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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602567
Report Date: 05/23/2025
Date Signed: 05/23/2025 03:38:07 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
05/20/2025 and conducted by Evaluator Perry Scott
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20250520112257
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: 74DATE:
05/23/2025
UNANNOUNCEDTIME BEGAN:
09:31 AM
MET WITH:Fabiola MarcianoTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff did not provide adequate supervision to resident(s) in care.
INVESTIGATION FINDINGS:
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On 5/23/25, at 09:00am, the department conducted an initial complaint visit to the facility and was greeted by Fabiola Marciano, Executive Director. The department explained the purpose of this visit is to gather information about the complaint, gather facility files, interview staff/residents, and deliver findings for the allegation mentioned above.

The investigation consisted of the following: The department investigated the allegation mentioned in this complaint; and conducted interviews with staff (S1-S7) and residents (R1-R6) from 10:00am-2:00pm. The department received the following documents: Resident Roster (Dated: No Date), Staff Roster (Dated: 05/12/2025), Work Order for Emergency Pull Chord (Dated:05/23/2025), Resident Incident Details Report (Dated: 05/18/2025-05/24/2025), Admission Agreements (Dated:02/19/2024, 10/16/2024, 04/15/2023), ID Emergency Information (Dated: 9/25/2022, 02/18/2024), Physicians Report (Dated: 03/11/2025, 10/17/2023), and Resident Appraisal (Dated:09/1/2024, 10/14/2024, 02/01/2025) from the facility.

Report Continued on LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
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 3
Control Number 11-AS-20250520112257
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
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The investigation revealed the following: Allegation-Staff did not provide adequate supervision to resident(s) in care.

The details of the complaint alleged that an alarm was going off in a resident’s room from 9:00am -9:25am on 05/19/25, but no one came to see what the problem was or if the resident was in danger or needed care. On 5/23/25, from 10:00am-2:00pm, the department interviewed staff (S1-S7) and residents (R1-R6) regarding the allegation. 6 of 7 staff denied the allegation that the Staff did not provide adequate supervision to resident(s) in care. All staff stated that all residents are provided with adequate supervision and if assistance is needed, residents have the option of using the call buttons in their room, pendants, or the motion sensors would alert staff that the resident needs assistance. One staff was aware that room 302B was having problems with the emergency pull chord device.

The department interviewed residents (R1-R6) about the allegation and 5 of 6 residents that were interviewed denied the allegation that Staff did not provide adequate supervision to resident(s) in care. The majority of residents interviewed stated that the staff are meeting their needs and are satisfied with the care and supervision they are receiving at the facility.

The Department toured room 302B and pulled the emergency pull chord, the light was flashing, but no one came to assist. The department observed the reason no one came to assist was because the signal system was not transmitting an auditory signal to the care staff. The department reviewed the Resident Incident Details Report (Dated: 05/18/2025-05/24/2025) and observed that on 05/19/2025 between 7:02am-09:23am the device was in motion but was not communicating with staff. The staff provided the department with a work order (Dated: 05/23/2025) for room 302B to address the pull chord and verify that the connection is working.

Based on observation, interviews conducted, and records reviewed, the preponderance of evidence standard has been met. Therefore, the above allegation Staff did not provide adequate supervision to resident(s) in care, is found to be Substantiated. The emergency pull chord in the resident’s room was not working and poses a potential health and safety risk. California Code of Regulations, Title 22, Division (6) and chapter (8) are being cited on the attached LIC 9099D.

Note: *Citations that are not cleared by the due date of 06/13/2025 will have a $100 fine assessed for each citation until it is cleared. Civil penalties will continue to accrue until Proof of Corrections (POC) is cleared.

Deficiencies are issued and plans of corrections were discussed.


An exit interview was conducted with Fabiola Marciano, Executive Director, and a hard copy of this Complaint Investigation Report was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
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 3
Control Number 11-AS-20250520112257
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: 05/23/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/29/2025
Section Cited
CCR
87303(i)(B)
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87303(i)(B) Maintenance and Operation. (i) Facilities shall have signal systems which shall meet the following criteria: (B) Transmit a visual and/or auditory signal to a central staffed location or produce an auditory signal at the living unit loud enough to summon staff. This requirement is not met as evidenced by:
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The Administrator will adhere to Title 22 regulations 87303(i)(B) Maintenance and Operation and submit a work order for the emergency pull chord device in room 302B to be repaired by the plan of correction due date of 06/13//25. Facility will submit proof that the device was repaired to LPA’s email address at perry.scott@dss.ca.gov to avoid monetary penalties.
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Based on observation and records reviewed, LPA observed that the emergency signal system in room 302B does not currently transmit an auditory signal to a central staffed location, which poses a potential health and safety risk to residents in care.
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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: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2025
LIC9099 (FAS) - (06/04)
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