198602567-5-21-2025-11-AS-EMAZ-DHPVQP-20250616163842

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602567
Report Date: 05/21/2025
Date Signed: 05/21/2025 05:10:38 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, 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
05/15/2025 and conducted by Evaluator Alfonso Iniguez

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20250515091559

FACILITY NAME:	REGENCY PALMS LONG BEACH		FACILITY NUMBER:	198602567
ADMINISTRATOR:	KENIA SANCHEZ PADILLA		FACILITY TYPE:	740
ADDRESS:	117 E 8TH STREET		TELEPHONE:	(562) 432-9260
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90813
CAPACITY:	91	CENSUS: 74	DATE:	05/21/2025
		UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Monique Avila-Wellness Director		TIME COMPLETED:	05:10 PM

ALLEGATION(S):

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Staff did not respond to residents’ requests for assistance in a timely manner.

INVESTIGATION FINDINGS:

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On 5/21/2025 at approximately 9:40 AM, LPA Alfonso Iniguez conducted an unannounced complaint visit. LPA Iniguez met with Fabiola Marciano/Executive Director and later with Monique Avila/Wellnes Director. LPA Iniguez explained the purpose of this visit.

Investigation Consisted of: LPA conducted the following interviews: Executive Director(A#1), Staff Interviews (S#1-S#5), Resident’s interviews (R#1-R#7). LPA obtained and reviewed the following documents: Resident Roster dated: 5/21/25, Staff Roster dated: 5/12/25, (R#1-R#4) Physicians Report for Residential Care Facilities for the Elderly (RCFE) or LIC 602A dated: 8/18/24, 4/5/25, 3/7/24 and 4/22/25 (R#1-R#4) Admissions Agreement dated: 8/24/24, (R#1-R#4) Identification and Emergency Information or LIC 601 dated: 8/24/24, 1/20/24, 4/27, 4/25/25, (R#1-R#4) Service Plan dated: 4/25/25, 4/22/25, 3/31/25 and 5/21/25 and Copies of Resident Incident Details Report for room # 303, 304, 305 and 308 dated: 4/1/25 to 5/22/25 and a Physical Inspection of (R#1)’s room.

Evaluation Report continues LIC 9099-C

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025

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 7

Control Number 11-AS-20250515091559

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: REGENCY PALMS LONG BEACH	FACILITY NUMBER: 198602567
	VISIT DATE: 05/21/2025

NARRATIVE

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Investigation Revealed the Following:

Allegation: Staff did not respond to residents’ requests for assistance in a timely manner.

The details of the complaint alleged that facility took a long time to tend to (R#2)’s call.

On May 21, 2025, at approximately 4:00 PM, during a records review, LPA Iniguez observed the Resident Incident Details Report for the period from April 1, 2025, to May 22, 2025. It was noted that in room 303, where (R#1 and R#2) reside, the maximum time recorded for facility staff response was 3 hours and 53 minutes on May 15, 2025, at approximately 6:58 AM. Additionally, on May 7, 2025, the time recorded was 1 hour and 43 minutes at approximately 8:28 AM. Furthermore, LPA Iniguez found that in room 304, the response time for facility staff was 2 hours and 50 minutes on April 10, 2025, at approximately 7:24 AM, and 1 hour and 6 minutes on May 6, 2025, at approximately 6:31 AM to clear the alarm.

On May 21, 2025, at approximately 10:00 AM, during an interview with the Administrator (A#1), she stated that the facility has a pull system, and the facility staff can hear who and where that alarm is coming from. Also, (A#1) stated that it takes approximately 10 minutes to tend to when a resident pulls the alarm. However, (A#1) stated that there have been times when facility staff take longer than 10 minutes to tend to the resident's alarm.

On May 21, 2025, at approximately 1:00 PM, during interviews with residents (R#1-R#7), (6) out of (7) stated that they had used the pull alarm system and noticed that the facility staff took longer than 10 minutes to come and assist them.

Evaluation Report continues LIC 9099-C

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 7

Control Number 11-AS-20250515091559

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: REGENCY PALMS LONG BEACH	FACILITY NUMBER: 198602567
	VISIT DATE: 05/21/2025

NARRATIVE

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On May 21, 2025, at approximately 02:00 PM, during interviews with facility staff (S#1-S#5), (5) out of (5) stated that stated that when it comes to a resident pulling the alarm cord, it takes them approximately 10 minutes. However, (5) out of (5) facility staff stated that there have been times when they have taken more than 10 minutes to help the residents.

