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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602567
Report Date: 12/18/2025
Date Signed: 12/18/2025 10:34:37 AM

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
08/07/2025 and conducted by Evaluator Zina Brown
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20250807153125
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: 73DATE:
12/18/2025
UNANNOUNCEDTIME BEGAN:
08:10 AM
MET WITH:Robert Jakini, AdministratorTIME COMPLETED:
10:45 AM
ALLEGATION(S):
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Facility staff are not properly trained.
INVESTIGATION FINDINGS:
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On 12/18/2025 at 08:10 am, Licensing Program Analyst (LPA) Zina Brown conducted a subsequent visit at this facility to deliver the complaint findings for the allegation above. LPA met with Robert Jakini (Administrator) and explained the purpose of the visit.

The investigation consisted of the following: On 08/11/2025 at 1:20pm, Licensing Program Analysts (LPAs) Zina Brown, Ernand Daubet, Lizeth Villegas and Licensing Program Manager (LPM) Janae Hammond conducted an unannounced initial complaint visit at this facility. During today’s visit, LPAs and LPM met with Robert Administrator and explained the purpose of the visit. LPAs conducted interviews with Administrator (A1), Staff (S1-S4) & Residents (R1-R8) between the hours of 2:15 pm - 3:41 pm. LPA requested copies of Resident Roster (received on 08/11/2025), Staff Roster (received 08/11/2025), ALW Resident List, Admission Agreement for ALW Resident, Invoices for Returned Rent Checks/Fees, Sign In Sheet (for month of August 2025) Memory Care Staff training from initial to present.

Report continues on LIC 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
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 9
Control Number 11-AS-20250807153125
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: 12/18/2025
NARRATIVE
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Please be advised: When the Department initiated this investigation, at the time that Variola Marciano was serving as the facility’s Administrator.

The investigation revealed the following:
Allegation: Facility staff are not properly trained
It was alleged that staff in the memory care new hires are not properly trained.

On 08/11/2025, LPA interviewed Administrator (A1) regarding the allegation. A1 denied the allegation. A1 states he believes his staff is properly trained as ongoing trainings are provided such as in-services, annual training, Relias and shadowing.

On 08/11/2025, between 2:30pm -3:50pm and on 10/02/2020 between the hours of 10:17am - 12:21pm, LPA interviewed 11 staff regarding the allegation: 2 of 11 staff confirmed the allegation and stated if staff is a first-time caregiver needs additional training. 6 of 11 staff denied the allegation and stated all staff are properly trained.
3 of 11 staff did not confirm nor deny the allegation and stated speaking for themselves that they have been properly trained .

On 08/11/2025, between 2:30pm -3:50pm and on 10/02/2020 between the hours of 10:00am -11:43am, LPA interviewed 9 residents: 9 of 9 residents denied the allegation and stated the staff appear to be trained and knowledgeable when assisting the residents.

On 12/05/2025, between 8:30am and 2:25pm, the LPA conducted a records review and noted the following:
A total of 27 caregivers work in the memory care unit. 11 caregivers participated in the required 2024–2025 training curriculum, which consists of 46 topics, including dementia care, incontinence care, medication assistance, care for bedridden residents, communication, person-centered care, hospice services, residents’ rights, infection control, and recognizing and reporting abuse, among other mandated subjects. Upon discovery, here is the training completion levels w as follows: 46 topics completed by 2 caregivers, both employed for 4 and 7 months. 40–45 topics completed by 3 caregivers, each employed for approximately one year. 8–24 topics completed by 6 caregivers; 2 have been employed since 2023 and 4 have been employed since 2024.

Based on LPAs observations and interviews which were conducted and the records that were reviewed, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED under California Code of Regulations, Title 22, Division 6 and Chapter 8 are being cited on the attached LIC 9099D.

