306005901-4-3-2025-22-AS-MSTC-DG98EF-20250430222702

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005901
Report Date: 04/03/2025
Date Signed: 04/03/2025 04:43:12 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/27/2025 and conducted by Evaluator Jerome Haley

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20250327152606

FACILITY NAME:	BEACH TERRACE ASSISTED LIVING AND MEMORY CARE		FACILITY NUMBER:	306005901
ADMINISTRATOR:	DENNIS ROBENIOL		FACILITY TYPE:	740
ADDRESS:	12282 BEACH BOULEVARD		TELEPHONE:	(714) 694-3205
CITY:	STANTON	STATE: CA	ZIP CODE:	90680
CAPACITY:	120	CENSUS: 38	DATE:	04/03/2025
		UNANNOUNCED	TIME BEGAN:	03:36 PM
MET WITH:	Christine Chon		TIME COMPLETED:	04:55 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility does not have enough staff to meet the residents needs.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Regarding the allegation: Facility does not have enough staff to meet the residents needs.
During the investigation 4 of 6 individuals interviewed denied the allegation. One individual that was interviewed claims there is not enough staff but said everyone is doing a good job. According to the staff members that were interviewed, there are enough caregivers. One individual said, with the census the facility has now, there is enough staff but when the census grows, the facility will need to add to the team. One of the staff members explained that if someone calls off, they will call on other team members to work overtime to cover the shifts.
Based on the information gathered during the investigation through interviews, and observations, the Department is unable to ascertain if the allegation occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed Unsubstantiated.
An exit interview was conducted, and a copy of this report was provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lourdes Montoya	TELEPHONE: (714) 703-2870
LICENSING EVALUATOR NAME: Jerome Haley	TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2025

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 1