<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602567
Report Date: 06/25/2025
Date Signed: 06/25/2025 03:41:37 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
05/27/2025 and conducted by Evaluator Lizeth Villegas
COMPLAINT CONTROL NUMBER: 11-AS-20250527101835
FACILITY NAME:REGENCY PALMS LONG BEACHFACILITY NUMBER:
198602567
ADMINISTRATOR:KENIA SANCHEZ PADILLAFACILITY TYPE:
740
ADDRESS:117 E 8TH STREETTELEPHONE:
(562) 432-9260
CITY:LONG BEACHSTATE: CAZIP CODE:
90813
CAPACITY:91CENSUS: 74DATE:
06/25/2025
UNANNOUNCEDTIME BEGAN:
12:48 PM
MET WITH:Wellness Director Monique AvilaTIME COMPLETED:
03:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Resident sustained unexplained injuries while in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 06/25/25 Licensing Program Analyst (LPA) Villegas conducted a subsequent complaint visit regarding the allegation(s) above. LPA met with as the purpose of today’s visit was explained.

The investigation consisted of the following: On 05/28/25 LPA Villegas obtained copies of the staff and resident roster, and copies of the following documents for Resident #1 (R1) face sheet, admission agreement dated: 10/29/2024, Preplacement appraisal dated 09/16/2024, assessment dated 07/30/2024, individual service plan dated: 07/30/2024, Physicians report dated: 09/09/2024, fall risk notice dated 09/26/2024, current physicians orders, medication administration records from April 2025-May 2025, and resident notes. On 06/04/24 from 10:15am- 11:23am LPA conducted interviews with resident#2-7 (R2-R7), LPA unable to interview R1 as R1 is on isolation. On 06/04/25 and 06/13/25 LPA conducted interviews with staff #1-5 (S1-S5). On 06/4/25 from 12:55pm-1:45pm LPA conducted a records review. On 06/25/25 LPA attempted to interview R1, on 06/25/25 conducted a tour of the facility.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2025
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-20250527101835
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: REGENCY PALMS LONG BEACH
FACILITY NUMBER: 198602567
VISIT DATE: 06/25/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPA conducted a records review.

The investigation revealed the following:

Allegation: Resident sustained unexplained injuries while in care.

It Is being alleged that resident in care has bruising on both arms. On 06/04/24 from 10:15am- 11:23am LPA conducted interviews with R2-R7 regarding the allegation above, 6 of 6 residents interviewed denied the allegation above and reported feeling safe when being assisted by staff. On 06/04/25 and 06/13/25 LPA conducted interviews with S1-S5 regarding the allegation above, 5 of 5 staff interviewed denied the allegation above. Per 5 of 5 staff interviewed, body checks are conducted daily and any bruising or change in condition is communicated to both Primary Care Physicians and families. On 06/03/25 LPA conducted interview with responsible party for R1, per responsible party there are no current safety concerns as responsible party has been in communication with both the facility and Primary Care Physician about the bruising. Responsible party also reported being aware that R1 has scratched and cause harm to self. On 06/23/25 LPA conducted a review of R1’s file, resident notes dated 05/25/25, 05/26/25, 05/22/25, and 05/18/25 indicated that R1 has been fixated on arms, rubbing arms with friction and picking arms causing bruising. On 05/04/25 primary care physician faxed an order for re-evaluation and adjust medications due to physical aggression. On 06/25/25 LPA attempted to interview R1, R1 was sleeping at the time of visit.

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 is unsubstantiated.



Exit interview conducted, and a copy of this report was provided.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2