198602567-5-23-2025-11-AS-JHAD-DJ6RDT-20250701125625

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602567
Report Date: 05/23/2025
Date Signed: 05/23/2025 03:56:57 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
05/13/2025 and conducted by Evaluator Ernand Dabuet

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20250513084722

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:	05/23/2025
		UNANNOUNCED	TIME BEGAN:	08:34 AM
MET WITH:	Fabiola Marciano		TIME COMPLETED:	03:59 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff retaliated against resident resulting in eviction.
Illegal Eviction.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On May 23, 2025, the California Department of Social Services Community Care Licensing (CDSS/CCL) Licensing Program Analyst (LPA) Ernand Dabuet conducted an initial visit to gather information regarding the above allegations. LPA met with Fabiola Marciano, Executive Director, and explained the purpose of the visit. LPA was granted entry to the facility.

The investigation consisted of interviews, a collection of records, and a tour of the facility. Interviews were conducted with staff members #1 to #3 (S1-S3) resident member #1 (R1) and witness #1 (W1). List of documents reviewed/obtained Faciltiy Resident Roster (dated 05/23/25), Personne Report LIC 500 (dated 05/12/25), (R1)'s Physician's Report LIC 602A (dated 08/19/24 and 02/12/25), Facility Resident Assessment (dated 04/23/25), Resident Lease Agreement (dated 8/24/24), Personal Rights LIC 603C (dated 08/24/24), 30-Day Notice of Termination of Residency Letter (dated 04/14/25), and Family Council Meetings and Follow-up Email Correspondences (dated 12/25/24, 02/12/25, 02/22/25, 04/08/25, 04/15/25 and 05/06/25) and other pertinent records associated with this investigation.
(Evaluation Report continues LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 05/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2025

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-20250513084722

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: 05/23/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

INVESTIGATION REVEALED THE FOLLOWING:

Allegation #1: Staff retaliated against resident resulting in eviction.

The complaint alleges that the facility staff retaliated against a resident, leading to an eviction. Reports indicate that Regency Palms attempted to evict Resident #1 (R1) in a classic retaliation case. It appears that the facility is using unspecified incidents, which are common among residents with Major Neurocognitive Disorder (NCD), as justification for removing (R1). The family representative for (R1) is part of the Family Council. The facility does not want to evict (R1); instead, it tries to stop the family's advocacy efforts.

On May 23, 2025, between 09:30 AM and 10:50 AM, the Department interviewed staff members identified as Staff #1 through Staff #3 (S1-S3). Three (3) out of the three (3) staff members could not validate this allegation. (S1-S3) denied any retaliation. (S1-S3) are aware that the incidents involving (R1) are not used for retaliation to serve for an eviction. (S1-S3) stated that they denied having retaliation due to (R1)’s family representatives’ involvement with the Family Council for Regency Palms. (S1-S3) stated the family’s involvement with the Family Council held monthly. These council meetings are specifically for residents and family members, and no Regency Palms personnel or staff are ever involved in these meetings. (S1) is notified when the meeting is scheduled and will promote it by posting in public spaces where visitors congregate. (S2-S3) stated they are not privileged to discuss any topics at these meetings, minutes a written record of a meeting, or capture key discussions, decisions, and action items.

On May 23, 2025, between 11:00 AM and 11:10 AM, the Department interviewed a resident member identified as Resident #1 (R1). (R1) uttered an appreciation for living at the facility, highlighting the staff's friendly demeanor, who have consistently treated (R1) with kindness and respect. (R1) confidently stated that there had been no experience of mistreatment during (R1)'s stay. Furthermore, (R1) expressed surprise when asked about any eviction notice, indicating a complete lack of awareness regarding such a matter.

On May 23, 2025, between 9:50 AM and 10:12 AM, the Department interviewed a witness member identified as Witness #1 the power of attorney for (R1). (W1) reiterated incidents that occurred with (R1) at the facility and felt that these incidents were reasons for the eviction, and perhaps the family representative’s advocate for (R1) is a retaliation for the eviction served to (R1) in April 2025. (W1) stated that they did not have demonstrative evidence or written communications, including emails and text messages, related to providing as retaliation for the family’s involvement with the Family Council.

(Evaluation Report continues LIC 9099-C)

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 05/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 11-AS-20250513084722

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: 05/23/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

After reviewing the Physician's Report LIC 602A for (R1) (dated 08/19/24 and 02/12/25), Facility Resident Assessment (dated 04/23/25) revealed with (R1) is diagnosed with (NCD). A review of the Resident Lease Agreement (dated 8/24/24) included Eviction, Family Council, House Rules, Complaint & Concerns, Complaint Grievance Policy procedures. Personal Rights LIC 603C (dated 08/24/24) acknowledged by (R1) with signature. 30 Day Notice of Termination of Residency Letter (dated 04/14/25), and Family Council Meetings and Follow-up Email Correspondences (dated 12/25/24, 02/12/25, 02/22/25, 04/08/25, 04/15/25 and 05/06/25) revealed no written action of retaliation.

During the May 23, 2025, visit, the Department identified that the facility promotes the rights of its residents. To improve the environment, the facility posted the Resident Rights, Personal Rights, California Residential Care Facilities for the Elderly Complaint Poster, California Long Term Ombudsman Poster, and the Family Council Meeting Poster.

Based on the information gathered, there is not enough evidence to support the allegation mentioned above.

Allegation #2: Illegal Eviction.

The complaint alleges that the facility issued an illegal eviction to Resident #1 (R1). It reported that the facility failed to issue a legal eviction because the notice was defective. The notice failed to state any of the five legal reasons for the eviction and failed to provide details required by Title 22 Regulations.

On May 23, 2025, between 09:30 AM and 10:50 AM, the Department interviewed staff members identified as Staff #1 through Staff #3 (S1-S3). Three (3) out of the three (3) staff members confirmed that a 30-Day Notice of Termination of Residency Letter (dated 04/14/25) was issued to Resident #1 (R1) along with the family representative and Community Care Licensing (CCL). According to (S1-S3) this Eviction Notice has now been terminated as of May 19, 2025, and is no longer valid.

On May 23, 2025, between 11:00 AM and 11:10 AM, the Department interviewed a resident member identified as Resident #1 (R1). (R1) asserted was completely unaware of any eviction notice that had been issued by the facility staff.

On May 23, 2025, between 9:50 AM and 10:12 AM, the Department interviewed a witness member identified as Witness #1 (W1) the power of attorney for (R1). (W1) acknowledged a 30-Day Notice of Termination (dated 04/15/25) was received. (W1) addressed that the Notice of Termination dated April 14, 2025, has become invalid.

(Evaluation Report continues LIC 9099-C)

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 05/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 11-AS-20250513084722

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: 05/23/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

A review of (R1)’s 30-Day Notice of Termination Letter (dated 04/15/25) and Fed Ex Receipt (dated 04/15/25) was sent to (R1), family representative and an email receipt to Community Care Licensing (CCL).

Based on the information gathered, there is not enough evidence to support the allegation mentioned above.

Based on the information collected from the facility inspection, observations, interviews, and records analysis, the Department found no evidence to support the above allegations. Although the allegations may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred. Therefore, the allegations are Unsubstantiated.

An exit interview conducted with Executive Director Fabiola Marciano and copies of the report provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 05/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2025

LIC9099 (FAS) - (06/04)

Page: 4 of 4