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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608029
Report Date: 11/06/2025
Date Signed: 11/06/2025 12:57:52 PM

Substantiated


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
10/27/2025 and conducted by Evaluator Jose Anguiano
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20251027112748
FACILITY NAME:VISTA DEL MAR SENIOR LIVINGFACILITY NUMBER:
197608029
ADMINISTRATOR:SUZETTE JOHNSONFACILITY TYPE:
740
ADDRESS:3360 MAGNOLIA AVENUETELEPHONE:
(562) 595-1559
CITY:LONG BEACHSTATE: CAZIP CODE:
90806
CAPACITY:300CENSUS: 248DATE:
11/06/2025
UNANNOUNCEDTIME BEGAN:
09:27 AM
MET WITH:Colleen RozattiTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Staff did not ensure facility was free from pests.
INVESTIGATION FINDINGS:
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On 11/06/2025, Licensing Program Analyst (LPA) Jose Anguiano conducted a subsequent complaint investigation regarding the above allegation to deliver findings and met with Interim Administrator Colleen Rozatti.
On 11/05/2025, Licensing Program Analyst (LPA) Jose Anguiano conducted an initial complaint investigation. Investigation consisted of the following: LPA toured the facility inside and out, including resident rooms, common areas, kitchen, and storage areas. LPA interviewed eleven (11) residents (R1–R11) and eight (8) staff members (S1–S8). LPA also reviewed and collected the following records: Admissions Agreement, Personnel Report, Resident Roster, Housekeeping/Laundry Task Legend and Work Log, four (4) Dewey Pest Control Apartment Service Logs, three (3) Dewey Pest Control Invoices for the months of August, September, and November, four (4) Waxie Sanitary Supply Invoices for cleaning products, one (1) carpet cleaning invoice, and two (2) CR&R invoices for Monday through Saturday trash and recycling pickup.

Please see LIC9099-C for report continuation.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Jose Anguiano
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
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 3
Control Number 11-AS-20251027112748
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: VISTA DEL MAR SENIOR LIVING
FACILITY NUMBER: 197608029
VISIT DATE: 11/06/2025
NARRATIVE
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Investigation revealed the following: Regarding the allegation, “Staff did not ensure the facility was free from pests,” it was alleged that staff did not ensure the facility was free from pests, specifically cockroaches. LPA interviewed eight (8) staff members and eleven (11) residents. Of those interviewed, one staff member and three residents confirmed ongoing issues with pests, specifically cockroaches. Residents reported sightings in their rooms and expressed concern about the facility’s ability to maintain a pest-free environment. Interviews with housekeeping staff confirmed that they alternate shifts and clean 2–3 times per day. However, despite these efforts, the presence of live and dead cockroaches observed during the visit indicates that current cleaning practices have not been effective in preventing pest activity. Records reviewed included pest control documentation from Dewey Pest Control, which showed that in October 2025, only 40 out of 165 resident rooms were fogged for cockroaches. Service logs dated 10/01, 10/15, 10/18, and 10/22 each documented fogging of only 10 rooms per visit. Sanitation conditions were marked as “Fair” in most rooms, with two rooms on 10/01 noted as “Poor.” Additionally, LPA reviewed the facility’s housekeeping and maintenance work logs. The logs confirmed that 165 resident rooms require cleaning, not including common areas. The housekeeping work log showed that two housekeeping staff (S3–S4) are assigned to clean the floor where Resident (R1) resides. During the tour, LPA observed and photographed three live cockroaches and four dead cockroaches inside Resident Room R1, confirming the presence of pests.

Although the facility has a pest control contract and cleaning protocols in place, the limited scope of treatment, inconsistent cleaning practices, and direct observation of live pests support the allegation. Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard has been met; therefore, the above-mentioned allegation is found to be SUBSTANTIATED. This is a violation of California Code of Regulations, Title 22, Division 6, Chapter 8. A citation is being issued on the attached (LIC-9099D). An exit interview, a copy of this report and appeal rights were provided to the Administrator.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Jose Anguiano
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 11-AS-20251027112748
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: VISTA DEL MAR SENIOR LIVING
FACILITY NUMBER: 197608029
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/20/2025
Section Cited
CCR
87303(a)(f)
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Maintenance and Operation…facility shall be clean…sanitary…at all times…for the safety…of residents...(f) All waste shall be located…and disposed of in a manner that will not…provide a breeding place or food source for insects or rodents. This requirement was not met as evidence by:
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Administrator and staff will meet to develop a plan to address and eliminate the cockroach infestation. The facility agreed to submit proof of treatment and corrective actions to LPA Jose Anguiano atjose.anguiano@dss.ca.gov by due date.
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Based on observations and record review, the licensee did not maintain a clean and sanitary environment. On 11/05/2025, LPA observed and photographed live and dead cockroaches in one resident room.This poses a potential health and safety risk to residents in care.
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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: Ulysses Coronel
LICENSING EVALUATOR NAME: Jose Anguiano
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
LIC9099 (FAS) - (06/04)
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