198200855-7-28-2026-11-AS-PMAA-DXJNRX-20260902104217

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198200855
Report Date: 07/28/2026
Date Signed: 07/28/2026 09:57:24 AM

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

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20260416163804

FACILITY NAME:	HARBOR TERRACE RETIREMENT CENTER OF SAN PEDRO, LLC		FACILITY NUMBER:	198200855
ADMINISTRATOR:	HOLLY RICE		FACILITY TYPE:	740
ADDRESS:	435 WEST 8TH STREET		TELEPHONE:	(310) 547-0090
CITY:	SAN PEDRO	STATE: CA	ZIP CODE:	90731
CAPACITY:	202; 202	CENSUS: 67	DATE:	07/28/2026
		UNANNOUNCED	TIME BEGAN:	08:11 AM
MET WITH:	Holly Rice - Executive Director		TIME COMPLETED:	10:12 AM

ALLEGATION(S):

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Staff did not follow doctor’s orders.

INVESTIGATION FINDINGS:

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On 07/28/26 Licensing Program Analyst (LPA) Mario Leon conducted a subsequent, 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.CDSS arrived to deliver updated findings to the facility.
The investigation consisted of the following:
During today's date, CDSS arrived to deliver updated findings. On 07/09/26 CDSS interviewed Witness one (W1). On 04/23/26 CDSS requested and reviewed facility documents and toured the facility. CDSS 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. On 04/23/26, between 08:15AM and 11:30AM, CDSS interviewed three (3) residents (R1-R3) and four (4) staff (S1-S4). Report continues, please see LIC9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2026

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

LIC9099 (FAS) - (06/04)

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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: 07/28/2026

NARRATIVE

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Interviews revealed that all three (3) residents (R1-R3) and all four (4) staff (S1-S4) and one (1) witness have denied the allegation has taken place. A resident (R1) has stated, "I’ve got my car down there, so I got my freedom." Record reviews have revealed that Doctors' orders have not restricted R1 from driving their car, according to the latest Physician's report which had been conducted on 07/13/26. 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.

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: 07/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2026

LIC9099 (FAS) - (06/04)

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