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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602567
Report Date: 11/13/2025
Date Signed: 11/13/2025 02:43:20 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
11/07/2025 and conducted by Evaluator Jose Calderon
COMPLAINT CONTROL NUMBER: 11-AS-20251107105924
FACILITY NAME:REGENCY PALMS LONG BEACHFACILITY NUMBER:
198602567
ADMINISTRATOR:ROBERT JAKINIFACILITY TYPE:
740
ADDRESS:117 E 8TH STREETTELEPHONE:
(562) 432-9260
CITY:LONG BEACHSTATE: CAZIP CODE:
90813
CAPACITY:91CENSUS: 70DATE:
11/13/2025
UNANNOUNCEDTIME BEGAN:
09:11 AM
MET WITH:ADMINISTRATOR ROBERT JAKINITIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff transferred funds from residents bank account without consent.
INVESTIGATION FINDINGS:
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On 11/13/2025 Licensing Program Analyst (LPA) Jose Calderon conducted an unannounced visit to Regency Palms Senior Living and was greeted by Administrator Robert Jakini (S1). LPA Calderon explained the purpose of this visit is to deliver the findings pertaining to the above-mentioned allegation.
The investigation consisted of the following: LPA Calderon interviewed Staff S1, resident R1-R7. LPA Calderon obtained the following records: Admission agreement (dated 01/09/2025), ACH activation and authorization form, signed by R1 (dated 01/10/2025), Demand for payment (dated 10/27/2025), Charges due from resident (dated 01/09/2025), Reviewed billing agreement (dated 01/09/2025), Statement activity (dated 01/01/2025 to 10/31/2025) for R1.
The investigation revealed the following:
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Jose Calderon
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2025
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-20251107105924
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: 11/13/2025
NARRATIVE
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Regarding the Allegation: Staff transferred funds from R1 bank account without consent.

This complaint alleged that the facility took money out of R1 bank account without permission. Record review indicates the following: Admission agreement indicates that R1 moved into the facility on 01/09/2025. R1 signed the ACH activation and authorization form which allowed the facility to take money out of R1 bank account. Reviewed R1 lease agreement which indicates that R1 had a balance due to the facility from 01/09/2025 to 11/01/2025. Interviews indicate the following: S1 indicates that R1 signed the admission agreement which allowed the facility to withdraw money from R1 bank account. S1 indicates that R1 did not pay R1 full rent and has a balance due. S1 indicates that no eviction notice had been given to R1. R1 indicates that the facility took money out of R1 bank account in January 2025. R1 indicates that R1 did not pay the full amount of rent to the facility. 6 out of 7 staff deny the allegation.

Based on interviews and supporting documentation, the preponderance of evidence standard has NOT been met therefore, the allegation of “staff transferred funds from residents bank account without consent” is found to be UNSUBSTANTIATED.

No deficiencies cited during today's visit.



An exit interview was conducted, and a copy of the Complaint Report was provided to the Administrator Robert Jakini.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Jose Calderon
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2025
LIC9099 (FAS) - (06/04)
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