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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602567
Report Date: 02/13/2026
Date Signed: 02/13/2026 11:24:16 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
05/20/2025 and conducted by Evaluator Antonine Richard
COMPLAINT CONTROL NUMBER: 11-AS-20250520093313
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: 77DATE:
02/13/2026
UNANNOUNCEDTIME BEGAN:
08:31 AM
MET WITH:JAKINI ROBERTTIME COMPLETED:
11:35 AM
ALLEGATION(S):
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Staff falsifield a resident's records while in care.
Staff mishandled a resident's medications while in care.
INVESTIGATION FINDINGS:
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On 02/13/26, Licensing Program Analyst (LPA) Antonine Richard conducted a subsequent visit to deliver findings regarding the above-mentioned allegations. The department met with Executive Director Jakini Robert and explained the purpose of the visit.

The Investigation consisted of the following: On 05/21/25, the department requested and obtained the following documents via email: Copy of the staff and resident roster, reviewed residents files and collected copies of a Resident #1 (R1) Lease Agreement, Service Plan, Resident Assessment, Preplacement Appraisal Information, Identification and Emergency Information, Physician’s Report, Medication Destruction Records, Resident Care Plan, Unusual Incident Report/Resident Medical Records, Staff notes, Doctor visit reports, Doctors orders, Hospital discharge papers for (R1). The Department interviewed 3 staff members (S1-S3), the Executive Director (ED), the Medical Physician (MP), and six Residents #1-6 (R1-R6).

Report Continued on LIC9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2026
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 7
Control Number 11-AS-20250520093313
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: 02/13/2026
NARRATIVE
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Allegation #2: Staff falsified a resident's records while the resident was in care.

Regarding the allegation, “Staff falsified a resident's records while in care,” The complaint alleged that staff are initialing medications they do not have or that have been discontinued.

During the department visit on 11/12/25, the department interviewed six residents, #1-6 (R1-R6), who denied the allegations. The department also interviewed three staff members, #1-3 (S1-S3). Two of the three staff members stated they mishandled R1’s medication while in care. The department reviewed the QuikMAR system and the medications for Resident #1 (R1). It was noted that two medications for R1 were marked as administered; however, one medication, Fluoxetine HCl 10 mg capsule, had been discontinued on July 7, 2024, but still appeared as administered in May 2025. Additionally, a new prescription for Fluoxetine HCl 40 mg capsule was issued on July 7, 2024, but it was also discontinued in May 2025.

The Department reviewed QuikMAR for Resident #1 and found the documentation for medication administration insufficient. Medications intended for oral administration as a single tablet every 12 hours were not accurately recorded. Med Tech did not initiate some entries; some medications were not documented when they were refused or when residents were out of the community; and others should not have been initiated for various reasons. Additionally, these medications should not be included on the list for administration by Med Tech for Resident #1 (R1).

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 7
Control Number 11-AS-20250520093313
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: 02/13/2026
NARRATIVE
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Regarding the allegation, “Staff falsified a resident's records while in care,” based on record reviews, the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be substantiated. The California Code of Regulations (Title 22, Division 6 & Chapter 8) is cited in the attached LIC 9099D.

A civil penalty was assessed for a repeat violation within the last 12 months.

Allegation: #3: Staff mishandled a resident's medications while in care

Regarding the allegation that “Staff mishandled a resident's medications while in care,” it is alleged that the staff is not dispensing medications as prescribed.

A review of R1’s April 2025 QuikMAR showed that several medications scheduled for twice daily were not administered correctly. For example, the Sodium Chloride 1GM Tablet prescribed by the doctor on April 8 was intended to be taken twice daily, in the morning and evening. The department's April 2025 QuikMAR records indicated that R1 did not receive the medication from April 8 to April 13. Later, in May 2025, the QuikMAR record showed the medication was given from May 1 to May 15, 2025, except for the morning of May 16 and the afternoon of May 17. The Department interviewed three staff members, #1-3 (S1-S3). Two of the three staff members suggested that medication handling was mishandled during R1's care. The Department also interviewed the Executive Director (ED), who stated that QuikMAR identified inconsistencies in the administration of R1’s sodium tablets and other medications.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 7
Control Number 11-AS-20250520093313
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: 02/13/2026
NARRATIVE
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However, the facility staff provided quality care to residents. Additionally, the Department interviewed MP, who was unable to confirm whether the medication mishandling caused R1’s hospitalization. The Department also interviewed R1, who said R1 liked living there. During interviews on 11/12/2025, six residents (R1-R6) were asked whether staff had signed off and whether Med Tech had provided medications; all six confirmed that Med Tech had given them their medications as prescribed.

