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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603428
Report Date: 04/12/2026
Date Signed: 04/12/2026 08:53:06 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/03/2026 and conducted by Evaluator Tena Herrera
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260303153553
FACILITY NAME:REGENCY GRAND AT WEST COVINAFACILITY NUMBER:
198603428
ADMINISTRATOR:MIMS-BURRIS, MARYFACILITY TYPE:
740
ADDRESS:150 SOUTH GRAND AVENUETELEPHONE:
(626) 332-3344
CITY:WEST COVINASTATE: CAZIP CODE:
91791
CAPACITY:160CENSUS: 124DATE:
04/12/2026
UNANNOUNCEDTIME BEGAN:
07:05 AM
MET WITH:Tabatha Lenoue - Sales/Marketing DirectorTIME COMPLETED:
09:00 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility is in disrepair.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced subsequent complaint visit to deliver findings on the above allegation. LPA met with Tabatha Lenoue and explained the purpose of today's visit.

The investigation consisted of the following:

On 3/6/26 LPA conducted initial visit obtained copies of Staff and Resident Rosters, copy of invoice for plumbing and dry wall repairs, toured facility, interviewed 6 Staff (S1-S6) and 10 Residents (R1-R10). LPA requested for copies of roof inspection and bids to be forwarded to LPA via email.
On 3/10/26 LPA received and reviewed copies of the requested documents (plumbing invoice, invoice for drywall repairs, and Proposal/Bid for Roof repairs) and interviewed 1 Resident (R11) via phone call.

(Continued on LIC9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Tena Herrera
LICENSING EVALUATOR SIGNATURE:

DATE: 04/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2026
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 5
Control Number 28-AS-20260303153553
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: REGENCY GRAND AT WEST COVINA
FACILITY NUMBER: 198603428
VISIT DATE: 04/12/2026
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
Allegation: Facility is in disrepair.
It is alleged that there are ongoing leaks throughout the facility that begin on the third floor and extend down to the first floor, several ceiling tiles throughout the facility show water damage, and multiple AC vents are rusted. LPA toured facility and observed multiple areas that indicated previous leaks, observations were made in 2 resident bedrooms, throughout the ceiling panels on the 3rd floor, in the exercise room and dining room ceilings, and on the 1st floor hallway ceiling. LPA interviewed 11 residents and 6 out of 11 residents denied the allegation; 5 of the 11 residents stated they have had leaks in their rooms during the last storm or due to piping issues, but the leaks have since been replaced, all 11 residents stated that they have observed watermarks throughout the facility that suggest there was a leak or water damage. LPA interviewed 6 staff and 5 out of the 6 staff stated they have witnessed leaks in the facility. Interview with S5 and S6 revealed that the facility has had ongoing issues with leaks and plumbing and that they have had repairs done to fix these issues, the facility has had half of the roof repairs and is in process of getting the other half repairs, there has been quotes provided and the licensee is waiting on the owner of the property to agree and make the needed repairs. LPA was provided with the invoice to the most recent pipe repairs in that were completed in the 3rd floor laundry room, during tour LPA observed that the repairs to the laundry room were complete. LPA was also provided with the quote for roof repairs that was dated 2/19/26.

Based on LPAs observations, interviews which were conducted and facility record review, the preponderance of evidence standard has been met, therefore the above allegations is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6 and Chapter 8 are being cited on the attached LIC 9099D. Exit interview held, and a copy of this report and appeal rights were provided.
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Tena Herrera
LICENSING EVALUATOR SIGNATURE:

DATE: 04/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 28-AS-20260303153553
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: REGENCY GRAND AT WEST COVINA
FACILITY NUMBER: 198603428
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/12/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/27/2026
Section Cited
CCR
87303(a)
1
2
3
4
5
6
7
87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not met as evidence by:
1
2
3
4
5
6
7
Administrator/Licensee provided LPA with Invoices to the repairs for the plumbing repairs and copy of proposal for roof repair.