During this investigation, LPA found sufficient evidence to support the above-mentioned allegation.

Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard has been met; therefore, the above-mentioned allegation is found to be SUBSTANTIATED.

California Code of Regulations (Title 22, Division 6, Chapter 8), the above-mentioned deficiency was observed, and citation issued (ref. LIC 9099D.

An exit interview was conducted, and a copy of the Complaint Report was given to Monique Avila/Wellness Director.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 7

Control Number 11-AS-20250515091559

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: REGENCY PALMS LONG BEACH	FACILITY NUMBER: 198602567
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/21/2025

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 06/02/2025 Section Cited CCR 87468.2(a)(4)	1 2 3 4 5 6 7	87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (a) In addition to...the elderly shall have all of the following personal rights: (4) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Licensee will adhere to Title 22 at all times. As plan of correction stated by the faciltiy staff, the facility will re-train all staff regarding the times for the pull alarm system. Proof of training will be submitted to LPA Iniguez via email before due date.
	8 9 10 11 12 13 14	Based on records review and interviews the facility staff are not answering residents’ s pull cords in a timely manner as shown in the Resident Incident Details Report for the period from April 1, 2025, to May 22, 2025. This poses a potential health and safety risk for all the residents in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025

LIC9099 (FAS) - (06/04)

Page: 4 of 7

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
05/15/2025 and conducted by Evaluator Alfonso Iniguez

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20250515091559

FACILITY NAME:	REGENCY PALMS LONG BEACH		FACILITY NUMBER:	198602567
ADMINISTRATOR:	KENIA SANCHEZ PADILLA		FACILITY TYPE:	740
ADDRESS:	117 E 8TH STREET		TELEPHONE:	(562) 432-9260
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90813
CAPACITY:	91	CENSUS: 74	DATE:	05/21/2025
		UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Monique Avila-Wellness Director		TIME COMPLETED:	05:10 PM

ALLEGATION(S):

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Staff did not ensure resident’s monitoring device was properly placed.

INVESTIGATION FINDINGS:

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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025

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

LIC9099 (FAS) - (06/04)

Page: 5 of 7

Control Number 11-AS-20250515091559

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: REGENCY PALMS LONG BEACH	FACILITY NUMBER: 198602567
	VISIT DATE: 05/21/2025

NARRATIVE

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Investigation Revealed the Following:

Allegation: Staff did not ensure resident’s monitoring device was properly placed.

The details of the complaint alleged that (R#1)’s monitoring device is not placed by their bed side.

On May 21, 2025, at approximately 3:00 PM, during a records review, LPA Iniguez observed (R#1) ’s Service Plan dated 4/25/25. The plan states that (R#1) is a fall risk, and the facility staff needs to assist them using assistive devices and monitoring due to non-compliance.

On May 21, 2025, at approximately 4:00 PM, LPA Iniguez physically inspected (R#1)’s room. LPA Iniguez observed a motion sensor device by the TV stand that faces (R#1)’s bed. LPA Iniguez asked facility staff to test the motion sensor, and LPA Iniguez observed that it was working properly.

On May 21, 2025, at approximately 11:30 AM, they stated that they had always seen that monitor device there during an interview with (R#1) in their room.

On May 21, 2025, at approximately 10:00 AM, during an interview with the Administrator (A#1), she stated that (R#1) has a sensor device that allows the facility staff to notice when (R#1) gets in bed or out. In addition, (A#1) stated that the facility staff checks on (R#1)’s monitor devices as needed.

On May 21, 2025, at approximately 02:00 PM, during interviews with facility staff (S#1-S#5), (5) out of (5) stated that (R#1) has a monitor device that tells them when (R#1) moves. In addition, (5) out of (5) facility staff stated that they check on (R#1)’s monitor device as needed.

Evaluation Report continues LIC 9099-C

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025

LIC9099 (FAS) - (06/04)

Page: 6 of 7

Control Number 11-AS-20250515091559

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: REGENCY PALMS LONG BEACH	FACILITY NUMBER: 198602567
	VISIT DATE: 05/21/2025

NARRATIVE

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During this investigation, LPA found did not find sufficient evident to support the above-mentioned allegation(s).

Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard has been met; therefore, the above-mentioned allegation(s) are found to be UNSUBSTANTIATED.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

An exit interview was conducted, and a copy of the Complaint Report was given to Monique Avila/Wellness Director.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025

LIC9099 (FAS) - (06/04)

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