198602039-4-11-2025-11-AS-EMAZ-DJA6CF-20250704204126

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602039
Report Date: 04/11/2025
Date Signed: 04/11/2025 03:14:16 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: 148	DATE:	04/11/2025
		UNANNOUNCED	TIME BEGAN:	08:00 AM
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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On April 11, 2025, Licensing Program Analyst (LPA) Deborah Lee conducted a complaint visit regarding the above allegations. LPA Lee met with Nicole Lozano, Admissions Director, and explained the reason for the visit. Subsequently, Jenni Gordon Administrator arrived and assisted with 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), 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 Tranfer and Ambulation policy (dated 3/6/25); Fall Policy (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).

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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2025

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: 04/11/2025

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 facility staff admitted to not having enough staff to “lift” resident. On 4/11/25 at 9:45am, LPA interviewed Administrator (A1) who denied allegation and stated that the facility has enough 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 4/11/25 between 1:00pm and 2:00pm, LPA interviewed 5 Residents (Residents #1-5). Of the 5 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 adequate staff present at time of visit. On 4/11/25, LPA reviewed staff and resident rosters which confirmed that adequate staffing is maintained.

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

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

The complaint alleges that facility staff on scene admittedly refused to assist patient from the ground and stated that it is not their policy to lift people up.

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SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2025

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: 04/11/2025

NARRATIVE

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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 paramedics who can better assess the situation. Consequently, if the resident is able to get up then we provide assistance to them such as offer 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 and reviewed 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 obtained and reviewed a copy fall policy (dated 3/6/25) which states in part that care staff will be trained by Wellness Director on providing lift assistance when appropriate. 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. 1 out of 5 stated that she had a recent fall and staff helped her immediately, by calling 911 because she 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: 04/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2025

LIC9099 (FAS) - (06/04)

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