Administrator/Licensee to provide LPA with the scheduled date for the roof repair, provide details on how long repairs will take and if residents will be affected during the repairs. Photos of the ceiling panels being replaced on third floor are to be submitted to LPA via email (tena.herrera@dss.ca.gov). Additionally Administrator/Licensee is to provide LPA with a plan on how they will ensure that facility pluming and roof is in good repair and free from leaks at all times.
8
9
10
11
12
13
14
During facility tour LPA observed multiple ceiling panels missing, it was confirmed through interviews that there are leaks from the roof when it rains (LPA also observed water marks on the ceiling throughout the facility that also confirms a leak had been present) , and that there have been multiple plumbing leaks and repairs.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: David Sicairos
LICENSING EVALUATOR NAME: Tena Herrera
LICENSING EVALUATOR SIGNATURE:

DATE: 04/12/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/03/2026 and conducted by Evaluator Tena Herrera
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260303153553

FACILITY NAME:REGENCY GRAND AT WEST COVINAFACILITY NUMBER:
198603428
ADMINISTRATOR:MIMS-BURRIS, MARYFACILITY TYPE:
740
ADDRESS:150 SOUTH GRAND AVENUETELEPHONE:
(626) 332-3344
CITY:WEST COVINASTATE: CAZIP CODE:
91791
CAPACITY:160CENSUS: 124DATE:
04/12/2026
UNANNOUNCEDTIME BEGAN:
07:05 AM
MET WITH:Tabatha Lenoue - Sales/Marketing DirectorTIME COMPLETED:
09:00 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff are not responding to call pendants in a timely manner.
Facility staff are not meeting residents’ needs.
Facility staff does not ensure facility is free of mold.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced subsequent complaint visit to deliver findings on the above allegations. LPA met with Tabatha Lenoue and explained the purpose of today's visit.

The investigation consisted of the following:

On 3/6/26 LPA conducted initial visit obtained copies of Staff and Resident Rosters, copy of invoice for plumbing and dry wall repairs, toured facility, interviewed 6 Staff (S1-S6) and 10 Residents (R1-R10). LPA requested for copies of roof inspection and bids to be forwarded to LPA via email.
On 3/10/26 LPA received and reviewed copies of the requested documents (plumbing invoice, invoice for drywall repairs, and Proposal/Bid for Roof repairs) and interviewed 1 Resident (R11) via phone call.

(Continued on LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Tena Herrera
LICENSING EVALUATOR SIGNATURE:

DATE: 04/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 28-AS-20260303153553
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: REGENCY GRAND AT WEST COVINA
FACILITY NUMBER: 198603428
VISIT DATE: 04/12/2026
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
Allegation: Facility staff are not responding to call pendants in a timely manner.
It is alleged that R1 had experienced a fall in May 2025 and there was no response from the staff, R1 ultimately had to lift themselves back up without assistance. LPA interviewed 11 residents and 10 out of 11 residents denied the allegation; 6 of the 11 residents stated they have used their pendant for assistance and staff responded right away. LPA interviewed 6 staff and each denied the allegation, S1-S3 stated that when a resident pulls their call string or press their call pendant the call goes directly to the them, and if the assigned caregiver is busy assisting another resident they communicate with other caregivers via walkie talkies to ensure the residents are being attended to in a timely manner.
Allegation: Facility staff are not meeting residents’ needs.
It is alleged that residents are frequently not receiving required assistance, including help returning to their rooms after dinner, toileting assistance, and other routine care needs. LPA interviewed 11 residents and 10 out of 11 residents denied the allegation and stated they feel that staff are meeting their needs, 3 of the 11 residents stated they do see some residents waiting to be assisted at times but this is usually because staff are busy assisting other residents. LPA interviewed 6 staff and each denied the allegation; S3 explained that residents may wait a little longer to be assisted back to their rooms after meals as there are many residents that require assistance that finish their meals at the same time, therefore, there may be a bit of a wait at times. During tour LPA observed residents in the dining, and 3 residents in wheelchairs were observed being assisted by staff to another area.
Allegation: Facility staff does not ensure facility is free of mold.
It is alleged that there is mold within resident rooms. LPA toured facility and a total of 10 resident rooms were entered and inspected for mold, there was no present mold observed in any of the rooms, LPA did not observe any odors of mold in the rooms. During tour LPA observed ceiling panels missing on the 3rd floor hallway, where the missing panels were LPA observed dark spots and areas that appeared to be mold, S5 stated that there was previously a concerns of mold in the area, however, the area was treated with a mold treatment that kills mold at the root and prevents mold from returning. LPA interviewed 11 residents and 10 out of 11 residents denied the allegation and stated they have not seen any mold in their rooms or in the facility. LPA interviewed 6 staff and 5 out of 6 staff denied the allegation and stated that they have not seen or heard of there being mold in the facility.

Based on statements, interviews conducted with staff/residents and review of facility records, there was not enough supportive evidence to concur with the reported allegations. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. Exit interview held, and a copy of this report was provided.

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Tena Herrera
LICENSING EVALUATOR SIGNATURE:

DATE: 04/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5