Luxury Living Senior Care Huntington Beach

Allegation investigated: Administrator failed to keep the facility free of an insect infestation.

On June 12, 2026, Licensing Program Analyst (LPA) Hiratsuka, contacted the facility via phone and email to deliver final findings regarding a complaint that was received on 10/04/2022. The time frame of the allegations is prior to the complaint received by the department Based on the information obtained during the course of the investigation, the Department is unable to determine the validity of the allegations listed above. Therefore, the allegations above are unsubstantiated. A finding that a complaint allegation is unsubstantiated means that, although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Unsubstantiatedthe state’s words, verbatim · CDSS document, Jun 12, 2026 · control 22-AS-20221004165353

Allegation investigated: Facility did not provide written notification of rate increase to responsible party.

Licensing Program Analyst (LPA) Garlli Tat made an unannounced visit to the facility to deliver the findings on the above allegation. LPA met with staff on duty and explained the purpose of the visit. Staff on duty contacted administrator regarding the visit. Administrator provided verbal consent that staff can sign the report on his behalf. During the course of the investigation, LPA toured the facility, interviewed staff and residents, obtained and reviewed resident records including the rate increase letter and admission agreement. Regarding the allegation that staff did not provide written notification of rate increase to the party responsible, the investigation revealed the following: Administrator provided a written notice of rate change to Resident 1's (R1) responsible party on December 9, 2025 after receiving notification from Community Care Licensing of the SSI rate change. Administrator included the PIN-15-19-CCLD, explanation of increase, the rate of increase and the date it would be in effect via text message. Responsible party verified they viewed the text message on December 9, 2025. Continued on LIC9099-C. Unfounded The 90-day notice does not apply because R1 participates in the ALW program. The notification from Community Care Licensing regarding rate change was sent out on December 8, 2025, to all residential care providers. Page 5 of the Admission Agreement states, “if the facility rate changes to reflect a government fund increase, written notice from the licensee if required as soon as the facility is notified of the increase and the rate shall not take effect until the operative date of the government fund increase”. Administrator submitted a written notice a day after notification of the increase was received. Based on the information above, the Department concluded that the allegation is Unfounded. A finding that an allegation is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis. An exit interview was conducted, and a copy of this report was provided to facility.the state’s words, verbatim · CDSS document, Mar 26, 2026 · control 22-AS-20260223132915

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. LPA Tea was greeted and granted entry into the facility by caregiver staff and explained the reason for the visit. Licensee (LE) Ban Nguyen is currently out of the country, but LPA was able to communicate with him via text message. LE Nguyen would stand by for assistance if needed. The facility is licensed for six non-ambulatory residents with a hospice waiver for five. Currently there are six residents, of which none are on hospice during today's visit. LPA Tea reviewed six resident files and two staff files. There were discrepancies with resident files. Some resident files are missing forms and need updated physician’s reports. The facility is up to date with required quarterly emergency disaster drills, which were last conducted in February 11, 2026. The administrator certificate expires October 17, 2026. LPA Tea along with staff toured the facility. LPA toured the physical plant, checked the food service, and the first aid kit. The facility is a two-story home, the first floor consists of five resident bedrooms, two bathrooms, a living room, family den, dining area, kitchen and attached garage. The second floor is a private resident area; no care residents reside on the second floor. Private residents are background cleared. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms are operational. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, and showers were free of mold/mildew. The water temperature measured between 116.9 to 118.9 Fahrenheit degrees. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of (Annual continuation on LIC809-C) visit. Common areas were clean and clear of hazards; doorways were free of obstructions. First aid kit had all the required elements including bandages, tweezers, thermometer, and scissors. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at the time of visit. LPA observed sharps locked and inaccessible to residents in a kitchen drawer. LPA also observed toxin substances secured underneath the kitchen sink and in cabinets in the garage. There were toxins placed underneath the bathroom sinks that were locked, but LPA felt the locks in place were not stable and suggested staff transfer toxins to the cabinet in the garage. The fire extinguisher in the dining area is fully charged. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there is ample seating underneath a shaded patio area in the backyard. There are two exit gates that are self-latching and operational on both sides of the house. LPA observed PPE supplies, emergency food and water stored in the garage. Facility provides activities based on resident personal choice and health condition. Residents like to play bingo and color. At the time of the visit, LPA observed residents lounging in the living room watching television and having lunch. LPA reviewed medication storage and administration. Medications are stored in a locked cabinets in the kitchen. Medications are being administered per physician order. LPA notice medication was incorrectly recorded for administration on the MAR record. LPA advised facility to be more diligent with MAR records and properly document dosages given. LPA interviewed residents regarding their quality of care and spoke to staff present regarding care provided. The following deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with the facility and a copy of this report LIC809, 809-C, LIC858, LIC859, LIC809D and Appeal Rights were read and provided to the facility.the state’s words, verbatim · CDSS document, Feb 13, 2026

The state marks this report as 6 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Allegation investigated: Facility is not following the proper protocol for COVID-19. Resident on Hospice transported via non-medical transportation.

