Regent Villa Retirement Home

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Staff did not prevent resident from punching another resident in care resulting in injuries.

On 12/22/25, The Department conducted a subsequent complaint visit to deliver findings. The Department met with Assistant Administrator as the reason for the visit was explained. The investigation consisted of the following: On 08/26/25, The Department requested a copies of the following documents: staff roster (dated 8/17/25 ), resident roster (dated 8/23/25 ), and the following documents for residents #1-2 (R1-R2): R1 Resident Pre-placement Appraisals (dated 12/13/23,) R2 pre-placement appraisal (dated 3/2/23 R1's Incident reports (dated 8/25/25), R1 Physician's Report (dated 11/8/24), R2's Physician’s Report (dated 12/10/24), R1's Admission Agreement (dated12/13/23) and R2's admission agreement (dated 3/2/23). On 09/03/25 The Department conducted a subsequent visit and conducted interviews with S1 and Resident #3 (R3). On 09/03/25 The Department also obtained copies of the following for R1 and R2: Identification and emergency information, physicians orders and medication logs for Juthe state’s words, verbatim · CDSS document, Dec 22, 2025 · control 11-AS-20250825155922

Allegation investigated: Staff did not provide resident with personal care supplies. Staff did not safeguard resident's mail.

On November 17, 2025, the California Department of Social Services/Community Care Community Care Licensing (CDSS/CCL) Licensing Program Analyst (LPA) Ernand Dabuet conducted an initial unannounced complaint visit. Jenni Gordon, administrator greeted the (LPA). (LPA) explained the purpose of the visit is to investigate the allegations mentioned above. The investigation included a collection of records, and an observation of the facility. The Department obtained several documents, including the Facility Staff Roster (dated 11/17/25), the Resident Roster (dated 11/17/25), service records for Resident #1 (R1) Identification and Emergency Information LIC 601 (dated 02/07/21), Medical Assessment for Residential Care Facilities for the Elderly LIC 624A (dated 06/24/25), Preplacement Appraisal Information LIC 603 (dated 08/20/18), Resident Personal Property and Valuables LIC 621 (dated 08/20/18) and Personal Rights Residential Care Facilities for the Elderly LIC 613C (dated 08/20/18) and otherthe state’s words, verbatim · CDSS document, Nov 17, 2025 · control 11-AS-20251113113954

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Licensee does not ensure that the facility has enough staff to meet the needs of residents in care. Staff did not provide assistance to resident in care as necessary.

*This report serves to clarify investigation findings and is created to supersede the LIC 9099 and LIC 9099C reports created on 04/11/25. Although this report supersedes the previous report, the complaint investigation findings remain the same. * On June 19, 2025, Licensing Program Analyst (LPA) Deborah Lee conducted a subsequent complaint visit regarding the above allegations. LPA Lee met with Jenni Gordon and explained the reason for the visit. The investigation consisted of the following: On April 11, 2025, LPA obtained and reviewed the following: staff roster (No date), resident's roster (dated 4/10/25), Unusual Incident Report (UIR) dated 4/7/25, Pre-Appraisal/Need and Services Plan for R1 (dated 8/2/2019, 1/23/25), Physician's Report for Residential Care for the Elderly (RCFE) for R1(dated 2/4/25), Residents Rights training/ALW disclosures (dated 6/23/24), Assistance with Transfer and Ambulation policy (dated 3/6/25); Written Fall Protocol (3/6/25). LPA reviewed R1’s file. LPA Lethe state’s words, verbatim · CDSS document, Jun 19, 2025 · control 11-AS-20250407123024

Allegation investigated: Staff pushed a resident in care. Staff mentally abused a resident in care.

On May 29, 2025, Licensing Program Analyst (LPA) Deborah Lee conducted an initial complaint visit regarding the above allegations. LPA Lee met with Jenni Gordon, Administrator and explained the reason for the visit. The investigation consisted of the following: On May 29, 2025, LPA obtained and reviewed the following: staff roster (No date), resident's roster (dated 5/28/25), Pre-Appraisal/Need and Services Plan for R1 (dated 7/3/21), Physician's Report for Residential Care for the Elderly (RCFE) for R1(dated 11/26/24), Residents Rights training (dated 6/22/24), and Abuse, Neglect,and Exploitation in a Elder Care setting (dated 4/4/25). LPA reviewed R1’s file. LPA Lee conducted 4 staff interviews (S1- S4), Administrator (A1), and 5 resident interviews (R1-R5). Page 1 of 3 Unsubstantiatedthe state’s words, verbatim · CDSS document, May 29, 2025 · control 11-AS-20250523155627

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Licensee does not ensure that the facility has enough staff to meet the needs of residents in care. Staff did not provide assistance to resident in care as necessary.

