dated: 3/21/25, pre appraisal dated: 1/30/25, resident assessment form dated: 3/21/25, MAR for July 2025, conservatorship paperwork, diet slip dated 2/6/23, and unusual incident reports dated: 3/28/25, and 7/16/25. On 7/17/25 LPA conducted interview with staff #1 (S1). On 7/23/25 at 11:30 am LPA conducted a tour of facility kitchen, and at 12pm LPA observed lunch service. On 7/23/25 from 1pm-1:45 pm LPA conducted interviews with resident 2-10 (R2-R10), R1 refused to be interviewed. On 7/23/25 from 2pm-2:45 pm LPA conducted interviews with S2-S5.

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

DATE: 07/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2025
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-20250711095008
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: 07/23/2025
NARRATIVE
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Allegation: Staff do not ensure that resident's dietary needs are met.

It is being alleged that R1 is the last to be fed, is served leftovers, and sometimes is not served food. On 7/23/25 from 1pm-1:45 pm LPA conducted interviews with R2-R10 regarding the allegation above, 9 of 9 residents interviewed denied the allegation above. Per 9 of 9 residents interviewed, there are no concerns about the meals being provided. 9 of 9 residents report that they are provided with 3 meals are provided along with snacks in between. On 7/23/25 R1 refused to be interviewed. On 7/17/25 and 7/23/25 LPA conducted interviews with S1-S5 regarding the allegation above, 5 of 5 staff denied the allegation above. On 7/23/25 3 of 5 staff interviewed reported that the food served at the facility is made fresh daily, and report that the quantity of food made is enough to give residents a second serving upon request. On 7/23/25 at 11:30 am LPA conducted a tour of facility kitchen, LPA observed kitchen pantry, walk-in refrigerator and freezer to be stocked and dated. LPA also observed an emergency food and water supply to be available if needed. On 7/23/25 LPA observed Lunch service, LPA observed residents being seated promptly and observed meals being served within 5-10 minutes. LPA observed R1 to have lunch. On 7/23/25 LPA conducted a review of R1's assessment form dated: 3/21/25, and Physicians report dated:3/27/25, per reports R1 is able to self feed nor requires a tray service.

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(s) is unsubstantiated.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2