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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602069
Report Date: 07/01/2026
Date Signed: 07/01/2026 04:57:36 PM

Substantiated


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 Elvira Gonzalez
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20260416084352
FACILITY NAME:PALMCREST GRAND RESIDENCEFACILITY NUMBER:
198602069
ADMINISTRATOR:GOMEZ, VERONICAFACILITY TYPE:
740
ADDRESS:3503 CEDAR AVENUETELEPHONE:
(562) 595-4551
CITY:LONG BEACHSTATE: CAZIP CODE:
90807
CAPACITY:262CENSUS: 115DATE:
07/01/2026
UNANNOUNCEDTIME BEGAN:
01:37 PM
MET WITH:Peggy ClarkTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Staff do not ensure the washer/dryer are working properly.
INVESTIGATION FINDINGS:
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On 07/01/26, department conducted an unannounced complaint visit at the above named facility. The department met with Administrator, Peggy Clark, and explained the purpose of the visit. LPA was granted access to the facility.

The investigation consisted of the following: On 04/23/26, the department received the following documents: staff roster, resident roster, an email thread between resident #1 (R1) and staff, and service requests from CSC Service Works. Additionally, the department conducted a facility tour, inspected the laundry rooms located on both the first and second floors, and conducted interviews with staff #1-#3 (S1-S3) and R1. On 07/01/26, the department conducted interviews with staff #4-#5 (S4-S5) and residents #2-#10 (R2-R10).

Continued on LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2026
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 11-AS-20260416084352
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: PALMCREST GRAND RESIDENCE
FACILITY NUMBER: 198602069
VISIT DATE: 07/01/2026
NARRATIVE
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The investigation revealed the following:

Allegation: Staff do not ensure the washer/dryer are working properly. It is being alleged that the washer and dryer machines don’t work properly. On 04/23/26, and 07/01/26, the department conducted interviews with S1-S5. Of those interviewed, 3 out of 5 staff corroborated with the allegation. 3 out of 5 staff stated that the dryers on the first floor were not functioning properly. Staff reported that multiple drying cycles were often required to fully dry residents' laundry, resulting in delays in laundry services.

On 04/23/26, and 07/01/26, the department conducted interviews with R1-R10. Of the 10 residents interviewed, 5 were unable to corroborate the allegation, while 5 corroborated the allegation.

On 07/01/26, the Department reviewed service records from CSC Service Works dated 01/08/26, 03/02/26, 03/05/26, 03/17/26, and 04/03/26. The records documented that one or more laundry machines were out of service on those dates.

Based on interviews conducted, and records reviewed, the preponderance of evidence standard has been met. Therefore, the above allegation is found to be substantiated.

California Code of Regulations, Title (22), Division (6) is being cited on the attached LIC9099-D.

An exit interview was conducted and a copy of this report was provided.
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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 Elvira Gonzalez
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20260416084352

FACILITY NAME:PALMCREST GRAND RESIDENCEFACILITY NUMBER:
198602069
ADMINISTRATOR:GOMEZ, VERONICAFACILITY TYPE:
740
ADDRESS:3503 CEDAR AVENUETELEPHONE:
(562) 595-4551
CITY:LONG BEACHSTATE:CAZIP CODE:
90807
CAPACITY:262CENSUS: 115DATE:
07/01/2026
UNANNOUNCEDTIME BEGAN:
01:37 PM
MET WITH:Peggy ClarkTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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9
Staff do not ensure the dryer are/lint screen are kept clean.
INVESTIGATION FINDINGS:
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On 07/01/26, department conducted an unannounced complaint visit at the above named facility. The department met with Administrator, Peggy Clark, and explained the purpose of the visit. LPA was granted access to the facility.

The investigation consisted of the following: On 04/23/26, the department received the following documents: staff roster, resident roster, an email thread between resident #1 (R1) and staff, and service requests from CSC Service Works. Additionally, the department conducted a facility tour, inspected the laundry rooms located on both the first and second floors, and conducted interviews with staff #1-#3 (S1-S3) and R1. On 07/01/26, the department conducted interviews with staff #4-#5 (S4-S5) and residents #2-#10 (R2-R10).

Continued on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 11-AS-20260416084352
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: PALMCREST GRAND RESIDENCE
FACILITY NUMBER: 198602069
VISIT DATE: 07/01/2026
NARRATIVE
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The investigation revealed the following:

Allegation: Staff do not ensure the dryer are/lint screen are kept clean. It is being alleged that the washer and dryer machines are filthy. On 04/23/26, and 07/01/26, the department conducted interviews with S1-S5. Of those interviewed, 5 out of 5 staff denied the allegation. 5 out of 5 staff said that the washer and dryers are cleaned, and sanitized daily and as needed.

On 04/23/26, and 07/01/26, the department conducted interviews with R1-R10. Of those interviewed, 9 out of 10 residents could not corroborate the allegation. 9 out of 10 residents said they are satisfied with the laundry services provided to them.

On 04/23/26, the Department conducted a tour of the facility and inspected the laundry rooms located on the first and second floors. During the inspection, all washers and dryers were observed to be clean and sanitary. The Department also observed that the lint screens in each dryer were clean and free of lint. No signs of mold were observed in either laundry room.

Based on observation, records reviewed and interviews conducted, there was not enough sufficient evidence to support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed unsubstantiated.

An exit interview was conducted and a copy of this report was provided.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 11-AS-20260416084352
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: PALMCREST GRAND RESIDENCE
FACILITY NUMBER: 198602069
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/01/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/15/2026
Section Cited
CCR
87303(a)
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87303(a) Maintenance and Operation: The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.
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The licensee will fix the dryers and email proof of correction to Elvira.Gonzalez@dss.ca.gov
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This requirement is not met as evidence by:

Based on interviews and a review of records the laundry machines are in disrepair.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5