On April 11, 2025, Licensing Program Analyst (LPA) Deborah Lee conducted a complaint visit regarding the above allegations. LPA Lee met with Nicole Lozano, Admissions Director, and explained the reason for the visit. Subsequently, Jenni Gordon Administrator arrived and assisted with visit. The investigation consisted of the following: On April 11, 2025, LPA obtained and reviewed the following: staff roster (No date), resident's roster (dated 4/10/25), Pre-Appraisal/Need and Services Plan for R1 (dated 8/2/2019, 1/23/25), Physician's Report for Residential Care for the Elderly (RCFE) for R1(dated 2/4/25), Residents Rights training/ALW disclosures (dated 6/23/24), Assistance with Tranfer and Ambulation policy (dated 3/6/25); Fall Policy (3/6/25). LPA reviewed R1’s file. LPA Lee conducted 5 staff interviews (S1- S5), Administrator (A1), Assistant Administrator (A2), and 5 resident interviews (R1-R5). Page 1 of 3 Unsubstantiatedthe state’s words, verbatim · CDSS document, Apr 11, 2025 · control 11-AS-20250407123024

Allegation investigated: Staff does not award resident privacy. Staff does not treat resident with respect.

On 3/12/25, at 9:25am, the department conducted an initial complaint visit to the facility and was greeted by Jenni Gordan, Administrator. The department explained the purpose of this visit is to gather information about the complaint, gather facility files, and deliver findings for the allegations mentioned above. The investigation consisted of the following: The Department investigated the allegations mentioned in this complaint; and conducted interviews with staff (S1-S4) and residents (R1-R10) from 10:00am-2:00pm. The department received the following: Resident Roster (Dated: 03/12/2025), Staff Roster (Dated: No Date) for the facility. Physicians Reports (Dated: 4/30/24, 4/16/24, 9/12/24, 1/16/24, & 8/13/24), In-Service Staff Trainings (Dated: 9/14/21-12/23/24), Personal Rights (Dated: 3/20/12, 5/22/23, 10/16/24, 8/18/16, & 8/20/18), Pre-Placement Appraisal (Dated: 2/4/20, 4/16/24, 9/12/24, 8/20/18), Admission Agreement (Dated: 3/1/23, 5/22/23, 10/16/24, 8/18/16, & 8/13/24) and Idethe state’s words, verbatim · CDSS document, Mar 12, 2025 · control 11-AS-20250305094429

Allegation investigated: Staff do not ensure urinary catheter is emptied for resident in a timely manner. Staff do not ensure resident receives assistance with activities of daily living. Staff do not ensure the facility is kept free of malodors. Staff do not ensure the facility is kept free of pests. Staff do not ensure medications are dispensed as prescribed to residents in care.

On 11/20/23, at 08:38am, Licensing Program Analyst (LPA) Mario Leon conducted an initial unannounced visit to the facility and was greeted by Jenni Gordon, Administrator (S1). LPA explained the purpose of this visit is to gather information for the complaint and tour the facility. The investigation consisted of the following: An initial complaint visit was completed by LPA Mario Lopez on 11/20/2023. A subsequent visit was completed by LPA Perry Scott on 10/17/2024. The department investigated the allegations mentioned in this complaint; and conducted interviews with staff (S1-S8) and residents (R1-R9). Personnel Report (Dated: 11/20/2023), Resident Roster (Dated: 11/20/2023); Preplacement Appraisal Information (Dated: 10/30/2023), Physician’s Report (Dated: 10/30/2023), Medication Administration Record (Dated: 10/1/2023-11/1/2023), Weekly Shower/Laundry Schedule (Dated: 11/20/2023), Relias Training Report (Dated: 11/20/2023), & Pest Control Service Report (Dated: 09/08/2023-11/13/2023)the state’s words, verbatim · CDSS document, Oct 17, 2024 · control 11-AS-20231114111202

Allegation investigated: Questionable Death Staff failed to respond to signal system in a timely manner. Staff are not properly trained in emergency procedures.

