198602567-9-25-2023-11-AS-UCOL-CY4PPH-20231201102930

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602567
Report Date: 09/25/2023
Date Signed: 09/25/2023 12:12:44 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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/20/2023 and conducted by Evaluator Mario Leon

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20230920124459

FACILITY NAME:	REGENCY PALMS LONG BEACH		FACILITY NUMBER:	198602567
ADMINISTRATOR:	KENIA SANCHEZ PADILLA		FACILITY TYPE:	740
ADDRESS:	117 E 8TH STREET		TELEPHONE:	(562) 432-9260
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90813
CAPACITY:	91	CENSUS: 53	DATE:	09/25/2023
		UNANNOUNCED	TIME BEGAN:	08:29 AM
MET WITH:	Kenia Padilla, Executive Director		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Staff did not provide meals to a resident in care.

INVESTIGATION FINDINGS:

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On 09/25/23 Licensing Program Analyst (LPA) Mario Leon conducted an unanounced visit to the above facility to investigate the above allegation. LPA was met by Kenia Padilla, Executive Director (S1), and the purpose of the visit was explained.

The investigation consisted of the following:
On 09/25/23 LPA Leon toured the facility with S1, interviewed five (5) residents (R1-R5) and three (3) staff (S1-S3) and interviewed one (1) witness. LPA Leon requested and reviewed facility documents.

The Investigation revealed the following:
Regarding the allegation: Staff did not provide meals to a resident in care.
It has been alleged that the facility is out of food. On 09/25/23 LPA observed the industrial kitchen, which contained ample food supply in the pantry, walk-in refrigerator and walk-in freezer.
Report continues, see LIC9099C.

Unsubstantiated

Estimated Days of Completion: 90

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Mario Leon	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20230920124459

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: REGENCY PALMS LONG BEACH	FACILITY NUMBER: 198602567
	VISIT DATE: 09/25/2023

NARRATIVE

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LPA interviewed 5 out of fifty-three (53) residents and observed 5 boxed breakfasts, each box marked appropriately for the resident's room. All 5 residents have denied the allegation.
LPA interviewed 3 staff and 1 witness. 3 out of four (4) interviewees have denied the allegation.

According to LPA's observations, interviews and record review conducted, there is not enough evidence to support the above allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred, therefore the above allegation is Unsubstatiated.

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Mario Leon	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2023

LIC9099 (FAS) - (06/04)

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