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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603092
Report Date: 03/19/2026
Date Signed: 03/19/2026 03:12:56 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
03/16/2026 and conducted by Evaluator Mario Leon
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20260316102440
FACILITY NAME:TORRANCE REGENCY SENIOR LIVINGFACILITY NUMBER:
198603092
ADMINISTRATOR:LAMB, JONNA LFACILITY TYPE:
740
ADDRESS:22929 PETROLEUM AVETELEPHONE:
(424) 263-4823
CITY:TORRANCESTATE: CAZIP CODE:
90502
CAPACITY:6CENSUS: 5DATE:
03/19/2026
UNANNOUNCEDTIME BEGAN:
08:22 AM
MET WITH:Susana "Nadine" Sibayan - Assistant AdministratorTIME COMPLETED:
03:38 PM
ALLEGATION(S):
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9
Staff do not ensure accurate resident records are maintained.
Staff did not provide medical personnel with medical records in a timely manner.
Staff are over medicating resident in care.
INVESTIGATION FINDINGS:
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On 03/19/26 Licensing Program Analyst (LPA) Mario Leon conducted an initial, unannounced, complaint visit at the facility. LPA was met by Susana "Nadine" Sibiayn - Assistant Administrator (S1) and the purpose of the visit was explained. S1 and LPA toured the facility.
The investigation consisted of the following:
On 03/19/26 LPA requested and reviewed facility documents: Admission Agreement for R1, Preplacement Appraisal Information, Medical Assessment (LIC602A) (dated: 08/07/25), Identification and Emergency Information, Medication Administration Record (MAR) for the months of February - March 2026, two (2) Veterans Affairs (VA) Advance Directive Power of Attorney for Health Care and Living Will (dated 07/07/23 & undated) and LPA toured the facility with S1. LPA interviewed three (3) out of five (5) residents (R1-R3) and three (3) out of eight (8) staff (S1-S3). R4 and R5 were not available to be interviewed due to their current medical condition.

Report continues, please see LIC9099-C.
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026
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 3
Control Number 11-AS-20260316102440
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: TORRANCE REGENCY SENIOR LIVING
FACILITY NUMBER: 198603092
VISIT DATE: 03/19/2026
NARRATIVE
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The investigation revealed the following:
Regarding the allegation "Staff do not ensure accurate resident records are maintained", it is being alleged that a hospital has outdated information regarding the Power of Attorney (POA). Between 09:00AM and 12:30PM, LPA interviewed three (3) residents and three (3) staff. Record reviews revealed that there has been a change in a residents' choice of POA. However the updated POA is only valid with Veterans Affairs (VA) hospital and has not yet been notarized due to a resident's California State Identification (ID) being expired. This indicates that the updated POA paperwork is not yet valid at hospitals outside of the VA, which is where a resident was most recently taken. Interviews revealed that all three (3) clients and all three (3) staff have denied the allegation has taken place. Based on record reviews and interviews conducted, the preponderance of evidence standard has not been met. 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 has been Unsubstantiated.
Regarding the allegation "Staff did not provide medical personnel with medical records in a timely manner.", it is being alleged that, as of 03/16/26, an updated POA has not been provided to a dialysis treatment center. Record reviews revealed that there has been a change in a residents' choice of POA. However the updated POA is only valid with Veterans Affairs (VA) hospital and has not yet been notarized due to a resident's California State Identification (ID) being expired. This indicates that the updated POA paperwork is not yet valid at hospitals outside of the VA, which is where a resident was most recently taken for dialysis treatment. Interviews revealed that all three (3) clients and all three (3) staff have denied the allegation has taken place. Based on record reviews and interviews conducted, the preponderance of evidence standard has not been met. 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 has been Unsubstantiated.
Regarding the allegation "Staff are over medicating resident in care." Record reviews revealed that all medications being provided to a resident (R1) align with medications that have been ordered by R1's doctor and are being provided in a timely manner. Interviews revealed that all three (3) clients and all three (3) staff have denied the allegation has taken place. LPA's observation of R1's medication align with R1's MAR and there are no other medications, outside of R1's doctor's orders, being provided to R1. Based on record reviews, interviews conducted and LPA's observation, the preponderance of evidence standard has not been met. 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 has been Unsubstantiated.
There have been zero (0) deficiencies cited during today's visit.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 11-AS-20260316102440
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: TORRANCE REGENCY SENIOR LIVING
FACILITY NUMBER: 198603092
VISIT DATE: 03/19/2026
NARRATIVE
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An exit interview was held with Susana "Nadine" Sibayan - Assistant Administrator and a copy of this report has been provided.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3