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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602567
Report Date: 06/18/2025
Date Signed: 06/18/2025 12:34:27 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
05/13/2025 and conducted by Evaluator Ernand Dabuet
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20250513084722
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: 75DATE:
06/18/2025
UNANNOUNCEDTIME BEGAN:
09:06 AM
MET WITH:Fabiola MarcianoTIME COMPLETED:
11:59 AM
ALLEGATION(S):
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9
Illegal Eviction
INVESTIGATION FINDINGS:
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13
***This report supersedes the report dated 05/23/25. This report is being created to remove the unsubstantiated allegation of “Illegal Eviction” to substantiated. All other aspects of the complaint report remain in effect.***

On June 18, 2025, the California Department of Social Services Community Care Licensing (CDSS/CCL) Licensing Program Analyst (LPA) Ernand Dabuet made this unannounced subsequent complaint visit for the purpose of delivering findings for the investigation into the above identified complaint allegation. The LPA met with facility Executive Director Fabiola Marciano and explained the reason for today’s inspection.

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).
(Evalution Report continues LIC 9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025
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-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: 06/18/2025
NARRATIVE
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 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.

Investigation Revealed the Following:
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 dismissed as of May 19, 2025.

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 been dismissed.

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). The 30-Day Notice of Termination under Title 22 Regulation 87244 Eviction Procedures subsection (d) The licensee shall set forth in the Notice to quit the reasons relied upon for the eviction with specific facts to permit determination of the date, place, witnesses, and circumstances concerning those reasons.


(Evaluation Report continues LIC 9099-C)
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025
LIC9099 (FAS) - (06/04)
Page: 2 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
05/13/2025 and conducted by Evaluator Ernand Dabuet
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20250513084722

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: 75DATE:
06/18/2025
UNANNOUNCEDTIME BEGAN:
09:06 AM
MET WITH:Fabiola MarcianoTIME COMPLETED:
11:59 AM
ALLEGATION(S):
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2
3
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5
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8
9
Staff retaliated against resident resulting in eviction.
INVESTIGATION FINDINGS:
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13
***This report supersedes the report dated 05/23/25. The findings for this above allegation remained unsubstantiated. All other aspects of the complaint report remain in effect. ***

On June 18, 2025, the California Department of Social Services Community Care Licensing (CDSS/CCL) Licensing Program Analyst (LPA) Ernand Dabuet made this unannounced subsequent complaint visit for the purpose of delivering findings for the investigation into the above identified complaint allegation. The LPA met with facility Executive Director Fabiola Marciano and explained the reason for today’s inspection.

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).
(Evalution Report continues LIC 9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025
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-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: 06/18/2025
NARRATIVE
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 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.

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.

(Evaluation Report continues LIC 9099-C)

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 7
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: 06/18/2025
NARRATIVE
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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.

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.

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 allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred. Therefore, the allegations isUnsubstantiated.

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: 06/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025
LIC9099 (FAS) - (06/04)
Page: 7 of 7
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: 06/18/2025
NARRATIVE
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This information was excluded from the Notice and does not meet Title 22 requirements.

Based on the information gathered, there is sufficient evidence to support the allegation mentioned above.

Based on observations, interviews, record reviews, and analysis, the preponderance of evidence standard has been met; therefore, the allegation that "Illegal Eviction" is determined Substantiated. California Code of Regulations, Title 22, Division 6, and Chapter 8 are being cited on the attached LIC 9099-D.

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: 06/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 7
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/18/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/25/2025
Section Cited
CCR
87244(d)
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87224 Eviction Procedures (d) The licensee shall set forth in the notice to quit the reasons relied upon for the eviction with specific facts to permit determination of the date, place, witnesses, and circumstances concerning those reasons.
This requirement is not met as evidenced by:
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The licensee will comply with Title 22 Reg 87244 and resubmit a Notice to Quit, per Title 22 87244. Proof of correction of a revised Notice to Quit must be sent to LPA Dabuet by 06/28/25 at ernand.dabuet@dss.ca.gov
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Based on the record review, the licensee failed to provide a valid Notice to Quit per Title 22 Reg 87244(d). This poses a potential Health, Safety, or Personal Rights risk to persons in care.
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This citation was corrected during visit on 05/23/25. The Notice of Termination was dismissed on 05/19/25 and a new Notice of Termination was submitted on 05/22/25.
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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: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 7