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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608842
Report Date: 01/22/2026
Date Signed: 01/22/2026 04:10:24 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
01/12/2026 and conducted by Evaluator Elvira Gonzalez
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20260112152629
FACILITY NAME:SUNNY HILLS ASSISTED LIVING (MEMORY CARE)FACILITY NUMBER:
197608842
ADMINISTRATOR:SUNGNAM PARK "SUSAN"FACILITY TYPE:
740
ADDRESS:8717 WEST OLYMPIC BLVD.TELEPHONE:
(310) 659-4301
CITY:LOS ANGELESSTATE: CAZIP CODE:
90035
CAPACITY:120; 120CENSUS: 68DATE:
01/22/2026
UNANNOUNCEDTIME BEGAN:
08:37 AM
MET WITH:Jung Hee KimTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Staff does not ensure facility is free of pests.
INVESTIGATION FINDINGS:
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On 01/22/26, LPA Gonzalez conducted an unannounced complaint investigation visit for the allegation listed above. LPA met with Jung Hee Kim, Administrator, and explained the purpose of the visit. LPA was granted access to the facility.

The investigation consisted of the following: On 01/22/26, LPA Gonzalez collected the following documents: staff roster, resident roster, and service invoices from OK Exterminators (dated:11/07/25, 12/12/25) and National Exterminator Company (dated: 01/09/26). LPA conducted interviews with staff #1-#5 (S1-S5), and residents #1-#6 (R1-R6). Additionally, LPA conducted a tour of the entire facility, and inspected resident rooms, kitchen and common areas.


Continued on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2026
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-20260112152629
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: SUNNY HILLS ASSISTED LIVING (MEMORY CARE)
FACILITY NUMBER: 197608842
VISIT DATE: 01/22/2026
NARRATIVE
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The investigation revealed the following:

For the allegation: Staff does not ensure facility is free of pests. It is being alleged that there are bedbugs and cockroaches in the facility. On 01/22/26, LPA Gonzalez conducted interviews with S1-S5. Of those interviewed, 5 out of 5 staff denied the allegation. 5 out 5 staff said pest control services are provided monthly.

On 01/22/26, LPA Gonzalez conducted interviews with R1-R6. Of those interviewed, 6 out of 6 residents could not corroborate with the allegation.

During a records review conducted on 01/22/26, LPA reviewed pest control service invoices from Ok Exterminators dated 11/07/25 and 12/12/25, and National Exterminator Company dated 01/09/26. Documentation reflected that general pest control services were performed on the referenced dates.

On 01/22/26, LPA and Jung Hee Kim conducted a tour of the facility and inspected rooms #102 and #113 on the first floor, rooms #206 and #217 on the second floor, rooms #302 and #306 on the third floor, as well as the kitchen and common areas. LPA observed the inspected areas to be clean, sanitary, and free of pests.

Based on observation, records reviewed, and interviews conducted, the department did not find sufficient evidence to support the allegation. 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.

No deficiencies were cited during this investigation.

An exit interview was conducted, and a copy of this report was provided to Jung Hee Kim, Administrator.
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2