198602039-5-29-2025-11-AS-EMAZ-DHQ3EK-20250616181115

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602039
Report Date: 05/29/2025
Date Signed: 05/29/2025 02:38:43 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
05/23/2025 and conducted by Evaluator Deborah Lee

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20250523155627

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: 139	DATE:	05/29/2025
		UNANNOUNCED	TIME BEGAN:	10:31 AM
MET WITH:	Jenni Gordon		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff pushed a resident in care.
Staff mentally abused a resident in care.

INVESTIGATION FINDINGS:

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On May 29, 2025, Licensing Program Analyst (LPA) Deborah Lee conducted an initial complaint visit regarding the above allegations. LPA Lee met with Jenni Gordon, Administrator and explained the reason for the visit.

The investigation consisted of the following:
On May 29, 2025, LPA obtained and reviewed the following: staff roster (No date), resident's roster (dated 5/28/25), Pre-Appraisal/Need and Services Plan for R1 (dated 7/3/21), Physician's Report for Residential Care for the Elderly (RCFE) for R1(dated 11/26/24), Residents Rights training (dated 6/22/24), and Abuse, Neglect,and Exploitation in a Elder Care setting (dated 4/4/25). LPA reviewed R1’s file. LPA Lee conducted 4 staff interviews (S1- S4), Administrator (A1), 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: 05/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2025

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-20250523155627

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: 05/29/2025

NARRATIVE

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Investigation reveals the following:

Allegation: Staff pushed a resident in care

The complaint alleges that "staff pushed R1." On 5/29/25 at 11:00am LPA interviewed Administrator (A1) who denied the allegation stating that there has been no reports of staff pushing or hitting a resident in care. Additionally, A1 reported that all staff had training on Resident Rights and Suspected Elder Abuse. On 5/29/25 between 11:30 am and 12:30pm, LPA interviewed 5 residents (R1-R5). Of those interviewed, 5 out of 5 stated that staff have never pushed or hit them. Additionally, 5 out of 5 stated that staff treat them with respect. Lastly, 5 out of 5 residents stated that they feel safe and comfortable living at the facility. On 5/29/25, between 12:30pm and 1:45pm LPA interviewed 4 staff (S1-S4) regarding the allegations. Of those interviewed, 4 out of 4 staff denied the allegation stating they have never hit or pushed a resident in care nor have they witness any other staff push or hit a resident it care. Lastly 4 out of 4 stated to have had Resident Rights and Suspected Elder Abuse training. On 5/29/25, LPA obtained and reviewed copies of staff training : Residents Rights training (dated 6/22/24), and Abuse, Neglect, and Exploitation in a Elder Care setting (dated 4/4/25).

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: 05/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2025

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20250523155627

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: 05/29/2025

NARRATIVE

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Allegation: Staff mentally abused a resident in care.

The complaint alleges that "staff mentally abused R1, however it was not disclosed how R1 was mentally abused." On 5/29/25 at 11:00am LPA interviewed Administrator (A1) who denied the allegation stating that there has been no reports of staff mentally abusing a resident in care. Additionally, A1 reported that all staff had training on Resident Rights and Suspected Elder Abuse. On 5/29/25 between 11:30 am and 12:30pm, LPA interviewed 5 residents (R1-R5). Of those interviewed 5 out of 5 stated that staff has never mentally abused them in anyway. Additionally, 5 out of 5 stated that staff treat them with respect. Lastly, 5 out of 5 residents stated that they feel safe and comfortable living at the facility. On 5/29/25, between 12:30pm and 1:45pm LPA interviewed 4 staff (S1-S4) regarding the allegation. Of those interviewed, 4 out of 4 staff denied the allegation stating they have never mentally abused a resident in care nor have they witness any other staff mentally abusing a resident it care. Lastly, 4 out of 4 staff stated to have had Resident Rights and Suspected Elder abuse training. On 5/29/25, LPA obtained and reviewed copies of staff training : Residents Rights training (dated 6/22/24), and Abuse, Neglect, and Exploitation in a Elder Care setting (dated 4/4/25).

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 allegations are UNSUBSTANTIATED.

There were no deficiencies cited during today's visit.

Exit interview conducted and report provided for Jenni Gordon, Administrator.

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SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2025

LIC9099 (FAS) - (06/04)

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