<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320315
Report Date: 11/06/2025
Date Signed: 11/06/2025 03:19:35 PM

Substantiated


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
11/03/2025 and conducted by Evaluator Perry Scott
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20251103094002
FACILITY NAME:BAY TOWERS AT BIXBY KNOLLSFACILITY NUMBER:
198320315
ADMINISTRATOR:MCDONALD, DONFACILITY TYPE:
740
ADDRESS:3747 ATLANTIC AVENUETELEPHONE:
(562) 426-6123
CITY:LONG BEACHSTATE: CAZIP CODE:
90807
CAPACITY:65CENSUS: 45DATE:
11/06/2025
UNANNOUNCEDTIME BEGAN:
09:31 AM
MET WITH:Don McDonaldTIME COMPLETED:
03:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not abide by the admission agreement.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 11/6/25, at 9:30am, the department conducted an initial complaint visit to the facility and was greeted by Don McDonald, Executive Director. The department explained the purpose of this visit is to gather information about the complaint, gather facility files, interview staff and residents, and deliver findings for the allegation mentioned above.

The investigation consisted of the following: The department investigated the allegations mentioned in this complaint and conducted interviews with staff (S1-S3) and resident (R1). The department received the following facility documents: Resident Roster (Date: 11/6/2025), Staff Roster (Dated: No Date), Admission Agreement (Dated: 06/29/2020, 07/28/2023, 06/02/2025), Face Sheet (Dated: 04/14/2021, 01/25/2024), Physician’s Report (Dated: 04/27/2024, 06/17/2020), Needs and Service Plan (Dated: 09/16/2025), Notice of Rent Increase Unsigned (Dated: 12/30/2024), 30-Day Termination Notice (Dated: 10/30/2025), Financial Power of Attorney (Dated: 03/07/2024), and Statement of Rent (Dated: 01/16/2024-11/5/2025) from the facility.

Report Continued on LIC909-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
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-20251103094002
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: BAY TOWERS AT BIXBY KNOLLS
FACILITY NUMBER: 198320315
VISIT DATE: 11/06/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
The investigation revealed the following: Allegation- Staff did not abide by the admission agreement.

The details of the complaint alleged that the facility did not notify the residents responsible party about a rate increase. As a result, they were issued a 30-Day Termination Notice for non-payment of outstanding fees. On 11/6/2025, from 9:30am-2:00pm, the department interviewed staff (S1-S3) and resident (R1) regarding the allegation. 3 of 3 staff denied the allegation that Staff did not abide by the admission agreement. All staff stated that the facility does abide by what is written in the admission agreement. However, 2 of 3 staff stated that they were not sure if the residents (R1s) responsible party was notified about the rate increase. Whereas another member of staff stated that the responsible party was not notified because they were listed as a contact only. Staff stated that they told the resident (R1) about the increase and issued a notice of the rate increase on 12/30/2024 and gave it to the resident.

The department interviewed resident (R1) about the allegation and the resident stated that they had no knowledge of the increase until a month ago. The resident also stated that they do not remember getting a notice or signing for it.

The department reviewed the Physician’s Report (Dated: 04/27/2024, 06/17/2020), Admission Agreement (Dated: 06/29/2020, 07/28/2023, 06/02/2025), Notice of Rent Increase Unsigned (Dated: 12/30/2024), Financial Power of Attorney (Dated: 03/07/2024), and the 30-Day Termination Notice (Dated: 10/30/2025). The department observed in the admission agreement dated and signed on 06/20/2025, that the legally responsible person for R1 was the residents responsible party noted in the Power of Attorney documents and other facility documents. The department observed on page 51 of the admission agreement entitled “Financial Status” that the legally responsible person was the same person that has power of attorney of R1. Additionally, the department observed that on page 72 of the admission agreement entitled “Resident Financial/Responsibility Form” the same name appears as well.

The department also reviewed the Physician’s Report (Dated: 04/27/2024) that states R1 is not able to handle their own cash resources due to their primary diagnosis. As a result of this diagnosis the responsible party or legally responsible person that signed the admission agreement should have been notified 90 days prior to the rent increase.

Report Continued on LIC9099-C

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 11-AS-20251103094002
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: BAY TOWERS AT BIXBY KNOLLS
FACILITY NUMBER: 198320315
VISIT DATE: 11/06/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Based on interviews conducted and records reviewed, the preponderance of evidence standard has been met. Therefore, the above allegation Staff did not abide by the admission agreement, is found to be Substantiated. Health and Safety Code 1569.655(a), Chapter (03.2) Residential Care Facilities for the Elderly are being cited on the attached LIC 9099D.

Deficiencies were issued and plans of corrections were discussed.

Note: *Citations that are not cleared by the due date of 11/14/25 will have a $100 fine assessed for each citation until it is cleared. Civil penalties will continue to accrue until Proof of Corrections (POC) is cleared. Deficiency was cleared at the time of the visit.

An exit interview was conducted with Don McDonald, Executive Director, and a hard copy of this Complaint Investigation Report was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 11-AS-20251103094002
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: BAY TOWERS AT BIXBY KNOLLS
FACILITY NUMBER: 198320315
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/14/2025
Section Cited
HSC
1569.655(a)
1
2
3
4
5
6
7
§1569.655(a) Increase in fee rates for elderly residents; 90 days’ written notice standing amount of reasons for increase…(a) If a licensee of a residential care facility for the elderly increases the rates of fees for residents or makes increases in any of its rate structures for services, the licensee shall provide no less than 60 days' prior written notice..... This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Licensee shall review the Health and Safety Code 1569.655(a) regarding rate increases and rescind the rate increase notice dated 12/30/2024 and the 30-day termination notice with an effective date of 12/01/2025. Licensee may re-issue a correct rate increase notice to the responsible party that is in-compliance with Health and Safety Code1569.655(a) Confirmation of all items will be submitted to CCLD by the POC due date of 11/14/25 to LPA Perry Scott’s email at perry.scott@dss.ca.gov to avoid monetary penalties.
8
9
10
11
12
13
14
Based on interviews conducted and records reviewed, the licensee failed to give R1s responsible party/legally responsible person as observed in the admissions agreement, 90 days’ notice of a rate increase. This posed potential personal rights and safety risk to residents in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4