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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198204950
Report Date: 05/13/2026
Date Signed: 05/13/2026 04:10:11 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
05/04/2026 and conducted by Evaluator Jose Anguiano
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20260504140021
FACILITY NAME:CARSON SENIOR ASSISTED LIVINGFACILITY NUMBER:
198204950
ADMINISTRATOR:SHOLOM GOLDMANFACILITY TYPE:
740
ADDRESS:345 EAST CARSON STREETTELEPHONE:
(310) 830-4010
CITY:CARSONSTATE: CAZIP CODE:
90745
CAPACITY:230CENSUS: 168DATE:
05/13/2026
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Ginger EnriquezTIME COMPLETED:
04:20 PM
ALLEGATION(S):
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Staff are not properly addressing bed bug infestation in the facility.
INVESTIGATION FINDINGS:
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On 05/13/2026, Licensing Program Analyst (LPA) Jose Anguiano conducted an unannounced complaint investigation visit regarding the allegation above. LPA met with Assistant Administrator Ginger Enriquez.
The investigation consisted of the following: The department interviewed ten (10) staff members (S1-S10), eleven (11) residents (R1-R11), observations of the facility including the television room and common areas, memory care and assisted living side. Review of pest control receipts, Staff & Resident roster, Resident file, Food policy, food menu for May 2026.
The investigation revealed the following: Regarding the allegation that staff are not properly addressing bed bug infestation in the facility, interviews conducted with (10) staff members (S1-S10) denied knowledge of an active bed bug infestation within the facility. Resident interviews conducted with (11) residents (R1-R11) did not corroborate the presence of bed bugs. During the visit, no bed bugs were observed within the television room or common areas.
Please see (LIC9099-C) for report continuation.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Jose Anguiano
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2026
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-20260504140021
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: CARSON SENIOR ASSISTED LIVING
FACILITY NUMBER: 198204950
VISIT DATE: 05/13/2026
NARRATIVE
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Records revealed: Pest control invoices and treatment records documenting ongoing extermination services conducted on multiple dates including March 18, March 25, April 1, April 8, April 15, and May 6, 2026. Records documented treatment and monitoring for various pests, including bed bugs, and indicated continued pest control maintenance services were being provided. Based on the evidence gathered, interviews conducted, observations made, and records reviewed, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation occurred. Therefore, the allegation is unsubstantiated.

No deficiencies were cited on this visit. A copy of this report and exit interview was provided to the Assistant Administrator.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Jose Anguiano
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2