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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603428
Report Date: 12/11/2025
Date Signed: 12/11/2025 02:20:54 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/03/2025 and conducted by Evaluator Bennette Pena
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251203083729
FACILITY NAME:REGENCY GRAND AT WEST COVINAFACILITY NUMBER:
198603428
ADMINISTRATOR:MIMS-BURRIS, MARYFACILITY TYPE:
740
ADDRESS:150 SOUTH GRAND AVENUETELEPHONE:
(626) 332-3344
CITY:WEST COVINASTATE: CAZIP CODE:
91791
CAPACITY:160CENSUS: 122DATE:
12/11/2025
UNANNOUNCEDTIME BEGAN:
10:58 AM
MET WITH:Mary Mims-Burris - Executive DirectorTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Staff are not providing nutritious meals to residents in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced initial complaint visit to
investigate the above allegation. LPA met with Mary Mims-Burris, Executive Director and explained the purpose of the visit.

The investigation consisted of the following: LPA conducted a tour of the facility including the kitchen, dining room during lunch time, and observed facility food supply. LPA obtained copies of the staff & resident rosters, dining hours schedule, weekly meal menus for 11/09/2025 - 12/13/202, today's menu and always available menu, Food council minutes (11/28/2025), Residency/Admission Agreement and Resident handbook indicating supplemental charges for additional dining services provided. LPA also reviewed pertinent files for cook staff. Between 11:45am-1:00pm, LPA interviewed Staff #1 (S1) - Staff #4 (S4) and Resident #1 (R1) - Resident #13 (R13). *****CONTINUED ON LIC9099-C*****
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Bennette Pena
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2025
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 28-AS-20251203083729
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: REGENCY GRAND AT WEST COVINA
FACILITY NUMBER: 198603428
VISIT DATE: 12/11/2025
NARRATIVE
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The investigation revealed the following:

In regards to the allegation: "Staff are not providing nutritious meals to residents in care." It is alleged that residents have not been served nutritious meals, and facility has not provided healthier options like fruits and vegetables. During interviews with the residents, thirteen (13) out of (13) interviewed did not corroborate the allegation. Interviewed residents stated that they like the food served to them and the facility provide them fruits and vegetables all the time. In addition, residents stated that they are satisfied with the quality of the food provided and they also get to choose from the alternate menu if they request for it. During interviews with four (4) staff, all denied the allegation that residents are not provided nutritious meals. S1-S2 stated that they use a meal planning service company to customize and approve menus for the facility. They use (5) weekly menus that they rotate on a quarterly basis and the meal plan/menus are approved by a registered dietitian. Furthermore, S1-S2 indicated that they have not heard any complaints from the residents regarding the nutritious meals they are served. LPA's review of the staff files revealed that the cooks have the proper training and culinary experience. During the tour of the kitchen and dining area, LPA observed that residents were served a balanced plate with lean protein, whole grains, vegetables and a bowl of assorted fruits. LPA also observed sufficient food supply for 7 days non perishables and 2 day perishables including fresh fruits and vegetables.

Based LPA's observations and on statements and interviews conducted with residents and staff as well as reviewed files and documentation, there was not enough supportive evidence to corroborate 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 and a copy of this report was provided to Mary Mims-Burris, Executive Director.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Bennette Pena
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2025
LIC9099 (FAS) - (06/04)
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