Licensing Program Analyst (LPA) Jessica Cho made an unannounced subsequent visit to continue the investigation into the above allegations. LPA was greeted and granted entry by Caregiver Jayvee Angeles and explained the reason for the visit. Administrator (Admin) Ban Nguyen was also advised of the visit by telephone at 8:45am today and gave verbal consent authorizing staff to sign said report. On October 7, 2022, the Department received the complaint, and the investigation was initiated by LPA Andrea Mendivil on October 13, 2022 with a subsequent visit conducted by LPA Jenifer Tirre on November 18, 2022. During the course of the investigation, a facility tour and two staff interviews were conducted, and copies of facility records were obtained: Resident Roster, Face Sheet, Phsyician's Reports, Preplacement Appraisal, Needs and Services Plan, Admission Agreement, text messages, and hospice records for Resident #1 (R1). The investigation is as follows: Regarding the allegation, facility is not following the proper protocol for COVID-19, it is alleged that the facility was not enforcing masks for the visitors. Unsubstantiated On today's date, LPA Cho observed masking and Coronavirus (COVID-19) signs posted on the front door with masks and hand sanitizers provided in the entry way. LPA Cho was greeted by staff wearing a mask. LPA reviewed the resident roster dated September 15, 2025, and the residents currently registered to the facility were not present at the time when the complaint was received. LPA interviewed two staff both denying the allegation indicating that COVID-19 protocol and visitation policy was strictly enforced including masking, and confirmed masks were worn properly by all visitors, staff, and residents. Regarding the allegation, resident on hospice transported via non-medical transportation, it is alleged that the transfer in the vehicle caused R1 to decline. R1 was admitted to the facility on August 1, 2021 per the face sheet. Hospice agreement confirms R1 was admitted to hospice on February 25, 2022 with a diagnosis of Alzheimer's Disease. Per the Department's COVID-19 records, the census was five on October 6, 2022. Four out of five residents and two out of two staff tested positive on September 30, 2022. Because R1's roommate and all the other residents tested positive with COVID-19, R1's representative had agreed to move R1 to an alternative location and responded with a "Thank you!!" which was communicated via text on September 30, 2022 at 3:30pm. Based on the review of the admission agreement signed by R1's representative, the option for facility to provide transportation was declined. According to the admission agreement, facility is responsible to "plan and arrange" transportation which is covered under Basic Services. For non-emergency transportation, Transportation Policy indicates that "if a resident requires unscheduled non-emergency medical transportation, the facility will arrange for a taxi or other transport service to transport the resident." In R1's situation, Admin had indicated that R1 was transported by the facility vehicle due to 911 emergency not providing non-emergency medical transport and R1's family not taking action to provide transport even though it was declined on the agreement. Admin stated that the facility vehicle (van) which had access to a ramp, transferred resident safely. Based on the review of hospice records, there was no evidence that the facility vehicle transfer was related to, or resulted in R1's decline. Therefore, based on observation, interviews, and record review, the allegations, facility is not following the proper protocol for COVID-19 and resident on hospice transported via non-medical transportation are deemed unsubstantiated. An exit interview was conducted by telephone with Ban Nguyen and Caregiver Jayvee Angeles, and a copy of this report was provided at exit.the state’s words, verbatim · CDSS document, Nov 20, 2025 · control 22-AS-20221007135859

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Nancy Guillen made an unannounced visit for the purpose of conducting a required annual Inspection. LPA was greeted and granted entry by caregiver Agafe Lorzano after explaining the purpose of the visit. Administrator was notified via telephone, but was unable to attend. LPA observed the Administrator certificate expired November 28,2024; a deficiency was cited on today’s date. This is a Residential Care Facility for the Elderly (RCFE) licensed to six non-ambulatory residents with a hospice waiver for five. The facility is a two story home. The first floor is made up of five resident bedrooms, two bathrooms, and an attached garage. The second floor contains 3 rooms and a bathroom that are not for resident use. During the inspection, LPA and caregiver Agafe conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, garage and observed the following: LPA observed residents watching television and resting in their respective bedrooms. LPA observed six residents in care and three staff present. LPA observed the See Something Say Something Poster (PUB 475) mounted on the wall by the entrance. All resident bedrooms had the required furnishings, however toxins were observed in a residents room; a deficiency is being cited on today’s date. LPA observed all resident beds had linens and blankets with additional linens stored in the hallway closet. LPA observed bathrooms were clean and equipped with grab bars and non skid floor mats. LPA observed all windows were appropriately screened. Bathrooms were observed to be free of debris and mildew, faucets and toilets were operational. Water temperature tested between 108.5 and 112 degrees Fahrenheit. LPA toured the outside of the facility and observed outdoor emergency exit was obstructed; a deficiency was cited on today’s date. LPA observed the backyard had a shaded sitting area with furniture for resident use. LIC809C LPA observed the facility had a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Smoke detectors and carbon monoxide detectors tested operational. Fire extinguisher was observed to fully charged and operational. Gas stove, microwave, washer, and dryer were all inspected and observed to be operable. Toxic chemicals, cleaning solutions, and disinfectants were observed to be locked in the garage and inaccessible to residents. While touring the garage LPA observed a section of the garage to be used as a bedroom; a deficiency was cited on today’s date. Medication cabinet was observed to be locked and centrally stored in the kitchen area. LPA observed the First Aid Kit had all the required components. LPA began review of the records. LPA Guillen reviewed six resident records. All the required documentation were present and current in the residents’ files reviewed. LPA reviewed three employee records. All employee’s present have a criminal record clearance and were associated to the facility. LPA observed records reviewed have a current First Aid certificate, however no trainings were documented. Per staff interview, no yearly training have been conducted; a deficiency was cited on today’s date. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report and appeal rights was left at the facility.the state’s words, verbatim · CDSS document, Feb 21, 2025