On 10/16/2024 LPA Alfonso Iniguez conducted an unannounced subsequent complaint visit. LPA Iniguez met with Jenni Gordon /Administrator. LPA explained the purpose of this visit. Investigation Consisted of: Investigations Branch (IB) referral accepted dated 2/12/24 and completed investigation on 6/26/24. CCLD staff conducted the following interviews: Administrator Interview (A#1) 4/22/24, Facility Staff Interviews (S#1, S#2 and S#5) 4/22/24,5/7/24, Witnesses Interviews (W#1-W#2) 3/6/24 and 5/8/24, and Residents Interviews (R#2-R#5) 4/22/24. IB investigator conducted the following records reviewed: R#1’s Physicians Assessment dated: 1/5/23, Pacific Villa discharge papers dated: 12/21/22, 911 Long Beach Fire Department call log regarding R#1’s emergency call dated:1/8/23, and R#1’s death certificate provided by McKenzie Mortuary and copy of list of staff with their current CPR training. Evaluation Report continues LIC 9099-C Unsubstantiatedthe state’s words, verbatim · CDSS document, Oct 16, 2024 · control 11-AS-20240209152545

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Staff do not allow residents to select the doctor of their choice.

On 08/29/24, at 11:54am, Licensing Program Analyst (LPA) Perry Scott conducted a 10-day complaint visit to the facility and was greeted by Jenni Gordon, Administrator. LPA explained the purpose of this visit is to gather information about the complaint and deliver findings for the allegation mentioned above. The investigation consisted of the following: LPA investigated the allegation mentioned in this complaint; and conducted interviews with staff (S1-S5) and residents (R1-R10). Resident Roster (Dated: 08/29/2024) Staff Roster (Dated: No Date), ID/Emergency Information (Dated: 08/20/2024 & 08/15/2024), Admission Agreement (Dated: 08/15/2024 & 08/20/2024), Physicians Report (Dated: 08/15/2024), and Pre-Placement Appraisal (Dated:08/15/2024) were obtained from the facility for R1-R3. Report continued on LIC 9099-C Unsubstantiatedthe state’s words, verbatim · CDSS document, Aug 29, 2024 · control 11-AS-20240822204910

Allegation investigated: Staff altered resident's record

On 04/15/24 Licensing Program Analyst (LPA) Mario Leon conducted an initial, unannounced, complaint visit at the above-mentioned facility. LPA was met by Jenni Gordon, Administrator (S1), and the purpose of the visit was explained. S1 and LPA toured the facility. The investigation consisted of the following: On 04/15/24 LPA requested and reviewed facility documents and toured the facility. LPA interviewed four (4) out of one-hundred and forty (140) residents (R1-R4) and four (4) out of forty (40) staff (S1-S4). LPA interviewed two (2) out of four (4) witnesses (W1-W4). Witness two and witness four (W2, W4) were not available for interview. Report continues, see LIC9099C Unsubstantiatedthe state’s words, verbatim · CDSS document, Apr 15, 2024 · control 11-AS-20240411130558

Allegation investigated: Facility staff did not seek medical attention in a timely manner.

On 11/30/23 Licensing Program Analyst (LPA) Mario Leon conducted a subsequent, unanounced, complaint investigation visit to the above-mentioned facility. LPA arrived at facility and was met by Jenni Gordon, Administrator, and explained the purpose of the visit. The investigation consisted of the following: On 08/21/23, LPA toured the inside and outside of the facility. During the course of the investigation LPA requested and received copies of the following: client roster, staff roster; ID and emergency information, physicians’ reports, resident appraisal and all medical records for Resident #1 (R1). On 11/30/23, LPA interviewed ten (10) out of one-hundred and forty-four (144) residents and seven (7) out of thirty-nine (39) staff. LPA obtained heart rate, blood pressure, blood sugar and insulin dosing of R1 for the month of admission January 2023. LPA obtained training records for Licensed Vocational Nurses (LVN) (S4-S5) and Caregivers (S3,S6), along with FirstAid/CPR certificates (S3-the state’s words, verbatim · CDSS document, Nov 30, 2023 · control 11-AS-20230811153533

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.