197608029-9-26-2025-11-AS-JHAD-DN83MW-20251107172301

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608029
Report Date: 09/26/2025
Date Signed: 09/26/2025 11:48:11 AM

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
09/17/2025 and conducted by Evaluator Lizeth Villegas

COMPLAINT CONTROL NUMBER: 11-AS-20250917144609

FACILITY NAME:	VISTA DEL MAR SENIOR LIVING		FACILITY NUMBER:	197608029
ADMINISTRATOR:	SUZETTE S. JOHNSON		FACILITY TYPE:	740
ADDRESS:	3360 MAGNOLIA AVENUE		TELEPHONE:	(562) 595-1559
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90806
CAPACITY:	300	CENSUS: 252	DATE:	09/26/2025
		UNANNOUNCED	TIME BEGAN:	09:06 AM
MET WITH:	Interim Executive Director Sidonia Cordis		TIME COMPLETED:	11:53 PM

ALLEGATION(S):

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Staff did not keep facility free of rodents.

INVESTIGATION FINDINGS:

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On 09/26/25 Licensing Program Analyst (LPA) Villegas conducted a subsequent complaint visit regarding the allegation(s) above. LPA met with Interim Executive Director Sidonia Cordis, as the purpose of today’s visit was explained.

The investigation consisted of the following: On 09/24/25 LPA Villegas obtained copies of the staff and resident roster, and copies of the following documents for resident #1 (R1) face sheet, service plan dated: 04/14/25, Physicians report dated: 03/10/25, physicians orders, housekeeping schedule, deep cleaning schedule, Dewey pest control report dated: 9/18/25, and work order dated 09/17/25. On 09/24/25 from 9:30am-12:00 pm LPA conducted Interviews with residents 2-10 (R2-R10), and from 1:35pm- 2:32pm LPA conducted interviews with staff #1-6 (S1-S6). On 09/24/25 LPA conducted tour of the facility and conducted check of 6 bedrooms. On 09/26/25 LPA conducted an interview with R1.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2025

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-20250917144609

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: 09/26/2025

NARRATIVE

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The investigation revealed the following:

Allegation: Staff did not keep the facility free of rodents.

It is alleged that a resident in care observed 6 rodents in the residents’ bedroom. On 09/24/25 from 9:30am-12:00 pm LPA conducted Interviews with R2-R10 regarding the allegation above. 6 of the 9 residents interviewed denied the allegation above. 3 of the 9 residents interviewed confirmed the allegation above and reported observing pest, per the 3 of 9 residents interviewed pest was reported to staff and staff services bedrooms. Additionally, 9 of 9 residents reported bedrooms being cleaned daily by staff, and 8 of 9 residents interviewed confirmed that the facility has a pest services come out to service. On 09/26/25 LPA conducted an interview with R1 regarding the allegation above, per R1 staff have addressed R1’s concerns and R1 has not observed any rodents in bedroom. On 09/24/25 from 1:35pm- 2:32pm LPA conducted interviews with S1-S6 regarding the allegation above, 6 of the 6 staff interviewed denied the allegation above. Per 6 of the 6 staff interviewed, the facility common areas, and bedrooms are cleaned daily. 6 of 6 staff also confirmed that the facility has a pest control contract, and that pest control comes out regularly to service the facility. 6 of the 6 staff interviewed also stated that if and when a resident reports observing pest, a work order will be created, maintenance staff will inspect, and pest control will come out to further service the reported area. On 09/24/25 LPA conducted a check of bedrooms: 119, 135, 137, 217, ML 21, and ML22, LPA observed bedrooms to be clean and pest free.

On 09/26/25 LPA conducted a review of the work order dated 09/17/25, per work order resident’s bedroom was inspected for mice infestation and a hole behind residents’ refrigerator. On 09/26/25 LPA conducted a review of Dewey pest control service agreement, per agreement 10 bedrooms are treated weekly as well as common areas, and the building exterior. Per Dewey pest control service agreement dated 9/18/25 resident’s bedroom was inspected and there was no activity found. A review of the housekeeping schedule was conducted, and it reads that every housekeeper cleans 8 bedrooms per shift. Bedrooms are deep cleaned once a week.

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

Exit interview conducted, and a copy of this report was provided to Sidonia Cordis.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2025

LIC9099 (FAS) - (06/04)

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