191600341-8-13-2025-11-AS-UCOL-DL7SM5-20250904135924

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191600341
Report Date: 08/13/2025
Date Signed: 08/13/2025 05:10:18 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/04/2025 and conducted by Evaluator Socorro Leandro

COMPLAINT CONTROL NUMBER: 11-AS-20250804235957

FACILITY NAME:	HUNTINGTON RETIREMENT HOTEL		FACILITY NUMBER:	191600341
ADMINISTRATOR:	HEATHER ARGUETA		FACILITY TYPE:	740
ADDRESS:	20920 EARL STREET		TELEPHONE:	(310) 370-5828
CITY:	TORRANCE	STATE: CA	ZIP CODE:	90503
CAPACITY:	155	CENSUS: 92	DATE:	08/13/2025
		UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Administrator - Heather Argueta		TIME COMPLETED:	05:10 PM

ALLEGATION(S):

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Questionable death.

INVESTIGATION FINDINGS:

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On 08/13/2025, Licensing Program Analyst (LPA) Socorro Leandro conducted a subsequent complaint investigation regarding the allegations listed above. LPA met with Resident Care Coordinator, Corina Kahl and the purpose of the visit was explained. The LPA was allowed entry to the facility.

The investigation consisted of the following:

On 08/06/2025, Resident 1’s (R1) records were gathered. R1’s records consisted of: Identification and Emergency Information dated 09/12/2024; Preplacement Appraisal Information dated 09/12/2024; Physician’s Report dated 10/04/2024; Service Assessment Form dated 10/04/2024; In-Home Communication Note from June 2025 to August 2025; Unusual Incident/Injury Report dated 08/01/2025; Death Report dated 08/05/2025. On 08/12/2025, Witness 1 (W1) was interviewed. On 08/13/2025, Staff 1 (S1) to Staff 5 (S5) were interviewed and records were reviewed.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:	DATE: 08/13/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20250804235957

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: HUNTINGTON RETIREMENT HOTEL	FACILITY NUMBER: 191600341
	VISIT DATE: 08/13/2025

NARRATIVE

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Allegation: “Questionable death”, it is being alleged that R1 passed away in the facility. Interviews conducted with W1 revealed the following: 1 out of 1 witness denied the allegation. Interviews conducted with S1, S2, and S3 (these staff are aware of the incident and/or are witnesses to the incident) revealed the following: 3 out of 3 staff denied the allegation. Records reviewed of R1 revealed the following: Unusual Incident/Injury Report dated 08/01/2025 indicates that on 08/01/2025, 911 was called and R1 was taken to the hospital; Death Report dated 08/05/2025 indicates that R1 passed away on 08/01/2025 in the hospital. Based on the department’s interviews and records reviewed this allegation is unfounded. Unfounded: This agency has investigated the complaint alleging "Questionable death." We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without reasonable basis. We have therefore dismissed the complaint.

No deficiencies were provided.

An exit interview was conducted, and a copy of this report was left with the Administrator, Heather Argueta and Resident Care Coordinator, Corina Kahl.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:	DATE: 08/13/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025

LIC9099 (FAS) - (06/04)

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