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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198200855
Report Date: 04/23/2026
Date Signed: 04/23/2026 12:24:55 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/16/2026 and conducted by Evaluator Mario Leon
COMPLAINT CONTROL NUMBER: 11-AS-20260416163804
FACILITY NAME:HARBOR TERRACE RETIREMENT CENTER OF SAN PEDRO, LLCFACILITY NUMBER:
198200855
ADMINISTRATOR:HOLLY RICEFACILITY TYPE:
740
ADDRESS:435 WEST 8TH STREETTELEPHONE:
(310) 547-0090
CITY:SAN PEDROSTATE: CAZIP CODE:
90731
CAPACITY:202; 202CENSUS: 69DATE:
04/23/2026
UNANNOUNCEDTIME BEGAN:
08:08 AM
MET WITH:Holly Rice - Executive DirectorTIME COMPLETED:
12:39 PM
ALLEGATION(S):
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9
Staff did not follow doctor’s orders.
INVESTIGATION FINDINGS:
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On 04/23/26 Licensing Program Analyst (LPA) Mario Leon conducted an initial, unannounced, complaint visit at the facility. California Department of Social Services (CDSS) was met by staff one, Holly Rice - Executive Director (S1), and the purpose of the visit was explained. S1 and LPA toured the facility.
The investigation consisted of the following:
On 04/23/26 CDSS requested and reviewed facility documents and toured the facility. LPA interviewed three (3) out of sixty-nine (69) residents and four (4) out of forty-eight (48) staff.
The investigation revealed the following:
Regarding the allegation “Staff did not follow doctor’s orders.”, it is being alleged that a resident is being allowed to drive themselves, against Dr's orders. Between 08:15AM and 11:30AM, LPA interviewed three (3) residents (R1-R3) and four (4) staff (S1-S4). Interviews revealed that all three (3) residents (R1-R3) and all four (4) staff (S1-S4) have denied the allegation has taken place. R1 has stated, "I’ve got my car down there, so I got my freedom."
Report continues, please see LIC9099-C
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2026
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 2
Control Number 11-AS-20260416163804
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: HARBOR TERRACE RETIREMENT CENTER OF SAN PEDRO, LLC
FACILITY NUMBER: 198200855
VISIT DATE: 04/23/2026
NARRATIVE
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Record reviews have revealed that Doctors' orders have not restricted a resident (R1) from driving their car. Based on record reviews and interviews conducted, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated.

There have been zero (0) deficiencies cited during today's visit.

An exit interview was held with Holly Rice - Executive Director and a copy of this report has been provided.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2