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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608029
Report Date: 09/24/2026
Date Signed: 09/24/2026 03:04:50 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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/15/2026 and conducted by Evaluator Socorro Leandro
COMPLAINT CONTROL NUMBER: 11-AS-20260915152119
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: 240DATE:
09/24/2026
UNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Resident Care Director - Sidonia CordisTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff hit resident.
Staff pressured resident to change health plan.
Staff attempted to relocate resident without consent.
Staff prevented resident from leaving the facility.
INVESTIGATION FINDINGS:
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On 09/24/2026, Licensing Program Analyst (LPA) Socorro Leandro conducted an unannounced complaint investigation visit regarding the allegation listed above. LPA met with the Resident Care Director, Sidonia Cordis, and the purpose of the visit was explained. LPA was granted entry to the facility.

Investigation consisted of the following:

On 09/24/2026, interviews were conducted and records were reviewed. Interviews conducted consisted of Staff 1 (S1) and Resident 1 (R1). Records reviewed consisted of facility records such as Personnel Report dated 09/24/2026 and Resident Roster. R1’s records reviewed consisted of Vista Del Mar Senior Living Residence and Care Agreement dated 08/11/2022, Physicians Report dated 04/13/2026, Service Plan dated 07/23/2026, Unusual Incident/Injury Report dated 08/03/2026 and 09/18/2026, Observations for 09/11/2026 and 0919/2026.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026
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 3
Control Number 11-AS-20260915152119
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: VISTA DEL MAR SENIOR LIVING
FACILITY NUMBER: 197608029
VISIT DATE: 09/24/2026
NARRATIVE
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Investigation revealed the following:

Allegation: “Staff hit resident”, it is being alleged that S1 hit R1 on the shoulder.

Interviews conducted with S1 revealed the following: S1 denied the allegation. S1 explained that they never hit R1.

Interviews conducted with R1 revealed the following: R1 agreed with the allegation. R1 indicated that they do not remember when the incident occurred. R1 then goes on to demonstrate how S1 hit them on the shoulder, it looked like and felt like a tap on the shoulder. Furthermore, R1 stated that it did not hurt nor were they in pain.

Unsubstantiated: Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Allegation: “Staff pressured resident to change health plan”, it is being alleged that R1 was pressured to change health plan by S1.



Interviews conducted with S1 revealed the following: S1 denied the allegation.

Interviews conducted with R1 revealed the following: R1 denied the allegation, moreover, R1 indicated that they have the same health plan as before.

R1’s records reviewed revealed the following: There are no records indicating that R1 has changed their health plan.

Unsubstantiated: Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Allegation: “Staff attempted to relocate resident without consent”, it is being alleged that S1 attempted to relocate R1 without their consent.


Interviews conducted with S1 revealed the following: S1 denied the allegation.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 11-AS-20260915152119
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: VISTA DEL MAR SENIOR LIVING
FACILITY NUMBER: 197608029
VISIT DATE: 09/24/2026
NARRATIVE
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Interviews conducted with R1 revealed the following: R1 agreed with the allegation, additionally, R1 stated that S1 pressured them to go to another place to receive more assistance but R1 refused. Furthermore, R1 indicated that they have no current arrangements to leave the facility.

On 09/24/2026 at around 09:28 AM, R1 was observed in their room.

R1’s records revealed the following: There were no documents indicating that R1 will be moving out of the facility.

Unsubstantiated: Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Allegation: “Staff prevented resident from leaving the facility”, it is being alleged that staff prevented R1 from leaving the facility.



Interviews conducted with S1 revealed the following: S1 denied the allegation.

Interviews conducted with R1 revealed the following: R1 agreed with the allegation. R1 indicated that S1 and other staff have attempted them from leaving the facility, but they were able to leave the facility. Furthermore, R1 explained that staff informed them that they were weak and afraid for them to go out by themselves. Additionally, R1 stated that last night (09/23/2026) and on Sunday (09/20/2026) they exited the facility. Also, R1 stated that every time they have wanted to leave the facility, they have been able to do so.

Observations on 09/24/2026 revealed the following: Staff were not observed, denying residents the ability to exit the facility.

R1’s records reviewed revealed the following: There are no records indicating that staff refused R1 from exiting the facility.

Unsubstantiated: Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

An exit interview was conducted, and a copy of this report was provided to the Resident Care Director, Sidonia Cordis.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3