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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320508
Report Date: 03/03/2026
Date Signed: 03/03/2026 04:24:12 PM

Substantiated


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
02/20/2026 and conducted by Evaluator Regina Cloyd
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20260220132544
FACILITY NAME:ACE ELDERLY HOMESFACILITY NUMBER:
198320508
ADMINISTRATOR:LIWANAG, FRANCISFACILITY TYPE:
740
ADDRESS:23223 PRYOR PLACETELEPHONE:
(310) 985-1059
CITY:HARBOR CITYSTATE: CAZIP CODE:
90710
CAPACITY:6CENSUS: 4DATE:
03/03/2026
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Lucia RamosTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Staff are not allowing a resident to have a visitor.
INVESTIGATION FINDINGS:
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On 03/03/2026, Licensing Program Analyst (LPA) Regina Cloyd conducted a subsequent visit to gather information regarding the above allegation. LPA met with Staff and the purpose of the visit was explained. LPA spoke with Administrator Frances Liwanage over the phone.

Investigation consisted of the following: On 03/02/2026, LPA obtained Personnel Report (dated 09/10/25), Register of Residents (no date), House Rules, Visitor Logs (01/03/26 – 03/02/26), R1 – R4’s Identification and Emergency Information, R1’s Agent Notice (02/20/26), Admission Agreement, Advanced Health Care Directive (page 2 and 12 only), Physician’s Report, Hospice Plan of Care, Personal Rights, and Theft and Loss Policy. LPA interviewed Staff #1 – 3, Witness #1, and Resident #2. On 03/02/26 5:39 PM, LPA received R1’s Advanced Health Care Directive (11/09/2021). On 03/03/26, LPA interviewed Staff #1 and #3. Note: Resident #1 is deceased.

Continue to LIC9099-C.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE:

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

DATE: 03/03/2026
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 3
Control Number 11-AS-20260220132544
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: ACE ELDERLY HOMES
FACILITY NUMBER: 198320508
VISIT DATE: 03/03/2026
NARRATIVE
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Investigation revealed the following:

Regarding the allegation, “Staff are not allowing a resident to have a visitor,” it is being alleged Staff #1 (S1) banned a family member from visiting Resident #1 (R1) by getting authorization from Witness #1 (W1). Record review of Resident #1 (R1) Advance Health Care Directive revealed Witness #1 (W1) as R1's Health Care Agent. It revealed R1’s health care agent must make health care decisions that are consistent with my instructions in this document, if any, and other wishes known by my agent. Otherwise, my agent must make health care decisions that he or she believes to be in my best interest, considering what he or she knows about my personal values. This form does not give my health care agent the authority to make financial or other business decisions. Review of My Values and Beliefs (Part 2), My Health Care Instructions (Part 3), My Hope and Wishes (Optional) (Part 4) are blank in the Advance Health Care Directive. Review of Health Care Agent’s (written) Notice revealed W1 prohibited a family member from visiting R1 as of 02/20/2026. On 03/02/26 10:36 AM, interview with W1 indicated W1 has power of attorney over R1's medical and has the paperwork (Advance Health Care Directive). Staff #1 (S1) indicated the family member came to visit and was informed that W1 said the family member could not visit R1. S1 reported the incident to W1. R1 passed away on 02/25/2026.

Regarding the allegation, “Staff are not allowing a resident to have a visitor,” based on record review and interviews, the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be substantiated. California Code of Regulations, Title 22, Division 6 are being cited on the attached LIC 9099D.

An exit interview was conducted, plans of correction developed, and a copy of this report with the appeal rights was provided to Staff Lucia Ramos.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE:

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

DATE: 03/03/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Citations on this Visit Report are Under Appeal!

Control Number 11-AS-20260220132544
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: ACE ELDERLY HOMES
FACILITY NUMBER: 198320508
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/03/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Under Appeal
Type B
03/18/2026
Section Cited
CCR
87468.1(a)(11)
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(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (11) To have their visitors...permitted to visit privately during reasonable hours and without prior notice, provided that the rights of other residents are not infringed upon.
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The Administrator will submit a plan of correction to regina.cloyd@dss.ca.gov by the POC due date.
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This requirement was not met:

Based on record review and interviews, staff prohibited a visitor from visiting with Resident #1 which posed a potential personal rights risk to client in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE:

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

DATE: 03/03/2026
LIC9099 (FAS) - (06/04)
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