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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320433
Report Date: 12/05/2025
Date Signed: 12/05/2025 02:09:37 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
12/02/2025 and conducted by Evaluator Mario Leon
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20251202161311
FACILITY NAME:OCEANVIEW LIVING OF SAN PEDROFACILITY NUMBER:
198320433
ADMINISTRATOR:SABINA NAYBERGFACILITY TYPE:
740
ADDRESS:2100 SOUTH WESTERN AVENUETELEPHONE:
(310) 548-0625
CITY:SAN PEDROSTATE: CAZIP CODE:
90732
CAPACITY:86CENSUS: 62DATE:
12/05/2025
UNANNOUNCEDTIME BEGAN:
08:44 AM
MET WITH:Maria Galvan - AdministratorTIME COMPLETED:
02:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not administer medication as prescribed to a resident in care.
Staff did not ensure that medications were inaccessible to a resident in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 12/05/25 Licensing Program Analyst (LPA) Mario Leon conducted an unannounced complaint visit at the facility to address the allegations listed above. LPA was met by staff one, Maria Galvan - Administrator (S1) and the purpose of the visit was explained.
The visit consisted of the following: LPA requested resident and staff roster(s), medication administration record (MAR) for four (4) residents, as well as their most current physician's report (R1-R4), LPA also received a copy of a police report (dated 12/02/25). LPA took a tour of the facility with staff five, Jose Hernandez - Housekeeping supervisor (S5) and observed a resident's medication and four (4) rooms of residents in care. LPA interviewed six (6) residents (R1-R6) and four (4) staff (S1-S4). R1 refused LPA's interview. R2-R4 were not available for interview due to their resting status.
The visit revealed the following: Regarding the allegation "Staff did not administer medication as prescribed to a resident in care", it is being alleged that a resident is not receiving a medication in a timely manner. LPA's record reviews revealed that two (2) out of 4 residents have showed that they have denied their medication during the month of December. Police report notes no evidence of elder abuse/crime against a resident in care. Report continues, please see LIC9099C.
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025
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 2
Control Number 11-AS-20251202161311
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: OCEANVIEW LIVING OF SAN PEDRO
FACILITY NUMBER: 198320433
VISIT DATE: 12/05/2025
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
LPA observed a resident's behavior and was not allowed to interview a resident. Based on record reviews interviews and LPA observation conducted, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated.
Regarding the allegation "Staff did not ensure that medications were inaccessible to a resident in care.", it is being alleged that staff leave medication accessible to residents in care. LPA's observation of 4 rooms, number (#) 203, #201, #226, #208, did not reveal any medication being left accessible to residents in care. LPA's interviews revealed that 4 out of 4 staff (S1-S4) and 2 out of 2 residents (R5-R6) have denied the allegation has taken place. Based on LPA's observation and interviews conducted, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated.

There have been zero (0) deficiencies cited during today's visit.

An exit interview was held with staff one, Maria Galvan - Administrator (S1) and a copy of this report has been provided.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2