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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608029
Report Date: 07/15/2026
Date Signed: 07/15/2026 03:12:08 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
07/07/2026 and conducted by Evaluator Mario Leon
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20260707112422
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: 234DATE:
07/15/2026
UNANNOUNCEDTIME BEGAN:
08:12 AM
MET WITH:Suzette Johnson, Executive DirectorTIME COMPLETED:
03:28 PM
ALLEGATION(S):
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Staff did not ensure that resident received showers while in care.
Staff did not ensure that resident's clothing was changed.
INVESTIGATION FINDINGS:
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On 07/15/26 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:
CDSS requested resident and staff roster (dated 07/15/26) and a care plan for a resident (R1) (dated 06/27/26), PM shower log of residents in care. Between 10:30AM and 2:00PM CDSS interviewed three (3) staff (S2-S4) and eight (8) residents (R1-R8).


Report continues, please see 90999C
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2026
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 2
Control Number 11-AS-20260707112422
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: 07/15/2026
NARRATIVE
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The investigation revealed the following:
Regarding the allegation “Staff did not ensure that resident received showers while in care.”, it is being alleged that residents are only showered two times per month. Record reviews of the PM shower log shows a resident (R1) on three (3) days to be showered. Record reviews of R1's care plan has bathing as "maximum assist", which indicates staff are now aware of R1's care plan. Interviews revealed that all three staff and six out seven residents 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.
Regarding the allegation “Staff did not ensure that resident's clothing was changed.”, it is being alleged that residents have been wearing the same pants for a month. Record reviews of R1's care plan indicate dressing as "moderate assist", which indicates staff are now aware of R1's care plan. Interviews revealed that all three staff and all seven residents have denied the allegation has taken place. Based on record reviews, 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 held with staff one, Suzette Johnson, and a copy of this report has been provided.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2