198320433-3-17-2026-11-AS-EMAZ-DSVTZP-20260406151038

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320433
Report Date: 03/17/2026
Date Signed: 03/17/2026 05:19:31 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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/05/2025 and conducted by Evaluator Wendy Gibbs

COMPLAINT CONTROL NUMBER: 11-AS-20251205145540

FACILITY NAME:	OCEANVIEW LIVING OF SAN PEDRO		FACILITY NUMBER:	198320433
ADMINISTRATOR:	SABINA NAYBERG		FACILITY TYPE:	740
ADDRESS:	2100 SOUTH WESTERN AVENUE		TELEPHONE:	(310) 548-0625
CITY:	SAN PEDRO	STATE: CA	ZIP CODE:	90732
CAPACITY:	86	CENSUS: 70	DATE:	03/17/2026
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Maria Galvan		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Unlawful eviction
Staff inappropriately evaluated resident without conservators knowledge
Staff are not providing adequate food service to residents
Staff are not allowing resident to have a camera in the room
Staff are not answering the phones

INVESTIGATION FINDINGS:

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On 03/17/2026, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced Complaint Visit to the facility listed above. LPA met with Administrator, Maria Galvan, and the purpose of today’s visit was explained. LPA was granted entry into the facility.
The investigation consisted of the following:
During today’s visit, LPA inspected the facility and interviewed Resident’s R2-R8.
During the initial visit conducted on 12/11/2025, LPA observed the lunch service being served to the residents, interviewed Staff S1-S6, and received documents pertinent to the investigation. The following documents were received and reviewed: Staff Roster, Resident Roster, Eviction Notice dated 12/04/2025, Physician’s Report dated 04/11/2025, Service Plan dated 09/15/2025 , physician’s Instructions to Assisted Living Home (dated 10/01/2025), Initial Psychological Evaluation dated 12/03/2025, Admission Agreement dated 09/15/2025, Physician Visit Summary dated 07/07/2025, Los Angeles Police Department incident 3027 dated 12/02/2025, Resident and Responsible Person or Conservator copy of Personal Rights in Privately Operated Residential Care Facilities for the Elderly dated 09/15/2025, Consent for Emergency

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2026

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 5

Control Number 11-AS-20251205145540

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: OCEANVIEW LIVING OF SAN PEDRO	FACILITY NUMBER: 198320433
	VISIT DATE: 03/17/2026

NARRATIVE

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Medical Treatment dated 09/15/2025, Unusual Incident/Injury Report dated 12/06/2025, Incident Reports, Menus from 10/12/2025 through 12/13/2025, and Always Available menu.

The investigation revealed the following:

Allegation: Unlawful eviction

The allegation alleges that a resident was unlawfully evicted.

During record review, LPA received and reviewed the evection notice dated December 4, 2025. During review of the eviction LPA observed the 30-day Eviction Notice included the effective date, specific Facility House Rules being violated listed in the Resident Care and Agreement and the incidents, resources available to assist in alternative housing and care option, the right to file a complaint with Community Care Licensing’s and the Long-Term Care Ombudsman’s contact information, and the Health and Safety Code section 1569.683(a)(4).

Additionally, LPA reviewed Staff Statements of interactions and incidents regarding violation of Facility House Rules dated 09/16/2025, 10/09/2025, 10/12/2025, 10/15/2025 at 9AM, 10/15/2025 at 1PM, 10/16/2025, 10/23/2025, 11/07/2025, 11/12/2025, 11/20/2025, 11/21/2025, 11/24/2025, 11/24/2025 at 7:55PM, 12/02/2025, 12/02/2025 at 2:15PM, 12/04/2025, 12/05/2025, and ongoing, repeat incidents from various dates.
LPA received and reviewed Resident R1’s Initial Psychological Evaluation conducted on 12/03/2025, that states “Patient’s mental health activity, does not support the services that assisted living can provide.”
Resident R1’s Residents and Care Agreement signed and dated on 09/15/2025, that states on page 10 to 11, “B. Termination by Us. 1. Upon thirty (30) Days’ Notice. We may terminate this Agreement upon thirty (30) days’ written notice to you if any of the following events occur: c. Your failure to comply with the general policies of the Community [These policies are as described in this Agreement and in the Resident Handbook].”
During interviews with Residents R2-R8, were asked if they have been issued an eviction notice or have been threatened with an eviction, seven (7) out of seven (7) stated no, they have not been issued an eviction or been threatened with one.
During interviews with Staff S1-S6, were asked if a resident was issued an unlawful eviction, six (6) out of six (6) stated no, no resident have been issued an unlawful eviction. Additionally, Staff S1-S6 stated Resident R1 was issued an eviction notice due to not following the policies of the community.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 11-AS-20251205145540

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: OCEANVIEW LIVING OF SAN PEDRO	FACILITY NUMBER: 198320433
	VISIT DATE: 03/17/2026

NARRATIVE

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Allegation: Staff inappropriately evaluated resident without conservators knowledge
The allegation alleges that a resident was evaluated by a doctor without the resident’s conservator being notified.

During record review, LPA received and reviewed Resident R1’s Residence and Care Agreement that states the following on page 4 “I. Observation and Consultation The staff at the Community will observe your health status to identify if you dietary, social and health care needs and will provide you with consultations regarding social and health-related issues. Additionally, LPA received and reviewed a Staff Note, signed by Staff S1-S3, and S5, dated 12/02/2025, that they met with W1 and discussed Resident R1 needing a Psychiatric Evaluation to evaluate if a medication adjustment was required. In the notes states W1 agreed and thanked them. LPA received and reviewed the Initial Psychological Evaluation report conducted on 12/03/2025.

