198320470-4-2-2026-11-AS-UCOL-DT8S8X-20260417133951

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320470
Report Date: 04/02/2026
Date Signed: 04/02/2026 04:51:40 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
03/24/2026 and conducted by Evaluator Regina Cloyd

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20260324110344

FACILITY NAME:	SERENITY SENIORS HOME		FACILITY NUMBER:	198320470
ADMINISTRATOR:	RICHARDSON, ANTOINETTE		FACILITY TYPE:	740
ADDRESS:	14043 S NORTHWOOD AVE		TELEPHONE:	(310) 763-7879
CITY:	COMPTON	STATE: CA	ZIP CODE:	90222
CAPACITY:	4	CENSUS: 4	DATE:	04/02/2026
		UNANNOUNCED	TIME BEGAN:	09:32 AM
MET WITH:	Maya Astier		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Staff does not provide adequate food service for residents.
Staff does not ensure residents' showering needs are being met.
Staff left resident covered in insects.
Staff curses at residents.

INVESTIGATION FINDINGS:

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On 04/02/2026, Licensing Program Analyst (LPA) Regina Cloyd conducted an initial visit to gather information regarding the above allegations. LPA met with Administrator and Licensee Maya Astier and the purpose of the visit was explained.

Investigation consisted of the following: On 04/02/2026, LPA obtained Personnel Report, Register of Residents, Menu (March and April 2026), Pest Control Invoice and Residents #1 - #4 Emergency Contact, Physician’s Report, Patient Visit Summary, IPP, and Medication Administration Records (February 1, 2026 – April 2, 2026). LPA interviewed Staff #1 – 4 and Witness #1 – 4 and toured the kitchen area and reviewed the medication.

Investigation revealed the following:
Regarding the allegation, “Staff does not provide adequate food service for residents.,” it is being alleged staff does not feed residents nor allow them to receive snacks throughout the day. Continue to LIC9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE:	DATE: 04/02/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2026

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-20260324110344

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: SERENITY SENIORS HOME	FACILITY NUMBER: 198320470
	VISIT DATE: 04/02/2026

NARRATIVE

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Record review of menu revealed breakfast, lunch, dinner, and two snacks are provided. LPA observed adequate amount of perishables in the refrigerator, food in the deep freezer, and canned goods. Four out of four staff interviews (S1 – S4) denied the allegation. S2 indicated that residents eat breakfast and dinner at the facility and lunch at the day program. S3 indicated residents’ meals varies because they attend day program but on the weekend they have lunch at noon, snacks at 9:00 AM and 3:00 PM, and dinner with dessert. Interview with Responsible Parties (W1 – W3) denied the allegation.

Regarding the allegation, “Staff does not provide adequate food service for residents,” based on observation, record review and interviews, the Department found no evidence to support the allegation mentioned above. 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, as a result, the allegation is Unsubstantiated.

Allegation: Staff does not ensure residents' showering needs are being met.

Record review of physician’s report revealed Resident #1 and Resident #4 needs assistance with bathing and Resident #2 needs some assistance. Four out of four staff interviews (S1 – S4) denied the allegation. S2 – S4 indicated residents receive showers every day after Day Program. Interview with Responsible Parties (W1 – W3) denied the allegation.

Regarding the allegation, “Staff does not ensure residents' showering needs are being met.” based on record reviews and interviews, the Department found no evidence to support the allegation mentioned above. 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, as a result, the allegation is Unsubstantiated.

Allegation: Staff left resident covered in insects.

It is being alleged, staff allowed a resident to be covered in ants for a while. Record review of Pest Control invoice revealed flea treatment was provided on 10/30/2025. Four out of four staff interviews (S1 – S4) denied the allegation. S1 indicated the facility had an ant problem on the exterior and in the kitchen but never in the residents’ rooms. Interview with Responsible Parties (W1 – W3) denied the allegation.
Continue to LIC9099-C.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE:	DATE: 04/02/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2026

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20260324110344

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: SERENITY SENIORS HOME	FACILITY NUMBER: 198320470
	VISIT DATE: 04/02/2026

NARRATIVE

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Regarding the allegation, “Staff left resident covered in insects,” based on record reviews and interviews, the Department found no evidence to support the allegation mentioned above. 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, as a result, the allegation is Unsubstantiated.

Allegation: Staff curses at residents

Three out of three staff interviews (S1 – S2, S4) denied the allegation. Interview with Responsible Parties (W1 – W3) denied the allegation.

Regarding the allegation, “Staff curses at residents, based on interviews, the Department found no evidence to support the allegation mentioned above. 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, as a result, the allegation is Unsubstantiated.

No deficiencies were cited.

An exit interview was conducted and a copy of this report was provided to the Licensee Maya Astier.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE:	DATE: 04/02/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2026

LIC9099 (FAS) - (06/04)

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