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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602567
Report Date: 04/11/2025
Date Signed: 04/11/2025 05:23:37 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
03/20/2025 and conducted by Evaluator Wendy Gibbs
COMPLAINT CONTROL NUMBER: 11-AS-20250320085632
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: 71DATE:
04/11/2025
UNANNOUNCEDTIME BEGAN:
08:57 AM
MET WITH:Robin WalkerTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Staff leaves resident soiled for an extended period of time.
INVESTIGATION FINDINGS:
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On 04/11/2025, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced subsequent complaint visit. LPA met with Resident Care Coordinator, Robin Walker, 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 toured the facility, interviewed Staff S5-S11, interviewed Residents R2-R8, and received and reviewed additional documents. The following documents were received and reviewed Resident Incontinent List, resident R1 Admission Agreement, and R1’s Care Plan.
During an initial visit conducted on 03/26/2025, LPA Dabuet they toured room 302, interviewed Staff S1, and collected records. The following records were received: Facility Staff Roster (dated 03/26/2025), Register of Facility Residents LIC9020 (dated 10/01/2024), Personnel Report LIC 500 (dated 03/20/25), Resident #1 (R1)'s Physician’s Report LIC 602A (dated 01/29/24), Resident Assessment (dated 02/10/24), and Resident Notes (dated 02/24/24 through 03/07/25).
The investigation revealed the following:
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
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)
Page: 1 of 4
Control Number 11-AS-20250320085632
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: 04/11/2025
NARRATIVE
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Allegation: Staff leaves resident soiled for an extended period of time.
The allegation alleges that a resident was left in a soiled pull-up for an extended period of time.
During the facility inspection, LPA observed Staff assisting residents to the bathroom, including R1.
During record review, LPA received and reviewed the Physician’s Report for R1 dated 12/27/2023, that indicates R1 has a Bladder Impairment that requires pull-ups. Additionally, the Physician’s Report indicates R1 is not Able to Manage Own Toileting Needs. LPA received and reviewed Resident R1’s Assessment dated 02/10/2024 that indicates R1’s Toileting needs consist of the following assistance, Reminders, verbal cueing, Help with bathroom activities and hygiene, and Full assistance with all aspects of bathroom activities and hygiene. R1’s Assessment indicated Enhanced Needs for Toileting that consist of Assistance with morning, bedtime, and nighttime toileting; Unscheduled escort and assistance with toileting; Two-person assistance with toileting. LPA received and reviewed Resident R1’s current Care Summary that indicates for Toileting R1 requires Minimum- Reminders, verbal cuing, and Needs toileting schedule to be followed. R1 requires Assistance with morning and bedtime toileting, Assistance with AM, PM, and nighttime incontinence care.
During interviews with Staff S1, S5-S11, were asked how often incontinent residents are changed and/or checked if they need to be changed, eight (8) out of eight (8) indicated residents are assisted with changing or going to the restroom
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
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)
Page: 2 of 4
Control Number 11-AS-20250320085632
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: 04/11/2025
NARRATIVE
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every 30 minutes to 2 hours depending on the resident. Additionally, Staff S5-S11 was asked if they have come onto shift and had a resident who was soiled, two (2) out of seven (7) stated yes, they have come onto shift and had residents soiled.
During interviews with Residents R2-R7, were asked if there was a time they were left in soiled pull-ups or diapers for an extended period of time, four (4) out of six (6) stated yes, they have been left in soiled diapers for an extended period of time.
During interviews with Witnesses W1 and W2, were asked if they have come and observed their resident in soiled diapers, one (1) out of two (2) stated they have observed their resident in soiled diapers for an extended period of time.

During the course of the investigation, LPA was able to find evidence to support the allegation. Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California code of Regulation, (Tittle 22, Division 6 & Chapter number 8), are being cited on the attached LIC 9099D.

An exit interview was conducted with Resident Care Coordinator, Robin Walker, and a copy of this report and Appeals Rights was provided.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
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)
Page: 3 of 4
Control Number 11-AS-20250320085632
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: 04/11/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/21/2025
Section Cited
CCR
87625(b)(3)
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87625 Managed Incontinence (b) In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for the following: (3) Ensuring that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence.
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The Administrator will review regulation 87625 and retrain staff on Incontinent Care and implement a log to document when incontinent care is conducted. The Administrator will email a copy of the training sign in and log for incontinent care to LPA by POC.
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Based on interviews and record review the licensee did not ensure Resident R1, R2, R4, R5, and R6 were provided timely incontinent care to ensure they were kept clean and dry.
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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: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4