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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005884
Report Date: 03/26/2026
Date Signed: 03/26/2026 02:45:23 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/23/2026 and conducted by Evaluator Garlli Tat
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20260223132915
FACILITY NAME:LUXURY LIVING SENIOR CARE HUNTINGTON BEACHFACILITY NUMBER:
306005884
ADMINISTRATOR:LE, TINFACILITY TYPE:
740
ADDRESS:7261 SUNBREEZE DR.TELEPHONE:
(714) 600-7083
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92647
CAPACITY:6CENSUS: 4DATE:
03/26/2026
UNANNOUNCEDTIME BEGAN:
02:06 PM
MET WITH:JV AngelesTIME COMPLETED:
03:05 PM
ALLEGATION(S):
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Facility did not provide written notification of rate increase to responsible party.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Garlli Tat made an unannounced visit to the facility to deliver the findings on the above allegation. LPA met with staff on duty and explained the purpose of the visit. Staff on duty contacted administrator regarding the visit. Administrator provided verbal consent that staff can sign the report on his behalf. During the course of the investigation, LPA toured the facility, interviewed staff and residents, obtained and reviewed resident records including the rate increase letter and admission agreement.

Regarding the allegation that staff did not provide written notification of rate increase to the party responsible, the investigation revealed the following: Administrator provided a written notice of rate change to Resident 1's (R1) responsible party on December 9, 2025 after receiving notification from Community Care Licensing of the SSI rate change. Administrator included the PIN-15-19-CCLD, explanation of increase, the rate of increase and the date it would be in effect via text message. Responsible party verified they viewed the text message on December 9, 2025. Continued on LIC9099-C.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Garlli Tat
LICENSING EVALUATOR SIGNATURE:

DATE: 03/26/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2026
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 2
Control Number 22-AS-20260223132915
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: LUXURY LIVING SENIOR CARE HUNTINGTON BEACH
FACILITY NUMBER: 306005884
VISIT DATE: 03/26/2026
NARRATIVE
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The 90-day notice does not apply because R1 participates in the ALW program. The notification from Community Care Licensing regarding rate change was sent out on December 8, 2025, to all residential care providers. Page 5 of the Admission Agreement states, “if the facility rate changes to reflect a government fund increase, written notice from the licensee if required as soon as the facility is notified of the increase and the rate shall not take effect until the operative date of the government fund increase”. Administrator submitted a written notice a day after notification of the increase was received.

Based on the information above, the Department concluded that the allegation is Unfounded. A finding that an allegation is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis. An exit interview was conducted, and a copy of this report was provided to facility.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Garlli Tat
LICENSING EVALUATOR SIGNATURE:

DATE: 03/26/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2