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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602567
Report Date: 08/20/2025
Date Signed: 08/20/2025 02:25:00 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
06/26/2025 and conducted by Evaluator Zina Brown
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20250626131828
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:
08/20/2025
UNANNOUNCEDTIME BEGAN:
11:36 AM
MET WITH:Robert Jakini, Executive DirectorTIME COMPLETED:
02:45 PM
ALLEGATION(S):
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9
Staff unlawfully evicted a resident.
INVESTIGATION FINDINGS:
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On 08/20/2025, at 11:45 am, Licensing Program Analyst (LPA) Zina Brown conducted a subsequent complaint visit at this facility to deliver findings. During today’s visit, LPA met with Robert Jakini (Executive Director) & explained the purpose of the visit.

The investigation consisted of the following: An initial complaint visit was conducted by the Department on 07/01/2025 and interviews with Administrator (A1), Staff (S1-S4), Residents (R1-R2) and Witness (W1) between the hours of 9:30 am – 11:53am. LPA requested and reviewed the following documents: Resident Roster (received on 07/01/2025), Staff Roster (dated 06/17/2025), LIC 601 Identification and Emergency Information (for R1- dated 02/18/2024 and for R2 - dated 09/10/2024), LIC 602: Physician Report for RCFE (for R1 - dated 04/23/2025 & for R2 - dated 02/12/2025), LIC 603A: Preplacement Appraisal (for R1 - dated 02/20/2024 & for R2 - dated 09/16/2024), LIC 625: Appraisal Needs & Service, Admission Agreement (for R1 dated 02/16/2024 & for R2 dated 04/08/2025) & Medication Administration Record for R1 & R2 from 05/2025 - 06/2025.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2025
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 2
Control Number 11-AS-20250626131828
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: 08/20/2025
NARRATIVE
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Allegation 1: Staff unlawfully evicted a resident.

It is alleged that the facility is attempting to evict Resident 1 (R1) for the failure of to comply with general policies of the compliance and failure to; comply with state or local law.

On 07/01/2025, between the hours of 9:00 am - 9:30 am, LPA interviewed A1 who denied the allegation and stated that an eviction notice was issued to R1 due to violating the facilities Admission Agreement. A1 further stated use of an unauthorized video surveillance devices with audio component as a contributing factor which is not allowed at facility as stated in the admission agreement which was signed by R1 on 08/26/2024. Between the hours of 11:43am - 11:50am, LPA interviewed 4 staff regarding the allegation: 4 of 4 staff denied the allegation.

Between 11:48am - 11:53am. LPA attempted to interview R1 who refused to be interviewed in regard to the allegation .

LPA reviewed records and observed the following: On 05/12/2025, the facility issued an eviction notice to R1 which stated the reason for the eviction was for violating 87224 Eviction Procedures of Title 22 Regulations section 87224(a)(3) “Failure of the resident to comply with general policies of the facility. Also, on 05/31/2025 via Personal Service, the 30-day Notice of Terminate provided additional with a timeline of R1 violating the Community's general polices. Based on review of the eviction notice it documents the use of video surveillance with an audio component being used which violates the facilities admission agreement. LPA reviewed R1's file and observed a reappraisal was conducted on 4/23/2025 by facility staff. LPA reviewed R1 Resident Lease Agreement which states under the section 10. Miscellaneous: 10.9 Due to the privacy of residents, Residents will not have Nanny Cams in their apartment. LPA reviewed the eviction notice and confirmed it was sent to CCLD within 5 days of issuance and based on LPAs review of the notice it appears to be in compliance with Title 22 regulations.

Based on information gathered, interviews, and record reviews, there is not enough evidence to support the allegation mentioned above. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore, the allegation is UNSUBSTANTIATED.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2