198602039-6-19-2025-11-AS-EMAZ-DJA6CE-20250704204125

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602039
Report Date: 06/19/2025
Date Signed: 06/19/2025 03:00:34 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
04/07/2025 and conducted by Evaluator Deborah Lee

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20250407123024

FACILITY NAME:	REGENT VILLA RETIREMENT HOME		FACILITY NUMBER:	198602039
ADMINISTRATOR:	GORDON, JENNI		FACILITY TYPE:	740
ADDRESS:	201 W WARDLOW RD		TELEPHONE:	(562) 595-6529
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90807
CAPACITY:	188	CENSUS: 147	DATE:	06/19/2025
		UNANNOUNCED	TIME BEGAN:	12:53 PM
MET WITH:	Jenni Gordon		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Licensee does not ensure that the facility has enough staff to meet the needs of residents in care.
Staff did not provide assistance to resident in care as necessary.

INVESTIGATION FINDINGS:

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*This report serves to clarify investigation findings and is created to supersede the LIC 9099 and LIC 9099C reports created on 04/11/25. Although this report supersedes the previous report, the complaint investigation findings remain the same. *
On June 19, 2025, Licensing Program Analyst (LPA) Deborah Lee conducted a subsequent complaint visit regarding the above allegations. LPA Lee met with Jenni Gordon and explained the reason for the visit.
The investigation consisted of the following:
On April 11, 2025, LPA obtained and reviewed the following: staff roster (No date), resident's roster (dated 4/10/25), Unusual Incident Report (UIR) dated 4/7/25, Pre-Appraisal/Need and Services Plan for R1 (dated 8/2/2019, 1/23/25), Physician's Report for Residential Care for the Elderly (RCFE) for R1(dated 2/4/25), Residents Rights training/ALW disclosures (dated 6/23/24), Assistance with Transfer and Ambulation policy (dated 3/6/25); Written Fall Protocol (3/6/25). LPA reviewed R1’s file. LPA Lee conducted 5 staff interviews (S1- S5), Administrator (A1), Assistant Administrator (A2), and 5 resident interviews (R1-R5). On June 19, 2025, LPA Lee conducted subsequent interviews with staff (S6-S8).
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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20250407123024

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: REGENT VILLA RETIREMENT HOME	FACILITY NUMBER: 198602039
	VISIT DATE: 06/19/2025

NARRATIVE

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Investigation revealed the following:

Allegation: Licensee does not ensure that the facility has enough staff to meet the needs of residents in care.

The complaint alleges that R1 was walking towards the front door when R1 lost balance and fell to the ground and facility staff was unable to lift R1 to R1’s feet, staff then called 911 for assistance. Facility staff allegedly told the paramedics that “they do not have enough staff to lift someone.”

On 4/11/25 at 9:45am, LPA interviewed Administrator (A1) who denied allegation and stated that the facility has sufficient staff to meet residents’ needs. On 4/11/25 between 10:45 am and 12:00pm, LPA interviewed 5 staff (Staff #1-5) and Assistant Administrator (A2) regarding the allegation; 5 out of 5 staff and A2 denied the allegation and reported that there is enough staff to meet the needs of the residents. On 6/19/25 during subsequent visit, between 1:00pm and 2:00pm, LPA interviewed 3 staff (S6-S8); 3 out of 3 staff interviewed denied allegation and reported that they never told paramedics that “they do not have enough staff to lift someone” as mentioned in the complaint. 3 out of 3 also stated that there is enough staff to meet the residents needs. On 4/11/25 between 1:00pm and 2:00pm, LPA interviewed 5 Residents (Residents #1-5). Of the 5 Residents interviewed, 5 out of 5 denied the allegation. 5 out of 5 stated that their needs are taken care of and that there is enough staff to meet their needs. On 4/11/25, LPA observed sufficient staff present at time of visit. On 4/11/25 and 6/19/25, LPA obtained, reviewed, and evaluated staff schedules and resident roster (current and week of incident) and found that sufficient staffing is maintained at the facility to meet the residents’ needs.

Based on the information gathered, there is insufficient evidence to support the stated allegation

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SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20250407123024

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: REGENT VILLA RETIREMENT HOME	FACILITY NUMBER: 198602039
	VISIT DATE: 06/19/2025

NARRATIVE

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Allegation: Staff did not provide assistance to resident in care as necessary.

The complaint alleges that when R1 lost balance and fell while entering the building, staff refused to assist R1 from the ground and stated that “it is not their policy to lift people up.”

On 4/11/25, LPA interviewed Administrator (A1) who denied the allegation and stated that according to their policy, when a resident has fallen and can’t get up, they don’t move them because the extent of the injury is unknown. A1 further stated that for the safety of the resident and the staff, we do not move them, we call the paramedics who can better assess the situation. Consequently, if the resident can get up we then aid them by offering a chair to use as leverage to assist them in getting up. On 4/11 /25 between 10:45 am and 12:00pm, LPA interviewed 5 Staff (Staff #1-5) and Assistant Administrator (A2) regarding the allegation; 5 out of 5 staff and A2 denied the allegation, stating that staff assist residents when it is safe to do so. On 4/11/25, LPA obtained, reviewed and evaluated a copy of the Assistance with Transfer and Ambulation policy (dated 3/6/25) which provides guidance to caregivers regarding lifting resident--it states that Caregivers are not to lift a resident who has fallen and appears to be injured, due to the risk of injury to both the resident and Caregiver(s) involved. On 4/11/25, LPA also obtained and reviewed a copy the facility’s fall policy (dated 3/6/25). On 4/11/25 between 1:00pm and 2:00pm LPA interviewed R1-R5 and of those interviewed 5 out of 5 stated that staff assists them when needed. R1 stated that R1 had a recent fall and staff helped immediately, by calling 911 because R1 was unable to get up.

Based on the information gathered, there is insufficient evidence to support the stated allegation.

Although the allegations above 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 are UNSUBSTANTIATED.

There were no deficiencies cited during today's visit.

Exit interview conducted and report provided to Jenni Gordon, Administrator

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SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025

LIC9099 (FAS) - (06/04)

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