Exit interview conducted with Robert Jakini (Administrator) and a copy of this report & appeal right were provided.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 9
Control Number 11-AS-20250807153125
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: 12/18/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/19/2026
Section Cited
CCR
87411(c)
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Personnel Requirements - General: All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69
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The facility will ensure all caregivers who work in memory care complete all the annual training need to be in compliance with Title 22 regulations.
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Based on observation and interviews, the facility failed to have 16 out 27 caregiver who work in Memory Care complete all the required training in 2025.
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The facility will submit the proof of correction to the CCLD/El Segundo ASC Office via fax at 424-544-1016 Attn: Zina Brown or via email at zina.brown@dss.ca.gov by the POC due date.
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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: Zina Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 9
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
08/07/2025 and conducted by Evaluator Zina Brown
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20250807153125

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: DATE:
12/18/2025
UNANNOUNCEDTIME BEGAN:
08:10 AM
MET WITH:Robert Jakini, AdministratorTIME COMPLETED:
10:45 AM
ALLEGATION(S):
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Facility is overcharging residents for rent.
Facility staff are not properly administer residents medications.
Facility staff is harassing residents.
Facility staff are refusing to provide care to resident.
Facility staff did not allow Home Health Agency entry in the facility to provide care to resident.
INVESTIGATION FINDINGS:
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On 12/18/2025 at 8:45am, Licensing Program Analyst (LPA) Zina Brown conducted a subsequent visit at this facility to deliver the complaint findings for the allegations above. During today’s visit, at 00:00 am, LPA met with Robert Jakini (Administrator) and explained the purpose of the visit.

The investigation consisted of the following: On 08/11/2025 at 1:20pm, Licensing Program Analysts (LPAs) Zina Brown, Ernand Daubet, Lizeth Villegas and Licensing Program Manager (LPM) Janae Hammond conducted an unannounced initial complaint visit at this facility. During today’s visit, LPAs and LPM met with Robert Administrator and explained the purpose of the visit. LPAs conducted interviews with Administrator (A1), Staff (S1-S4) & Residents (R1-R8) between the hours of 2:15 pm - 3:41 pm. LPA requested copies of Resident Roster (received on 08/11/2025), Staff Roster (received 08/11/2025), ALW Resident List, Admission Agreement for ALW Resident, Invoices for Returned Rent Checks/Fees, Sign In Sheet (for month of August 2025) Memory Care Staff training from initial to present.

Report continues on LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 9
Control Number 11-AS-20250807153125
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: 12/18/2025
NARRATIVE
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Please be advised: When the Department initiated this investigation, Fabiola Marciano was serving as the facility’s Administrator.

The investigation revealed the following:
Allegation: Facility is overcharging residents for rent
It was alleged that the facility Administrator has been sending back Resident 1 (R1) payments for rent and cannot send back check payments.

On 08/11/2025, LPA interviewed Administrator (A1) regarding the allegation. A1 denied the allegation and stated residents are given a clear breakdown of their rent and any additional fees. A1 says the people in question not being charged due to eviction. The attorney suggested this to send back payment if it is sent to the facility. ALW rent amount is $1,600 which is not listed on the facility Admission Agreement. A1 also stated care component and rent component are all combines sand ALW makes determination of rent supplement.

On 08/11/2025, between 2:30pm - 3:50pm and on 10/02/2025 between the hours of 10:17am - 12:21pm, LPA interviewed 11 staff regarding the allegation: 11 of 11 staff were unaware of the allegation and stated not having any knowledge of the facility overcharging residents for rent.

On 08/11/2025, between 2:30pm -3:50pm and on 10/02/2025 between the hours of 10:00am -11:43am, LPA interviewed 9 residents: 8 of 9 residents denied the allegation and stated the facility rent is fair for residents. 1 of 9 residents did not confirm nor deny the allegation and stated not having any knowledge of whether rent is fair

On 12/05/2025, between the hours of 9:22am - 9:30am, LPA conducted a records review and observed the following:
Invoices for Memory Care (MC) rent for Apartment 303A for Resident 1 in the amount of $1,600 were documented as follows: MC Rent Invoice Date/Due Date: 08/31/2024 – $721.55 . Other Charges Invoice Date/Due Date: 08/31/2024 – $412.90 . Monthly MC Rent Invoice Date/Due Date: 09/01/2024, 10/01/2024, 11/01/2024, 12/04/2024, 01/01/2025, 02/01/2025, 03/01/2025, 04/01/2025, 05/01/2025, 06/01/2025 – $1,600 each.

The Regency Lease Agreement, signed and dated on 08/24/2024 by Resident 1’s authorized representative, indicates that the agreement was entered into on 08/24/2024 for Apartment 303A on a month-to-month basis beginning 08/24/2024, with an apartment fee of $1,600 per month and a waived ALW care fee, for a total of $1,600 per month, payable in advance on the first day of each month.

