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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602567
Report Date: 12/17/2024
Date Signed: 12/17/2024 04:09:48 PM

Substantiated


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
11/25/2024 and conducted by Evaluator Socorro Leandro
COMPLAINT CONTROL NUMBER: 11-AS-20241125165223
FACILITY NAME:REGENCY PALMS LONG BEACHFACILITY NUMBER:
198602567
ADMINISTRATOR:KENIA SANCHEZ PADILLAFACILITY TYPE:
740
ADDRESS:117 E 8TH STREETTELEPHONE:
(562) 432-9260
CITY:LONG BEACHSTATE: CAZIP CODE:
90813
CAPACITY:91CENSUS: 69DATE:
12/17/2024
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Executive Director, Fabiola MarcianoTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Staff handled resident in a rough manner.
INVESTIGATION FINDINGS:
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On 12/17/2024, the Department of Social Services (DSS) - Community Care Licensing Division (CCLD) staff conducted an unannounced subsequent complaint visit at this facility. CCLD staff was greeted by Executive Director, Fabiola Marciano.

The investigation consisted of the following:
On 12/03/2024, The department interviewed 4 staff, 6 residents, and 4 witnesses, and gathered facility records.
On 12/16/2024, The department reviewed facility records and interviews conducted.
On 12/17/2024, The department delivered findings.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024
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 4
Control Number 11-AS-20241125165223
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: REGENCY PALMS LONG BEACH
FACILITY NUMBER: 198602567
VISIT DATE: 12/17/2024
NARRATIVE
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Regarding the allegation “Staff handled resident in a rough manner”, it is being alleged that on 11/20/2024 Staff 1 (S1) handled Resident 1 (R1) (who has dementia and wanders) in a rough manner. Interviews conducted revealed the following: Staff 1 indicated that they placed their arms underneath R1’s arm pits and walked behind R1 to take them out of another resident’s room. Witness 2 (W2) indicated that they saw R1 go into another resident’s room and S1 did not redirect R1 but instead S1 took out R1 by holding both hands behind R1’s body. Witness 2 explains that they did not clearly see what happened but is certain that S1 physically removed R1 from the other resident’s room. Witness 1 (W1) indicated that they saw R1 walk into another resident’s room. Witness 1 goes on to explain that S1 grabbed both of R1’s arms behind their body and then pushed out R1 with their upper body. Three staff who were not witnesses of the incident indicated that they heard a similar story of the incident. During interviews conducted with staff, staff gave examples of how to redirect residents with dementia and none of the examples involved physically touching residents. Records reviewed of the Facility "Dementia Care Plan of Operation for Regency Palms Long Beach" state the following:

“Respect the Individual: In addition to specific “resident rights” outlined in state regulations, we advocate the following rights for all residents: Freedom from…physical restraints o Freedom to move without being confined including space…3. Special Techniques/programs for managing specific types of behavior. In order to provide optimal care…Agitation…wandering…can become difficult management issues…Appropriate behavioral interventions can include: Offer a snack, sensory stimulation, 1 on 1 interaction…Wandering: daily living skills, walking, dancing…”

The Facility “Dementia Care Plan of Operation for Regency Palms Long Beach” provides 20 different examples of redirection when residents are wandering. Moreover, none of these examples indicated physically touching a resident nor physically relocating a resident. Furthermore, S1 did not follow the Facility’s “Dementia Care Plan of Operation for Regency Palms Long Beach” because they indicated they used “physical restraints” by physically removing R1 from a resident's room. S1 did not use “Appropriate behavioral interventions” at outlined in the “Dementia Care Plan of Operation for Regency Palms Long Beach.” Regarding the allegation “Staff handled resident in a rough manner”, the preponderance of the evidence standard has been met therefore the allegation is substantiated.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 11-AS-20241125165223
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: REGENCY PALMS LONG BEACH
FACILITY NUMBER: 198602567
VISIT DATE: 12/17/2024
NARRATIVE
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Deficiencies cited based on interviews conducted and record review in accordance with the California Code of Regulations, Title 22. An exit interview was conducted, and a copy of this report was left with the Executive Director along with their appeal rights.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 11-AS-20241125165223
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: REGENCY PALMS LONG BEACH
FACILITY NUMBER: 198602567
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/17/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/07/2025
Section Cited
CCR
87468.1(a)(3)
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87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature...interfering with daily living functions such as...elimination.

This requirement was not met as evidenced by:
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The Executive Director has agreed to retrain staff on Personal Rights and email proof of correction to Socorro.Leandro@dss.ca.gov.
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Based on interviews conducted and record review, the licensee did not comply with section cited above by having S1 physically remove R1 from a resident room. Thus, R1 was not free from punishment, humiliation, physical abuse, or actions that were punitive in nature, which poses a health, safety, and personal rights risks to residents in care.
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Type B
01/07/2025
Section Cited
CCR
87705(a-I8)
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87705 Care of Persons with Dementia (a) This section applies to licensees who accept or retain residents diagnosed…to have dementia…(b) In addition to…the plan of operation shall address the needs of residents with dementia, including:…(2) Safety measures to address behaviors such as wandering, aggressive behavior and ingestion of toxic materials…(3) In addition to the on-the-job training…staff who provide direct care to residents with dementia shall receive the following training as appropriate for the job assigned and as evidenced by safe and effective job performance: (4) There is an adequate number of direct care staff to support each resident’s physical, social, emotional, safety and health care needs as identified in his/her current appraisal. (4) Without violating Section 87468, Personal Rights, facility staff shall attempt to redirect a resident who attempts to leave the facility. (5) Residents who continue to indicate a desire to leave the facility following redirection shall be permitted to do so with staff supervision. (6) Without violating Section 87468, Personal Rights, facility staff shall ensure the continued safety of residents if they wander away from the facility…(A) Facility staff shall attempt to redirect any unaccompanied resident(s) leaving the facility. (5) Interior and exterior space shall be available on the facility premises to permit residents with dementia to wander freely and safely. (8) Fire and earthquake drills shall be conducted at least once every three months on each shift and shall include, at a minimum, all direct care staff.


This requirement was not met as evidenced by:
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The Executive Director has agreed to re-read and follow their "Dementia Care Plan of Operation for Regency Palms Long Beach" and CCR87705. The staff has agreed to retrain staff on Care of Persons with Dementia and How to Redirect on Residents with Dementia.
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Based on interviews conducted and record review, the licensee did not comply with section cited above by not following their Plan of Operation regarding safety measures to address behaviors such as wandering; S1 not redirecting R1 safely; S1 violating Personal Rights during attempted redirection for R1; not allowing R1 to wander freely and safely within the premises.
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 The licensee will email proof of correction to Socorro.Leandro@dss.ca.gov.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 4