197608029-6-25-2026-11-AS-PMAA-DW8QEA-20260722120600

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608029
Report Date: 06/25/2026
Date Signed: 06/25/2026 03:51:40 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
06/18/2026 and conducted by Evaluator Mario Leon

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20260618154401

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: 240	DATE:	06/25/2026
		UNANNOUNCED	TIME BEGAN:	10:43 AM
MET WITH:	Suzette Johnson - Executive Director		TIME COMPLETED:	04:03 PM

ALLEGATION(S):

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Staff do not provide adequate food service.

INVESTIGATION FINDINGS:

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On 06/25/26 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 one, Suzette Johnson (S1), and the purpose of the visit was explained.
The investigation consisted of the following:
On 06/25/26 CDSS requested and reviewed facility documents which included resident roster (dated 06/25/26), staff roster (dated: 06/25/26), a resident's care plan (R1) (dated: 06/14/26), R1's Medication Administration Record (MAR) (dated: 06/25/26), weekly menu (dated: 06/21/26 through 06/27/26) and CDSS toured the facility. Between 10:45AM and 3:15PM, LPA interviewed nine (9) residents and three (3) staff.
The investigation revealed the following:
Regarding the allegation “Staff do not provide adequate food service.”, it is being alleged that staff do not wake a resident for breakfast and lunch mealtimes. Interviews revealed that seven (7) residents and all three (3) staff have denied the allegation has taken place, while one (1) resident refused CDSS' interview.
Report continues, please see LIC9099C.

Unsubstantiated

Estimated Days of Completion: 90

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:	DATE: 06/25/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2026

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-20260618154401

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: 06/25/2026

NARRATIVE

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CDSS made the following observations: CDSS observed a "PM" meal in a to go box, which had been brought up to R1 on 06/24/26. The meal appeared to be dinner from the night before, which included a cup of soup, a roll, a slice of cantaloupe and Shepherd's pie. The meal had not been altered, meaning the meal had not been touched. CDSS record reviews consisted of R1's MAR, R1's service plan and weekly menu along with an alternative menu which is available each day. All of these files were reviewed and appeared to have no discrepancies. Based on interviews conducted, observation and record reviews, 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: 06/25/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2026

LIC9099 (FAS) - (06/04)

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