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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602567
Report Date: 05/08/2025
Date Signed: 05/08/2025 12:39:06 PM

Document Has Been Signed on 05/08/2025 12:39 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME:REGENCY PALMS LONG BEACHFACILITY NUMBER:
198602567
ADMINISTRATOR/
DIRECTOR:		KENIA SANCHEZ PADILLAFACILITY TYPE:
740
ADDRESS:117 E 8TH STREETTELEPHONE:
(562) 432-9260
CITY:LONG BEACHSTATE: CAZIP CODE:
90813
CAPACITY: 91CENSUS: 74DATE:
05/08/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Executive Director, Fabiola MarcianoTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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This report supersedes, report dated 04/23/2025 to add additional information and additional citations.

On 05/08/2025 at 11:15am Licensing Program Analyst (LPA) Zina Brown conducted an unannounced Case Management visit to issue deficiencies found during complaint investigation 11-AS-20250417101102. LPA met with Executive Director, Fabiola Marciano and explained the purpose of the visit.

On the following dates, 1/6/2025 and 4/18/2025, the department received video surveillance from a shared residents' room. The videos received were from various angles inside the shared residents' room. The video surveillance also has audio component.

On 4/23/2025, LPA conducted an interview with Executive Director (ED) Fabiola Marciano and the ED stated she was aware of the video surveillance in resident rooms and confirmed that no consent forms are on file. The ED also confirmed Regency Palms did not submit to Community Licensing a waiver request for the use of video surveillance in resident rooms.

LPA conducted a file review of Resident #1 (R1) – Resident #7 (R7). Review of the Admissions Agreement observed on page 6 under Miscellaneous, which states, "10.9 Due to the privacy of the residents, residents will not have nanny cams in their apartment."

Report continues on LIC 809-C

NAME OF LICENSING PROGRAM MANAGER: Janae Hammond
NAME OF LICENSING PROGRAM ANALYST: Zina Brown
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/08/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: REGENCY PALMS LONG BEACH
FACILITY NUMBER: 198602567
VISIT DATE: 05/08/2025
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Based on the interviews conducted and records reviewed, Regency Palms Long Beach violated residents' personal rights by allowing video surveillance in residents with shared rooms. Regency Palms Long Beach did not adhere to its Plan of Operation by allowing the use of video surveillance in the room of Resident #1 (R1) - Resident #7 (R7). Regency Palms Long Beach failed to comply with Title 22 Regulations and the Evaluator Manual section 2-5800 Guidance on using Video Surveillance.

Deficiencies cited under California Code of Regulation Title 22 Division 6 Chapter 8 are being cited on the attached LIC 809-D.

Exit interview conducted with Executive Director - Fabiola Marciano and copy of this report was provided with appeal rights.

NAME OF LICENSING PROGRAM MANAGER: Janae Hammond
NAME OF LICENSING PROGRAM ANALYST: Zina Brown
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/08/2025 12:39 PM - It Cannot Be Edited


Created By: Zina Brown On 05/08/2025 at 11:39 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: REGENCY PALMS LONG BEACH
FACILITY NUMBER: 198602567

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/08/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type B
06/08/2025
Section Cited
CCR
87208(a)

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Plan of Operations: The licensee shall have and maintain a current, written definitive plan of operation for the facility. The licensee shall operate the facility in accordance with the terms specified in the plan of operation. . . This requirement is not met as evidenced by:
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The licensee will provide the Department with an updated copy of the Admission Agreement as a means to update the facility Plan of Operation on file with the Department by POC due date.
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Based on interviews conducted and records review the facility is not following the approved plan of operation by allowing the use of video surveillance in resident rooms. This poses as a personal rights risk to residents in care.
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Deficiency Dismissed
Type B
06/09/2025
Section Cited
CCR87468.2(a)(1)

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Additional Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities. . . to have a reasonable level of personal privacy in accommodations. This requirement is nor met as evidenced by: Based on interview conducted and record review. . .
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The licensee will submit a plan that states fully complying with the tems outlined in it's Admission Agreement and all applicable sections in the California Code of Regulations Title 22, Section 87468, regarding the unauthorized video surveillance in residents living areas or other areas . . .
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Residents #1-7 currently have video surveillance with audio component. 5 of 7 residents are in shared rooms where the video surveillance are located. The facility does not have consent forms on file or approved waiver from licensing in compliance with EM 2-5800.
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where privacy is expected. The facility will not allow the installation or use of video surveillance in residents apartment which will outline the facility Admission Agreement and Plan of Operation filed with DSS by POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Janae Hammond
NAME OF LICENSING PROGRAM MANAGER:
Zina Brown
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/08/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/08/2025


LIC809 (FAS) - (06/04)
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