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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320302
Report Date: 07/09/2025
Date Signed: 07/09/2025 04:08:47 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
07/02/2025 and conducted by Evaluator Elvira Gonzalez
COMPLAINT CONTROL NUMBER: 11-AS-20250702145723
FACILITY NAME:BENTLEY SUITESFACILITY NUMBER:
198320302
ADMINISTRATOR:AQUINO, ROBINFACILITY TYPE:
740
ADDRESS:851 4TH STREETTELEPHONE:
(213) 478-0460
CITY:SANTA MONICASTATE: CAZIP CODE:
90403
CAPACITY:44CENSUS: 38DATE:
07/09/2025
UNANNOUNCEDTIME BEGAN:
09:42 AM
MET WITH:Muriel Cabacungan TIME COMPLETED:
04:20 PM
ALLEGATION(S):
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Facility staff does not comply with its neighborhood complaint policy.
Facility is not in clean and sanitary condition.
INVESTIGATION FINDINGS:
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On 07/09/25, Licensing Program Analyst (LPA) Elvira Gonzalez and Licensing Program Manager (LPM) Stephanie Cifuentes conducted an unannounced complaint visit to the facility listed above. LPA and LPM met with Assistant Manager, Muriel Cabacungan, and the purpose of today’s visit was explained. LPA and LPM were granted entry to the facility. Administrator, Belen Taico later joined LPA and LPM for the visit.

The investigation consisted of the following:

During today’s visit on 07/09/25, LPA interviewed staff #1 - #4 (S1-S4), residents #1 -#4 (R1-R4), and witnesses #1-#2 (W1 -W2) and attempted to interview #3 (W3). LPA received and reviewed the following documents: staff roster, resident roster, and Neighborhood Complaint/Concern Policy. Additionally, LPA and Assistant Manager, Muriel Cabacungan toured the inside and outside grounds of the facility.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2025
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 4
Control Number 11-AS-20250702145723
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: BENTLEY SUITES
FACILITY NUMBER: 198320302
VISIT DATE: 07/09/2025
NARRATIVE
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The investigation revealed the following:

Allegation: Facility staff does not comply with its neighborhood complaint policy. It is being alleged that neighbors have complained about the facility noise level, and their concerns have not been addressed. On 07/09/25 between 10:45 AM and 11:45 PM, LPA conducted interviews with S1 – S4. Administrator Belen Taico (S1) stated that when a neighbor has a complaint regarding the facility, she will address the complainant and work on a solution. Belen Taico stated that in the past there have been complaints from neighbors, and that when she’s reached out to these neighbors regarding their complaints, the neighbors have dismissed the complaint. Furthermore, 4 out of 4 staff interviewed denied the allegation.

On 07/09/25 between 11:50 AM and 12:35 PM, LPA conducted interviews with R1 – R4. Based on interviews conducted, 4 out of 4 residents interviewed stated they did not know of the neighborhood complaint policy. 3 out of 4 residents interviewed said they don’t know if neighbors have complained about the facility noise level.

On 07/09/25, between 1:45 PM and 2:10 PM, LPA Gonzalez interviewed W1-W2. Of those interviewed, 2 out of 2 stated they have no problems with the facility.

Based on observation, interviews conducted, and records reviewed, there is insufficient 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.

Allegation: Facility is not in clean and sanitary condition. It is alleged that the residents frequently discard their cigarette buds on neighbor’s property, facility cleaning supplies are left under neighbor’s windows and facility trash cans overflow. On 7/7/2025 LPA and Muriel Cabacungan toured the inside and outside grounds of the facility. During facility tour, LPA observed the facility to be clean and sanitary. LPA inspected the kitchen, resident rooms, and common areas, and observed them to be clean and in sanitary condition. LPA observed that the facility has a smoking area, located on the side of the facility towards the back, secluded and away from staff and residents. LPA observed that the smoking area had an ashtray where the residents throw their cigarette buds. LPA observed the smoking area to be clean. LPA did not observe any buckets filled with bleach or cleaning supplies on the side of the facility. During the facility tour, LPA observed the back alley to be clean and free of trash, or obstructions. LPA did not observe any cigarette buds on the ground or anywhere near the neighbor’s property. LPA did not observe the trash overflowing.

Continued on LIC9099-C

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 11-AS-20250702145723
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: BENTLEY SUITES
FACILITY NUMBER: 198320302
VISIT DATE: 07/09/2025
NARRATIVE
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On 07/09/25 between 10:45 AM and 11:45 AM, LPA conducted interviews with S1 – S4. Based on interviews conducted, 4 out of 4 staff denied the allegation, adding they do not use bleach to clean the facility. S2 stated that staff pour all the used water, after mopping into a container on the side of the house that leads to the drain.

On 07/09/25 between 11:50 AM and 12:35 PM, LPA conducted interviews with R1 – R4. Based on interviews conducted, 4 out of 4 residents interviewed said they don’t know if staff leave bleach filled buckets and cleaning supplies right under a neighbor’s window. 4 out of 4 residents interviewed stated that they don’t know if the trash is frequently overflowing. 4 out of 4 residents interviewed said this facility is kept clean and in a sanitary condition. 4 out of 4 residents interviewed stated that their rooms are cleaned daily. 4 out of 4 residents interviewed stated that they are satisfied with the services provided to them at this facility.

LPA and Muriel Cabacungan toured the inside and outside grounds of the facility. During facility tour, LPA observed the facility to be clean and sanitary. LPA inspected the kitchen, resident rooms, and common areas, and observed them to be clean and in sanitary condition. LPA observed that the facility has a smoking area, and it is located on the side of the facility towards the back, secluded and away from staff and residents. LPA observed that the smoking area had an ashtray where the residents throw their cigarette buds. LPA observed the smoking area to be clean. LPA did not observe any buckets filled with bleach or cleaning supplies on the side of the facility. During the facility tour, LPA observed the back alley to be clean and free of trash, or obstructions. LPA did not observe any cigarette buds on the ground or anywhere near the neighbor’s property. LPA did not observe the trash overflowing.

Based on observation, interviews conducted, and records reviewed, there is insufficient 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.

LPA did not find any deficiencies during this investigation; therefore, no citations were issued.

An exit interview was conducted, and a copy of the report was provided to Assistant Manager, Muriel Cabacungan.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 11-AS-20250702145723
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: BENTLEY SUITES
FACILITY NUMBER: 198320302
VISIT DATE: 07/09/2025
NARRATIVE
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LPA did not find any deficiencies during this investigation; therefore, no citations were issued.

An exit interview was conducted, and a copy of the report waws provided to Administrator Belen Taico.
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4