565850112-4-24-2026-29-AS-KHEN-DVHR3P-20260629124017

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565850112
Report Date: 04/24/2026
Date Signed: 04/24/2026 01:22:06 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/20/2026 and conducted by Evaluator Emily Peraldi

COMPLAINT CONTROL NUMBER: 29-AS-20260120130811

FACILITY NAME:	REGENCY PALMS OXNARD		FACILITY NUMBER:	565850112
ADMINISTRATOR:	KENNETH MAHLER		FACILITY TYPE:	740
ADDRESS:	1020 BISMARK WAY		TELEPHONE:	(805) 247-0227
CITY:	OXNARD	STATE: CA	ZIP CODE:	93033
CAPACITY:	127	CENSUS: 92	DATE:	04/24/2026
		UNANNOUNCED	TIME BEGAN:	10:24 AM
MET WITH:	Stephani Smith		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff handle resident roughly causing injury.
Staff do not treat resident with dignity or respect.

INVESTIGATION FINDINGS:

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

Licensing Program Analyst (LPA) Emily Peraldi conducted an unannounced subsequent complaint visit to this facility. At 10:24 a.m., the LPA met with Interim Executive Director (ED) Stephani Smith and explained the reason for the visit.

During the initial visit on 01/21/2026 between 9:30 a.m. and 12:16 p.m., LPA Peraldi conducted a brief physical plant tour and interviews with the Executive Director (ED) at the time, Kenneth "Ken" Mahler and one (1) staff. During a subsequent visit on 01/29/2026, LPA Peraldi conducted interviews with five (5) staff. During a second subsequent visit on 02/12/2026, between 9:52 a.m. and 11:56 a.m., the LPA conducted interviews with the ED, six (6) staff and two (2) residents. In addition, during another visit conducted on 03/18/2026, between 10:00 a.m. and 3:10 p.m., LPAs Peraldi and Barutyan conducted a brief physical plant tour and interviews with the Interim ED and two (2) residents. During all visits, the LPA reviewed and obtained copies of pertinent documents. Continued on LIC 9099-C.

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2026

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 5

Control Number 29-AS-20260120130811

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: REGENCY PALMS OXNARD	FACILITY NUMBER: 565850112
	VISIT DATE: 04/24/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Regarding the allegation: Staff handle resident roughly causing injury. On 01/20/2026, it was alleged that Individual #1 (I1) handled Resident #1 (R1) in a rough manner causing bruising on R1’s arm. Record review revealed that R1 requires full assistance for bathing, dressing, transferring and toileting. Interviews with R1 revealed that Individual #1 handled R1 in a rough manner when assisting R1 with getting out of bed. R1 described how I1 handled R1’s arm in an aggressive manner and squeezed R1’s arm causing R1’s arm to bruise. During the course of the investigation, the LPA was provided with pictures of R1’s bruised arm. Interviews with the ED at the time, revealed that I1 was not staff and instead was a staffing agency staff that only worked for a few days, no exact dates were provided. Interviews with staff revealed no witnesses to the incident involving I1 handling R1 in a rough manner, however staff stated that R1 is alert and can verbalize when issues arise. Based on interviews, the preponderance of evidence standard has been met, therefore the above allegation, “Staff handle resident roughly causing injury” is deemed Substantiated at this time.

2.) Staff do not treat resident with dignity or respect. It was alleged that Staff #1 (S1) told R1 that if R1 were to walk away and fall, that S1 will not help R1. When interviewed on two separate dates, R1 revealed consistent statements and descriptions of the interaction between R1 and S1. Interviews with R1 revealed that in January 2026, R1 was trying to get out of bed and S1 told R1 if R1 does not listen to S1 and if R1 walks away and falls that S1 is not going to help R1. R1 did fall on 01/08/2026 and was sent to the hospital, no fractures were noted. However, R1 discharge diagnosis was listed as sacral contusion and left hip pain. Interviews with S1 denied the allegation. Interviews with staff and R1 revealed that S1 is no longer assigned to assist R1. R1 stated that R1 does not want S1 to assist with their care needs. Based on interviews, the preponderance of evidence standard has been met, therefore the above allegation, “Staff do not treat resident with dignity or respect.” is deemed Substantiated at this time.

