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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602567
Report Date: 06/06/2025
Date Signed: 06/06/2025 02:56:10 PM

Document Has Been Signed on 06/06/2025 02:56 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		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 BEACHFACILITY NUMBER:
198602567
ADMINISTRATOR/
DIRECTOR:		KENIA SANCHEZ PADILLAFACILITY TYPE:
740
ADDRESS:117 E 8TH STREETTELEPHONE:
(562) 432-9260
CITY:LONG BEACHSTATE: CAZIP CODE:
90813
CAPACITY: 91CENSUS: 75DATE:
06/06/2025
TYPE OF VISIT:OfficeANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Fabiola Marciano, Executive DirectorTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
NARRATIVE
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This report supersedes report dated 05/08/2025.

On 06/06/2025 at 12:00 pm, an office visit was held by the El Segundo Adult and Senior Care Regional Office. During the meeting the following people were present: Benita Yates (Regional Manager), Janae Hammond (Licensing Program Manager), Zina Brown (Licensing Program Analyst), Fabiola Marciano (Executive Director), Lisa To (Regional Director) and facility representative: Christine Hannah (Managing Member for the Licensee) and Sarang Tatimatla (CRO Board Member) to issue deficiencies identified during unrelated complaint investigation 11-AS-20250417101102.

On 01/06/2025 and 04/18/2025, the Department received information indicating that video surveillance with an audio component was being used in four resident bedrooms (three shared and one private).

On 04/23/2025 & 05/08/2025 the Department conducted a comprehensive review of facility operations and practices. A physical tour of the facility was conducted and the following records were obtained and reviewed: Register of Residents, Physician Reports for Residents #1 thru #7 (R1 to R7); Power of Attorney for Resident #3 & Resident # 7; Advance Health Directive for R1, and Admission Agreements for R1 to R7.

Report continues on LIC 809C page.

NAME OF LICENSING PROGRAM MANAGER: Janae Hammond
NAME OF LICENSING PROGRAM ANALYST: Zina Brown
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/06/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 06/06/2025 02:56 PM - It Cannot Be Edited


Created By: Zina Brown On 05/22/2025 at 03:44 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 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: 06/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/06/2025
Section Cited
CCR
87208(a)

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Plan of Operations: The licensee shall have and maintain a current, written definitive plan of operation for the facility. The licensee shall operate the facility in accordance with the terms specified in the plan of operation. . . This requirement is not met as evidenced by:
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The facility will be reviewing the Plan of Operation and updating to adhere with current Title 22 regulations but will not seek changes with the use of video surveillance with audio and will submit plan of operation to department by POC due date via email at Zina.Brown@dss.ca.gov
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Based on interviews conducted and records review the facility is not following the approved plan of operation by allowing the use of video surveillance in four (4) resident rooms.
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Type B
06/30/2025
Section Cited
CCR87468.2(a)(1)

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Additional Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities. . . to have a reasonable level of personal privacy in accommodations. This requirement is nor met as evidenced by: Based on interview conducted and record review. . .
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The facility will notify the families of the residents in the shared room who do not have video survilleance with audio installed in the shared room with resident who still have video survilleance with audio in use of the shared room
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Based on interviews and records reviewed the facility violated 2 out of 7 residents right to privacy by allowing the use of video surveillance with audio in residents rooms without consent.
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and will submit proof of notification to the department by POC due date via email at Zina.Brown@dss.ca.gov
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Janae Hammond
NAME OF LICENSING PROGRAM MANAGER:
Zina Brown
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/06/2025


LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 06/06/2025
NARRATIVE
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On April 22, 2025, the department reviewed the facility's plan of operation including admission agreement which the review revealed that Regency Palms Long Beach stated in the plan of operations that video surveillance wouldn't be used in residents rooms too protect privacy. Further review of the admission agreement—specifically page 6 section “miscellaneous,” item 10.9—state “due to privacy of residents, residents will not have nanny cam’s in there apartment.”

Contrary to these stated policies, the Department observed, during a facility tour, signage on rooms 302, 303, 305, and 502 indicating that video surveillance was active in those rooms.

Interviews were conducted with the Administrator (A1) on April 23, 2025. A1 confirmed that video surveillance devices, including audio components, were installed in four resident rooms. A1 stated that the video surveillance was installed by residents' families and that facility staff did not have access to the video recordings. A1 provided the following room-specific details:

  • Room 302 (shared): Both R2 and R3 have video surveillance with an audio component.
  • Room 303 (shared): R1 has video surveillance with an audio component; R4 does not.
  • Room 305 (private): R7 has video surveillance with an audio component.
  • Room 502 (shared): R5 has video surveillance with an audio component; R6 does not.

On May 27, 2025, the Department interviewed W1, the responsible party for 1 out of 7 residents who did not have capacity. W1 stated they were not informed of any video or audio surveillance in the residents’ room and did not provide consent for its installation or use. W1 further expressed concerns about the surveillance constituting an invasion of privacy, particularly given the potential recording of confidential medical information.

Report continues on LIC 809-C page.

NAME OF LICENSING PROGRAM MANAGER: Janae Hammond
NAME OF LICENSING PROGRAM ANALYST: Zina Brown
LICENSING PROGRAM ANALYST SIGNATURE:

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

DATE: 06/06/2025
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 06/06/2025
NARRATIVE
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On 05/28/2025, the Department interviewed one of the seven residents. The resident denied any knowledge of the presence of video or audio surveillance in their shared room and denied giving consent for such surveillance.

Based on observations, review of facility records, and interviews, the Department finds that Regency Palms Long Beach is in violation of its approved Plan of Operation and Admission Agreement by allowing video surveillance with audio capabilities in residents' bedrooms.


Furthermore, the facility failed to safeguard residents’ personal rights, as required by Title 22 regulations. Specifically, 2 out of 7 residents’ right to privacy was violated due to the presence of video surveillance with an audio component capturing private conversations, including those with family members, visitors, and the Ombudsman.

Deficiencies are cited under California Code of Regulations, Title 22, Division 6, Chapter 8, and are documented on the attached LIC 809-D.

An exit interview was conducted with Executive Director Fabiola Marciano. A copy of this report, along with appeal rights, was provided.

NAME OF LICENSING PROGRAM MANAGER: Janae Hammond
NAME OF LICENSING PROGRAM ANALYST: Zina Brown
LICENSING PROGRAM ANALYST SIGNATURE:

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

DATE: 06/06/2025
LIC809 (FAS) - (06/04)
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