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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320059
Report Date: 03/12/2026
Date Signed: 03/12/2026 10:10:20 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
03/10/2026 and conducted by Evaluator Jose Calderon
COMPLAINT CONTROL NUMBER: 11-AS-20260310110813
FACILITY NAME:OCEAN BREEZE CARE HOME IIFACILITY NUMBER:
198320059
ADMINISTRATOR:MACELLVEN, GREGFACILITY TYPE:
740
ADDRESS:26509 ROLLING VISTA DRTELEPHONE:
(310) 721-9667
CITY:LOMITASTATE: CAZIP CODE:
90717
CAPACITY:6CENSUS: 5DATE:
03/12/2026
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:ADMINISTRATOR GREG MACELLVENTIME COMPLETED:
10:00 AM
ALLEGATION(S):
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9
 Resident sustained multiple bruises due to staff neglect.
INVESTIGATION FINDINGS:
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On 03/12/2026 Licensing Program Analyst (LPA) Jose Calderon conducted an unannounced visit to Ocean Breeze Care Home 2 and was greeted by Administrator Greg Macellven (S1). LPA Calderon explained the purpose of this visit is to deliver the findings pertaining to the above-mentioned allegation.
The investigation consisted of the following: LPA Calderon interviewed Staff S1-S2, residents R1-R4, W1. LPA Calderon obtained the following records: Physician report (dated 01/28/2026), for R1. Toured the facility with S1
The investigation revealed the following:
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Jose Calderon
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2026
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-20260310110813
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: OCEAN BREEZE CARE HOME II
FACILITY NUMBER: 198320059
VISIT DATE: 03/12/2026
NARRATIVE
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Regarding the Allegation: Resident sustained multiple bruises due to staff neglect.

This complaint alleged that the facility neglected R1 causing bruises. LPA Calderon witnessed staff moving residents with no issues and there were no negative interactions between staff and residents. LPA Calderon noted residents having breakfast. LPA Calderon noted 4 residents at the dining table. All residents looked well and in good health. Records review indicate the following: Physician report (dated 01/28/2026) indicates that R1 has health issues and cognitive issues. Interviews indicate the following: W1 indicates that W1 visits R1 every day and staff take care of R1 needs. W1 indicates that staff does not neglect R1. W1 indicates that R1 has thin skin and bruises easily. S1-S2 deny the allegation. R2-R4 deny the allegation.

Based on interviews and supporting documentation, the preponderance of evidence standard has NOT been met therefore, the allegation of “resident sustained multiple bruises due to staff neglect” is found to be UNSUBSTANTIATED.

No deficiencies cited during today's visit.



An exit interview was conducted, and a copy of the Complaint Report was provided to the Administrator Greg Macellven (S1).
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Jose Calderon
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2