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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191200037
Report Date: 04/17/2023
Date Signed: 04/17/2023 01:51:33 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/10/2023 and conducted by Evaluator Mary G Flores
COMPLAINT CONTROL NUMBER: 28-AS-20230410112236
FACILITY NAME:REGENCY PARK OAK KNOLLFACILITY NUMBER:
191200037
ADMINISTRATOR:ANABELLE ARGENALFACILITY TYPE:
740
ADDRESS:255 SOUTH OAK KNOLLTELEPHONE:
(626) 578-1551
CITY:PASADENASTATE: CAZIP CODE:
91101
CAPACITY:206CENSUS: 79DATE:
04/17/2023
UNANNOUNCEDTIME BEGAN:
11:23 AM
MET WITH:Anabelle Argenal - Administrator TIME COMPLETED:
02:05 PM
ALLEGATION(S):
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Staff denied resident visitors.
Resident left in soiled clothing for extended period of time.
Staff yelled at resident.
INVESTIGATION FINDINGS:
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Licensing Program Analyst(s) (LPA) Mary Flores conducted an unannounced complaint investigation visit regarding the above allegation(s). LPA Flores met with Anabelle Argenal and explained the reason for the visit.

The investigation consisted of the following: LPA Flores requested a copy of resident, staff roster and death reports within the last month. LPA conducted interview with Administrator and with staff,#2(S2),#3(S3),#4(S4),#5(S5),#6(S6). LPA reviewed last 6 months of billing statements.
During the review of resident roster, death reports, and interview with administrator it was found that resident in question did not reside at the facility. Interviews with 5 additional staff and reviewed of billing statements verified resident in question has not reside at the facility.

Based on the information gathered during this visit, the allegation(s) are deemed UNFOUNDED.
A finding of UNFOUNDED means that the allegations are either false, could not have happened, and/or are without a reasonable basis.

Exit interview conducted with Anabelle Argenal administrator and a copy of this report was provided.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Tony VasalloTELEPHONE: (818) 419-8131
LICENSING EVALUATOR NAME: Mary G FloresTELEPHONE: (323) 981-3965
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2023
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 28-AS-20230410112236
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: REGENCY PARK OAK KNOLL
FACILITY NUMBER: 191200037
VISIT DATE: 04/17/2023
NARRATIVE
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Regarding allegation: Staff denied resident visitors. It is alleged that facility wouldn't let reporting party visit a resident who resides at facility.

Regarding allegation: Resident left in soiled clothing for extended period of time. It is alleged facility had resident sleep in "piss".

Regarding allegation: Staff yelled at resident. It is alleged facility staff screamed at resident.
SUPERVISOR'S NAME: Tony VasalloTELEPHONE: (818) 419-8131
LICENSING EVALUATOR NAME: Mary G FloresTELEPHONE: (323) 981-3965
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2