During interviews with Staff S1-S6, were asked if residents are evaluated without the conservator or responsible parties’ permission, six (6) out of six (6) stated no evaluations will be conducted without the permission of the conservator or responsible party.
During interviews with Residents R2-R8, were asked if a medical professional has conducted an assessment without their prior knowledge or their responsible party’s prior knowledge, seven (7) out of seven (7) stated no, no assessments were conducted without their or their responsible party’s prior knowledge.
During interview with Staff S1-S6, were asked if a residents conservator or responsible party is notified before receiving medical treatment or assessment, six (6) out of six (6) stated yes they are informed and it is discussed before unless it is an emergency.
During an interview with Resident R1’s conservator W1, was asked if they requested R1 to be evaluated, W1 stated yes, I told the staff I wanted R1 evaluated. W1’s main concern was that they wanted to be present when R1 was evaluated.

Allegation: Staff are not providing adequate food service to residents

The allegation alleges the staff do not ensure a resident eats their meal, do not take residents a sandwich, do not serve fresh vegetables and chips are given as a snack.

During the facility visit, LPA observed lunch being served. LPA observed the meal being served was what was listed on the weekly menu. LPA observed the following foods served green salad, beef brisket, red potatoes, creamed spinach, bread, and peach crisp. LPA observed an Always Available Menu posted that consist of cottage cheese with peaches, turkey sandwich, and soup du jour. In the kitchen, LPA observed a list of Diet/Restrictions that consisted of residents’ special diets and a Food Preference List that lists resident’s

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 11-AS-20251205145540

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: OCEANVIEW LIVING OF SAN PEDRO	FACILITY NUMBER: 198320433
	VISIT DATE: 03/17/2026

NARRATIVE

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preference. During record review, LPA received and reviewed a Dietary Order (dated on 10/01/2025 and received on 12/03/2025) for R1 from their physician that indicates R1 has a diet restriction of no coffee or caffeine products.
During interviews with Staff S1-S7, were asked if residents’ dietary orders, restrictions, and preferences are followed, seven (7) out of seven (7) stated yes, they are followed according to the orders provided to them.
During interviews with Residents R2-R8, were asked if their dietary orders, restrictions and/or preferences are followed, seven (7) out of seven (7) stated yes, their dietary orders, restrictions, and preferences are followed.

Allegation: Staff are not allowing resident to have a camera in the room

The allegation alleges that a resident’s conservator was told they could not have a camera in a resident’s room and was told to remove it.

During the facility inspection, LPA observed there are three (3) rooms that have a sign posted on the outside of their doors indicating surveillance monitoring is in progress. Additionally, LPA received and reviewed Resident R1’s Residence and Care Agreement, signed and dated on 09/15/2025, that states on page 17 “XI. MISCELLANEOUS B. Video Surveillance In order to protect the dignity and privacy of our resident, we do not permit the use of nanny cams or other video surveillance devices in resident apartments.”

During an interview with resident R1’s conservator W1, stated the camera from R1’s room was disconnected by a family member and that W1 reinstalled them. W1 stated they posted a notice on the door that states “WARNING Premises Protected By 24-Hour Audio and Video Surveillance By entering You Agree To Be Audio & Video RECORDED.”
During an interview with Staff S1-S6, were asked what the policy regarding cameras in a resident’s room, six (6) out of six (6) stated the facility does not allow video surveillance in resident’s rooms.
During an interview with Residents R2-R8, were asked if they were made aware of the Video Surveillance policy prior to moving in, seven (7) out of seven (7) stated they were made aware of the policy while reviewing the Residence and Care Agreement prior to moving in.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2026

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 11-AS-20251205145540

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: OCEANVIEW LIVING OF SAN PEDRO	FACILITY NUMBER: 198320433
	VISIT DATE: 03/17/2026

NARRATIVE

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Allegation: Staff are not answering the phone.
The allegation alleges that during the night staff do not answer the phones and that a residents family member called and was hung up on.

During the facility visit, LPA worked in the main room and observed the front desk worker answering phone calls throughout the day. LPA called the facility number and had their call answered. LPA reviewed Staff Statements from 09/16/2025 through 11/24/2025 regarding phone calls and interactions with R1 and W1.

During an interview with Staff S1 stated phones are monitored and answered by the front desk receptionist during business hours 9AM to 5PM. After hours, calls are forwarded to the Medication Room and are answered by Med Techs when they are available and not assisting residents.
During interviews with Staff S1-S6, were asked if phones are answered the whole day, six (6) out of six (6) stated phones are answered by the receptionist during business hours and transferred to the Medication Room after hours and the med tech will answer calls or return call when they are available.
During interviews with Residents R2-R8, were asked if their or their family’s calls are answered, four (4) out of seven (7) stated their phone calls are always answered. Additionally, three (3) out of seven (7) stated the receptionist leaves at 5 and the phone is transferred upstairs and if they are assisting a resident, it might take 5 minutes for the phone to be answered.

During the course of the investigation, LPA was unable to find evidence to support the allegation(s). Although the allegation(s) may have happened or is valid, there is no preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation(s) is/are unsubstantiated.

During today’s visit, LPA did not observe or cite any deficiencies.

An exit interview was conducted with Administrator, Maria Galvan, and a copy of this report was provided.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2026

LIC9099 (FAS) - (06/04)

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