197608029-2-23-2026-11-AS-JHAD-DS42TV-20260311174122

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608029
Report Date: 02/23/2026
Date Signed: 02/23/2026 07:09:43 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
02/20/2026 and conducted by Evaluator Ernand Dabuet

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20260220150636

FACILITY NAME:	VISTA DEL MAR SENIOR LIVING		FACILITY NUMBER:	197608029
ADMINISTRATOR:	SUZETTE JOHNSON		FACILITY TYPE:	740
ADDRESS:	3360 MAGNOLIA AVENUE		TELEPHONE:	(562) 595-1559
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90806
CAPACITY:	300	CENSUS: 238	DATE:	02/23/2026
		UNANNOUNCED	TIME BEGAN:	09:02 AM
MET WITH:	Suzette Johnson		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Staff handled resident in an aggressive manner.

INVESTIGATION FINDINGS:

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On February 23, 2026, the California Department of Social Services/Community Care Licensing (CDSS/CCL) Licensing Program Analyst (LPA) Ernand Dabuet conducted an initial unannounced complaint visit. Suzette Johnson Executive Director greeted the LPA. LPA explained that the purpose of the visit is to investigate the allegation mentioned above.

The investigation included a collection of records, interviews and tour of the facility. The Department collected service records for Resident #1 (R1), Physician's Report LIC 624 (dated 12/15/25), Face Sheet and Emergency Informaition (dated 12/29/25), Service Plan (dated 12/31/25), Medication Administration Record and Physicians Orders (dated 02/23/26), Unusual Incident Report LIC 624 (dated 02/20/26) and other documents pertinent or associated with this complaint.

(Evaluation Report contnues LIC 9099-c)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2026

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 4

Control Number 11-AS-20260220150636

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: 02/23/2026

NARRATIVE

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INVESTIGATION REVEALED THE FOLLOWING:

Allegation: Staff handled residents in an aggressive manner.

The complaint alleges that staff at a facility handled Resident #1 (R1) aggressively. On February 14, 2026, both (R1) and Resident #2 (R2) attempted to use the restroom at the same time. According to reports, a staff member aggressively grabbed (R1), pulled (R1) out of the restroom, pinched (R1's) arm, and hit (R1's) head. Further investigations revealed no visible markings or bruises on (R1); however, the administrator stated that an internal investigation was conducted, resulting in the termination of the staff member involved. No further information has been provided regarding this situation.

On February 23, 2026, between 10:20 AM and 02:10 PM, the Department interviewed residents members identified as Resident #1 through Resident #11 (R1-R11). Ten (10) out of eleven (11) residents could not validate this claim. (R2-R11) were under the care and supervision of Staff #1 (S1) on February 14, 2026. All residents praised the staff for their professionalism and courteous behavior. They confirmed that they had never experienced or witnessed any aggressive mistreatment of residents. (R2-R11) stated that if such inappropriate behavior were observed, it would be reported to management or Community Care Licensing (CCL).

During the interview (R1) reported a mistreatment incident involving Staff #1 (S1), claiming that the (S1) roughly grabbed (R1) by the left arm and struck (R1) several times on the head. (R1) stated that (R2) was present during the incident but not in any way involved in the restroom issue. (R1) did not provide the staff’s name or a clear description and claimed to have called 9-1-1 for law enforcement, but they did not arrive. The statement from (R1) disputes the information reported to (CCL). (R1) mentioned that, despite being struck multiple times on the head, no medical attention was deemed necessary, and this was not reported to management. According to (R2), no such incident occurred. (R2) stated that any inappropriate behavior by staff will be reported immediately and clarified that no such incident has ever occurred on February 14, 2026.

On February 23, 2026, between 09:30 AM and 12:00 PM, the Department interviewed staff members identified as Staff #2 through Staff #5 (S2-S5). Four (4) out of the four (4) staff members could not corroborate this claim involving (R1) and (S1). All staff members were verified to have acted appropriately, both verbally and physically, towards the residents.

(Evaluation Report continues LIC 9099-C)

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2026

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20260220150636

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: 02/23/2026

NARRATIVE

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(S3) and (S4), who were working on the day of the incident, did not witness any inappropriate behavior by staff members. However, they received inconsistent accounts of what transpired between (R1) and (S1). (S3) reported to have walked in during the incident involving (R1) and noted that (R1) appeared agitated while getting out of the shower. According to (S3), (S1) left the scene after supervising (R1) out of the shower, and there was no physical engagement with (R1). (S3-S4) examined (R1) and did not observe any injuries or bruises on (R1). Both (S3) and (S4) confirmed that (R2) was present in the room when this incident occurred. Both (S2 and S5) stated that an investigation was conducted. They clarified that S1 is not an employee of Vista Del Mar but rather of Great Comfort Home Care, which the facility uses for staffing. Additionally, (R1) provided inconsistent accounts of what occurred. (S5) further clarified that (S1) was not terminated, as was previously reported.

On February 23, 2026, between 02:00 PM and 02:30 PM, the Department interview witness identified as Witness #1 (W1) by telephone. (W1) has information about the incident from (R1) but did not witness it. (W1) also noted that (R1) tends to distort statements unintentionally and may have confabulation issues.

The Department made several attempts to contact Staff #1 (S1) for an interview, but the calls went unanswered and were not returned.

During the investigation on February 23, 2026, the Department observed staff members interacting with residents and noted that their conduct was appropriate. The Department found that the facility upholds the rights of its residents. Posters detailing Resident Rights, Personal Rights, were displayed prominently throughout the facility. The Department inspected for bodily injuries on (R1) and found none. Furthermore, recent phone records show no log of (R1) making any 9-1-1 calls on February 14, 2026, confirming that there was no emergency.

The Department reviewed Resident #1 (R1’s) Medical Assessment for Residential Care Facilities for the Elderly LIC 624A (dated 12/15/25), Face Sheet and Emergency Information (dated 12/29/25), Service Plan (dated 12/31/25), Preplacement Appraisal Information LIC603A (dated 12/30/25) and Unusual Incident Report LIC 624 (dated 02/2025) revealed that (R1’s) medical diagnosis contributes to (R1’s) line of thinking/belief system. Further review of Medication Administration and Physician’s Orders (dated 02/23/26) revealed (R1) is on 19 prescribed medications and (8) of the (19) contribute to risk of unusual bruising and mental status conditions of dizziness and confusion (ref: National Institute of Health).

(Evaluation Report continues LIC 9099-C)

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 11-AS-20260220150636

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: 02/23/2026

NARRATIVE

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Based on the information gathered, there is not enough evidence to support the allegation mentioned above.

Based on the information gathered from the facility inspection, observations, interviews, and records analysis, the Department found no evidence to support the above allegation. The allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is Unsubstantiated.

An exit interview was conducted with Suzette Johnson, and copies of the reports were provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2026

LIC9099 (FAS) - (06/04)

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