197608029-5-20-2026-11-AS-UCOL-DUUTER-20260608144021

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608029
Report Date: 05/20/2026
Date Signed: 05/20/2026 01:12:25 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
05/12/2026 and conducted by Evaluator Mario Leon

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20260512153126

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: 243	DATE:	05/20/2026
		UNANNOUNCED	TIME BEGAN:	08:07 AM
MET WITH:	Sidonia Cordis - Resident Care Director		TIME COMPLETED:	01:22 PM

ALLEGATION(S):

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Staff speaks inappropriately to resident in care

INVESTIGATION FINDINGS:

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On 05/20/26 Licensing Program Analyst (LPA) Mario Leon conducted an initial, unannounced, complaint visit at the facility. California Department of Social Services (CDSS) was met by staff two, Sidonia Cordis - Resident Care Director (S2) and later by staff three, Suzette Johnson - Executive Director (S3), and the purpose of the visit was explained.
The investigation consisted of the following:
On 05/20/26 CDSS requested and reviewed facility documents and toured the facility. Between 8:00AM and 11:00AM, LPA interviewed ten (10) out of two-hundred and forty-three (243) residents (R1-R10) and six (6) out of one-hundred and twenty-two (122) staff (S1-S6). S1 was not available for CDSS interview, as S1 did not answer CDSS phone call.
The investigation revealed the following:
Regarding the allegation “Staff speaks inappropriately to resident in care”, it is being alleged that staff speak inappropriately to the residents during medication rounds.
Report continues, please see LIC9099-C.

Unsubstantiated

Estimated Days of Completion: 90

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026

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-20260512153126

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: 05/20/2026

NARRATIVE

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Record reviews have indicated that S1 has fulfilled all staff requirements under personnel requirements and personnel records and is eligible to work at and are associated to the facility. Interviews revealed that nine (9) out of ten (10) residents and all six (6) staff have denied the allegation has taken place. Based on record reviews and interviews conducted, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated.

There have been zero (0) deficiencies cited during today's visit.

An exit interview was conducted with Suzette Johnson - Executive Director, and a copy of this report has been provided.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026

LIC9099 (FAS) - (06/04)

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