Based on information gathered through interviews and record reviews, there is not enough evidence to support the allegation. 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: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 9
Control Number 11-AS-20250807153125
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: 12/18/2025
NARRATIVE
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Allegation: Facility staff are not properly administering residents’ medication
It was alleged that resident was not consistently receiving medication on a regular basis.

On 08/11/2025, LPA interviewed Administrator (A1) regarding the allegation. A1 denied the allegation. A1 stated the Medication Administrated Record (MAR) informs the facility what time to dispense the prescribed medication to each resident.  A1 states all staff are provided training on Relias and by the pharmacy. At times if there is no order it will cause a delay particular from the Va and Kaiser which slows the process down. The facility documents medication refusals and if there are suspected or identified it is verified and reported to the residents' family.

On 08/11/2025, between 2:30pm -3:50pm and on 10/02/2025 between the hours of 10:17am - 12:21pm, LPA interviewed 11 staff regarding the allegation: 3 of 11 staff did not confirm nor deny the allegation and stated not having any knowledge of any reported medication errors. 8 of 11 staff were unaware of the allegation and stated not administering medication to the residents

On 08/11/2025, between 2:30pm -3:50pm and on 10/02/2025 between the hours of 10:00am -11:43am, LPA interviewed 9 residents: 9 of 9 residents denied the allegation and stated their medication is always administered on time.

On 08/11/2025, between the hours of 1:40pm - 2:50pm, LPAs conducted a medication administration review and observed the following: All medications were counted and matched the residents medication administrator record (MAR): 2nd Floor:The resident in Room 202B takes 4 pills in the morning, 1 pill at noon, and 4 pills in the evening/bedtime.The resident located in Room 202A takes 5 pills in the morning, 1 weekly pill in the morning, 1 pill at noon, and 3 pills in the evening/bedtime 3rd Floor: For Resident 1 (R1), LPA counted 4 remaining pills for Levofloxacin. The prescription started on 08/10/2025 and must be administered daily at 7 p.m. per physician orders. For R1’s Myrbetriq, which started on 07/22/2025 with 30 tablets, there were 9 pills remaining as of 08/11/2025. Resident 3 (R3) takes 5 pills in the morning, 1 pill at noon, and 3 pills in the evening/bedtime. The resident located in Room 302B a takes 9 pills in the morning, 1 pill at noon, and 5 pills in the evening/bedtime.M. Barras takes 7 pills in the morning, 1 pill at noon, and 3 pills in the evening.
4th Floor: For the resident located in Room 301A, LPA counted 30 pills for each prescribed medication. The resident takes 5 medications in the morning and 3 in the evening. On 08/06/2025, the facility documented on the MAR that the following medications were not administered—Memantine HCL 10 mg, Donepezil HCL 10 mg, Januvia 50 mg, Rosuvastatin Calcium 20 mg, and Metformin HCL 500 mg—due to the resident being out of the facility at a day center program. The resident located in Room 407 takes 3 pills in the morning and 3 pills in the evening/bedtime.

Based on information gathered through interviews and record reviews, there is not enough evidence to support the allegation. 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: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 9
Control Number 11-AS-20250807153125
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: 12/18/2025
NARRATIVE
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Allegation: Facility staff are harassing residents
It was alleged that staff are intentionally harassing resident to cause behaviors due to them trying to push .

On 08/11/2025, LPA interviewed Administrator (A1) regarding the allegation. A1 denied the allegation.  A1 states not witnessing or hearing about any instances of staff behaving inappropriately towards residents . The facility policy is providing care. A1 also stated there is no formal complaints or investigations related to staff harassment towards the staff. However an immediate termination would be in place if staff intentionally harassing resident to cause a behavior.

On 08/11/2025, between 2:30pm - 3:50pm and on 10/02/2025 between the hours of 10:17am - 12:21pm, LPA interviewed 11 staff regarding the allegation: 11 of 11 staff denied the allegation and stated have not witness nor heard about staff behaving inappropriately towards the residents.

On 08/11/2025, between 2:30pm - 3:50pm and on 10/02/2025 between the hours of 10:00am -11:43am, LPA interviewed 9 residents: 9 of 9 residents denied the allegation and stated the staff treat the resident with respect are kind, and outstanding to the residents

On 12/11/2025, between the hours of 2:20pm - 2:30pm, LPA conducted a records review and observed the following: LPA did not observe any incidents reports nor resident notes in regards to this allegation.