During the investigation, the Department found evidence supporting the allegations. Based on the Department interviews which were conducted and record review (s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be Substantiated. California Code of Regulations (Title 22, Division 6 & Chapter 8) is being cited on the attached LIC 9099D.

Deficiencies were cited.

A copy of this report and the appeal rights were provided to the Executive Director, Jakini Robert.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 7
Control Number 11-AS-20250520093313
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: 02/13/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/17/2026
Section Cited
CCR
87506(a)
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87506 Resident Records (a)The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff.
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Administrator will develop a plan to ensure that medication administration records are checked frequently to avoid discrepancies. Administrator will submit plan to LPA by POC due date. CIVIL PENATLY ASSESSED.
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Based on observations, interviews, and record review Staff failed to ensure medications were provided to R1, that were signed off as administered. This poses an immediate health and safety risk to residents in care.
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Type A
02/17/2026
Section Cited
CCR
87465(a)(4
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87465 Incidental Medical and Dental Care
...The licensee shall assist residents with self-administered medications as needed.
This requirment has not been met as evidenced by:
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Administrator will develop a plan to ensure that medication administration records are checked frequently to avoid discrepancies. Administrator will submit plan to LPA by POC due date.
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Based on observation, interviews and records review the administrator failed to ensure medication for resident R1 medications reviewed was not adminstrated accurately. This poses an immediate health and safety risk to residents in care.
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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: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 7
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
05/20/2025 and conducted by Evaluator Antonine Richard
COMPLAINT CONTROL NUMBER: 11-AS-20250520093313

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: 77DATE:
02/13/2026
UNANNOUNCEDTIME BEGAN:
08:31 AM
MET WITH:JAKINI ROBERTTIME COMPLETED:
11:35 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff neglect resulted in a resident to be hospitalized.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 02/13/26, Licensing Program Analyst (LPA) Antonine Richard conducted a subsequent visit to deliver findings regarding the above-mentioned allegation. The department met with Executive Director Jakini Robert and explained the purpose of the visit.

The Investigation consisted of the following: On 05/21/25, the department requested and obtained the following documents via email: Copy of the staff and resident roster, reviewed residents files and collected copies of a Resident #1 (R1) Lease Agreement, Service Plan, Resident Assessment, Preplacement Appraisal Information, Identification and Emergency Information, Physician’s Report, Medication Destruction Records, Resident Care Plan, Unusual Incident Report/Resident Medical Records, Staff notes, Doctor visit reports, Doctors orders, Hospital discharge papers for (R1). The Department interviewed 3 staff members (S1-S3), the Executive Director (ED), the Medical Physician (MP), and six Residents #1-6 (R1-R6).

Report Continued on LIC9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 6 of 7
Control Number 11-AS-20250520093313
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: 02/13/2026
NARRATIVE
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Allegation: #1: Staff neglect resulted in a resident to be hospitalized

The complaint alleged that, due to their negligence in managing R1's medications, sodium chloride was not administered to R1, who had recently been prescribed it by an emergency room physician (ER). R1 ended up in the hospital for a week with severe hyponatremia.

On 06/13/2025, the Department interviewed the Executive Director (ED) and the three staff members #1-3 (S1-S3), who acknowledged a possible error in documenting medication administration. On 08/01/2025, the Department interviewed the Medical Physician (MP), who stated that it is difficult to determine whether any lack of medications caused the hospitalization of resident #1 (R1). They also stated that R1's declining health could be a factor. On 11/12/2025, the department interviewed six residents, #1-6 (R1-R6), all of whom denied the allegation and stated that facility staff helped them with their medications. R1 also stated that R1 likes living at the facility and receiving medication as prescribed.

Regarding the allegation, “Staff neglect resulted in a resident being hospitalized,” based on record reviews and interviews, the Department found no evidence to support the allegation mentioned above. Although the allegation may have occurred or be valid, there is not a preponderance of evidence to prove whether the alleged violation did or did not occur; as a result, the allegation is Unsubstantiated.

No deficiencies were cited.

An exit interview was conducted. A copy of the report was provided to the Executive Director Jakini Robert.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2026
LIC9099 (FAS) - (06/04)
Page: 7 of 7