198204399-7-13-2026-11-AS-PMAA-DWEUUX-20260728155417

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198204399
Report Date: 07/13/2026
Date Signed: 07/13/2026 10:00:41 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
05/27/2026 and conducted by Evaluator Zina Brown

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20260527154622

FACILITY NAME:	VILLA REDONDO CARE HOME		FACILITY NUMBER:	198204399
ADMINISTRATOR:	MARIA BRAVO		FACILITY TYPE:	740
ADDRESS:	237 REDONDO AVENUE		TELEPHONE:	(562) 434-9931
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90803
CAPACITY:	80; 80	CENSUS: 56	DATE:	07/13/2026
		UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Wesam "Sam" Kachouri (Administrator)		TIME COMPLETED:	10:10 AM

ALLEGATION(S):

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Staff did not ensure the resident attended their religious services on time.

INVESTIGATION FINDINGS:

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**This report supersedes the report delivered on 06/02/2026 to include additional information to the findings.**

On 07/13/2026 at 9:10 am, the Department arrived at the facility to conduct an subsequent visit to deliver the findings for the allegation listed above. During today’s visit, the Department met with Wesam "Sam" Kachouri (Administrator) and explained the purpose of the visit.

The investigation consisted of the following: On 06/02/2026, the Department conducted interviews between the hours of 9:35 am - 11:28 am with the Administrator (A1), Staff (S1-S5), and Residents (R1-R6). The Department also requested and obtained copies of the staff roster (dated 05/15/2026), resident roster (received on 06/02/2026), and R1’s documents including the Admission Agreement (dated 08/08/2025), LIC 602 Medical Assessment (dated 08/25/2025), LIC 603 Preplacement Appraisal Information (not dated), LIC 613C-2 Personal Rights (dated 08/25/2025), Personal Rights Policy (GP02) (dated 06/01/2025), Resident Sign-In/Sign-Out Policy (GP08) (dated 12/13/2024), and Resident Sign-In/Out Log (March 2026 – May 2026).

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2026

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-20260527154622

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: VILLA REDONDO CARE HOME	FACILITY NUMBER: 198204399
	VISIT DATE: 07/13/2026

NARRATIVE

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On 06/02/2026 between 1:00 pm - 2:15 pm, the Department conducted a records review. The Admission Agreement states visiting hours are 9:00 am - 7:00 pm daily and that arrangements can be made for special visits at any time. The LIC 613C-2 Personal Rights document states residents may receive visitors privately and without prior notice during reasonable hours. The Personal Rights Policy (GP02) states residents have the right to attend religious services inside or outside the facility and the right to leave the facility at any time. The Resident Sign-In/Sign-Out Policy (GP08) requires residents to sign out when leaving but does not impose time restrictions, require prior approval, or permit staff to delay departure. None of the reviewed policies authorize staff to delay resident departure for religious services or require visitors to wait due to housekeeping activities.

The Department reviewed the Resident Sign-In/Out Log for March 2026 - May 2026. The log reflects that R1 routinely leaves the facility with her authorized representative for various outings including beach trips, shopping, meals, medical appointments, and religious services. The log demonstrates that R1 regularly departs the facility without documented restriction and staff consistently facilitate R1’s ability to leave for community activities in accordance with facility policy and resident personal rights.

On 07/02/2026 between the hours of 4 pm – 5 pm, the Department received additional written clarification from Administrator (A1). A1 stated the lobby is unlocked at 9:00 am daily and visitors may enter earlier with staff assistance using the video call system. A1 stated housekeeping normally mops the lobby at approximately 7:30 am and that any later mopping occurs only when housekeeping must respond to urgent cleaning needs elsewhere. A1 stated visitors are not required to wait outside and may be assisted through the lobby safely even when the floor is wet. A1 stated residents are not delayed when leaving for religious services and may depart at any time, including before 9:00 am.

Based on information gathered through interviews and record reviews, there is not enough 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.

Exit interview conducted with Wesam "Sam" Kachouri (Administrator) and a copy of this report was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2026

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20260527154622

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: VILLA REDONDO CARE HOME	FACILITY NUMBER: 198204399
	VISIT DATE: 07/13/2026

NARRATIVE

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The investigation revealed the following:

Allegation: Staff did not ensure the resident attended their religious services on time.
It was alleged that on the morning of the incident, a staff member refused to allow R1’s family member to sign R1 out at the agreed upon time of 9:00am, as previously approved by facility management. The family member reported being unable to sign R1 out until 9:30am, resulting in a late arrival to church, and stated they were on the phone with R1 during the delay.

On 06/02/2026 between 9:35 am - 9:55 am, the Department interviewed A1. A1 denied the allegation and stated R1’s family member may sign R1 out at any time based on R1’s personal rights. A1 stated that staff may ask visitors to briefly wait if the lobby floor is wet due to mopping to prevent fall risk, but clarified that the lobby is unlocked at 9:00 am and visitors may enter earlier with staff assistance. A1 stated the facility does not restrict resident departure for religious services and that residents may leave freely at any time. A1 confirmed that staff can disengage the door lock for early visitors using the video call system and that advance arrangements are accommodated but not required. A1 stated that any temporary waiting would be due to immediate safety concerns and not due to a facility policy or routine practice.

On 06/02/2026, between 9:01am -11:28am, the Department interviewed 5 staff in regards the allegation. 4 out of 5 staff denied the allegation, stating that no staff refused or delayed the sign-out and explained that the lobby is typically closed until 9:30am due to housekeeping mopping the floors, requiring residents to be escorted downstairs during that time to prevent fall risk. Staff reported that R1’s family member arrived early at approximately 8:35am before staff were present in the lobby, and 1 staff stated that similar situations have occurred once or twice before on Sundays. Staff consistently stated that residents may leave whenever they choose and that the facility does not restrict religious attendance. 1 out of 5 staff was unaware of the allegation, stating they were not on duty and could not provide information on what had occurred.

On 06/02/2026 between the hours of 9:28am - 10:53am, the Department interviewed 6 residents in regards the allegation. 6 out of 6 residents denied the allegation, stating they had not experienced staff refusing or delaying sign outs and had not witnessed staff preventing a resident’s family member from signing them out at an agreed upon time. Residents reported that staff allow them to leave when requested, that staff respect their rights, and that any waiting is due to staff assisting other residents or normal delays. R1 stated that they usually leave on time and that any delays are rare and related to staff assisting multiple residents, not refusal. No residents reported being aware of or observing the alleged incident.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2026

LIC9099 (FAS) - (06/04)

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