Per the California Code of Regulations, Title 22, Division 6, Chapter 8, the following deficiencies were observed and cited during the visit (See 9099-D). Civil Penalties issued for the total amount of $500. The Interim ED was informed that failure to correct deficiencies may result in additional civil penalties.

Exit interview conducted with Interim Executive Director (ED) Stephani Smith. A copy of the report and appeal rights were provided.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 29-AS-20260120130811

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: REGENCY PALMS OXNARD	FACILITY NUMBER: 565850112
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/24/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 04/27/2026 Section Cited CCR 87468.1(a)(3)	1 2 3 4 5 6 7	Personal Rights of Residents in All Facilities (b) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature... This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Interim ED stated that an inservice will be held regarding the regulation.
	8 9 10 11 12 13 14	Based on interviews, the Licensee did not comply with the section cited above as, R1 was handled in a rough manner by Individual #1 which poses an immediate health and safety risk to resident in care.	8 9 10 11 12 13 14	Civil Penalty issued for the amount of $250 for repeat violation.
Type A 04/27/2026 Section Cited CCR 87468.1(a)(1)	1 2 3 4 5 6 7	87468.1(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights:(1) To be accorded dignity in their personal relationships with staff...This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Interim ED stated that an inservice will be held regarding the regulation.
	8 9 10 11 12 13 14	Based on interviews, the licensee did not comply with the section cited above, as S1 did not treat R1 with dignity and respect which poses an immediate health and safety risk to residents in care.	8 9 10 11 12 13 14	Civil Penalty issued for the amount of $250 for repeat violation.

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: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/20/2026 and conducted by Evaluator Emily Peraldi

COMPLAINT CONTROL NUMBER: 29-AS-20260120130811

FACILITY NAME:	REGENCY PALMS OXNARD		FACILITY NUMBER:	565850112
ADMINISTRATOR:	KENNETH MAHLER		FACILITY TYPE:	740
ADDRESS:	1020 BISMARK WAY		TELEPHONE:	(805) 247-0227
CITY:	OXNARD	STATE: CA	ZIP CODE:	93033
CAPACITY:	127	CENSUS: 92	DATE:	04/24/2026
		UNANNOUNCED	TIME BEGAN:	10:24 AM
MET WITH:	Stephani Smith		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff left resident in soiled clothing/linens for an extended period of time.

INVESTIGATION FINDINGS:

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

Licensing Program Analyst (LPA) Emily Peraldi conducted an unannounced subsequent complaint visit to this facility. At 10:24 a.m., the LPA met with Interim Executive Director (ED) Stephani Smith and explained the reason for the visit.

During the initial visit on 01/21/2026 between 9:30 a.m. and 12:16 p.m., LPA Peraldi conducted a brief physical plant tour and interviews with the Executive Director (ED) at the time, Kenneth "Ken" Mahler and one (1) staff. During a subsequent visit on 01/29/2026, LPA Peraldi conducted interviews with five (5) staff. During a subsequent visit conducted on 02/12/2026, between 9:52 a.m. and 11:56 a.m., the LPA conducted interviews with the ED at the time, six (6) staff and two (2) residents. During a subsequent visit conducted on 03/18/2026, between 10:00 a.m. and 3:10 p.m., LPAs Peraldi and Barutyan conducted a brief physical plant tour and interviews with the Interim ED and two (2) residents. During all visits, the LPA reviewed and obtained copies of pertinent documents. Continued on LIC 9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2026

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

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 29-AS-20260120130811

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: REGENCY PALMS OXNARD	FACILITY NUMBER: 565850112
	VISIT DATE: 04/24/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Regarding the allegation: 1.) Staff left resident in soiled clothing/linens for an extended period of time. It was alleged that R1 would be left in soiled clothing. Interviews with R1 did not reveal any concerns regarding being left in soiled clothing for extended periods of time. R1 stated that when R1 calls for assistance staff respond within a few minutes. Interviews with staff did not reveal any concerns regarding R1’s incontinence care. The information obtained during the investigation did not include sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not sufficient evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed Unsubstantiated at this time.

Exit interview conducted. A copy of the report was provided.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2026

LIC9099 (FAS) - (06/04)

Page: 5 of 5