Based on information gathered through interviews and record reviews, there is not enough evidence to support the allegation. 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.

Report continues on LIC 9099-C.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
LIC9099 (FAS) - (06/04)
Page: 7 of 9
Control Number 11-AS-20250807153125
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: 12/18/2025
NARRATIVE
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Allegation: Facility staff are refusing to provide care to residents

It was alleged that caregivers were in R1's room and contacted the med tech for assistance. The med tech stated that he had shown them how to complete the task; however, staff reportedly refused to raise the resident’s bed rails.

On 08/11/2025, LPA interviewed Administrator (A1) regarding the allegation. A1 denied the allegation. A1 stated no such thing as care no being provided has happened ; yet staff can be called to help other staff. There are no cases where care was refused nor delayed for the resident but if so, it would be documented. Also, A1 stated in the event of staff failing to provide required care would result in immediate termination.

On 08/11/2025, between 2:30pm -3:50pm and on 10/02/2025 between the hours of 10:17am - 12:21pm, LPA interviewed 11 staff regarding the allegation: 11 out of 11 staff denied the allegation and stated there are no documented cases where care is refused or delayed for the residents . However, staff do document when care is /was refused or delayed for residents.

On 08/11/2025, between 2:30pm -3:50pm and on 10/02/2025 between the hours of 10:00am -11:43am, LPA interviewed 9 residents: 9 of 9 residents denied the allegation and stated when asking for help, the staff do come help.

On 12/11/2025, between the hours of 2:20pm - 2:30pm, LPA conducted a records review and observed the following: LPA did not observe any incidents reports nor resident notes in regards to this allegation.

Based on information gathered through interviews and record reviews, there is not enough evidence to support the allegation. 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.

Report continues on LIC 9099C

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
LIC9099 (FAS) - (06/04)
Page: 8 of 9
Control Number 11-AS-20250807153125
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: 12/18/2025
NARRATIVE
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Allegation: Facility staff did not allow Home Health agency entry to provide care to resident
It was alleged that nurse that comes once a month to change her catheter fire Royal Majesty Home Health Teresa Andaya refused entry on August 2nd and 8:14am ask med tech to unlock door and waited until 8:26am and no one answered, and she had to leave at 8:30am.

On 08/11/2025, LPA interviewed Administrator (A1) regarding the allegation. A1 denied the allegation. A1 stated no Home Health agencies were denied entry access on the day of August 2nd at 8am for Resident 1 (R1) as it would be impossible that staff was not available at that time. A1 states the facility does not deny visit as it is a violation of rights. A1 states if Home Health agencies are behaving with the perimeters.

On 08/11/2025, between 2:30pm -3:50pm and on 10/02/2025 between the hours of 10:17am - 12:21pm, LPA interviewed 11 staff regarding the allegation: 1 of 11 staff denied the allegation and stated there have no instances where Home Health Agencies such as Royal Majesty home were denied access on August 2, 2025, around 8am for Resident 1 (R1).
10 of 11 staff were unaware of the allegation & stated not having any knowledge of Home Health Agency not being allowed entry to provide care to Resident 1 (R1)

On 08/11/2025, between 2:30pm -3:50pm and on 10/02/2025 between the hours of 10:00am -11:43am, LPA interviewed 9 residents: 6 of 9 residents denied the allegation and stated no nurse from an outside agency has ever come to the facility to care for the residents. 4 of 9 residents did not confirm nor deny the allegation and stated a nurse from an outside agency such as Home Health has not been stopped to come into the facility to provide care to the resident.

On 12/08/2025, between the hours of 1:45pm -1:55pm LPA conducted a records review and observed the following:
On the visitors sign in sheet, Teresa Andaya from Royal Majesty Home Health signed on the following dates and time 08/03/2025 at 12:39pm, 08/12/2025 at 11:03pm and 08/26/2025 at 11:28pm

Based on information gathered through interviews and record reviews, there is not enough evidence to support the allegation. 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.

Exit interview conducted with Robert Jakini (Administrator) and a copy of this report & appeal right were provided.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
LIC9099 (FAS) - (06/04)
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