197606145-2-14-2022-28-AS-FFIS-CDX2NF-20220428173235

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197606145
Report Date: 02/14/2022
Date Signed: 02/14/2022 04:41:26 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
10/25/2021 and conducted by Evaluator Bonnie Tao

COMPLAINT CONTROL NUMBER: 28-AS-20211025125712

FACILITY NAME:	ARCADIA GARDENS RETIREMENT HOTEL		FACILITY NUMBER:	197606145
ADMINISTRATOR:	PAT REDNER		FACILITY TYPE:	740
ADDRESS:	720 W. CAMINO REAL		TELEPHONE:	(626) 574-8571
CITY:	ARCADIA	STATE: CA	ZIP CODE:	91007
CAPACITY:	200	CENSUS: 178	DATE:	02/14/2022
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Pamela Parson, Administrator		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Facility staff left resident on the floor for an extended period of time.
Facility staff do not allow residents to have visitors.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tao conducted an unannounced subsequent complaint investigation for the allegations listed above. An initial complaint visit was conducted on 11/03/21 and a subsequent visit was conducted on 12/7/2021. During today’s visit, LPA was allowed entry by Administrator. LPA explained the purpose of today's visit.

Investigation consisted of the following: interviews of Staff #2, Staff#4 and Staff #5; interviews of residents from Resident#2 to Resident #7, reviewed resident#1’s record reviews, and a facility tour. LPA obtained copies of the Staff and Resident Rosters; and resident files for Resident #1 (R1) with relevant information.

The investigation revealed the following:
In regard to allegation "Facility staff left resident on the floor for an extended period of time," it was alleged that R1 fell off the bed and was on the floor for an hour. (-continued in LIC 9099 C-)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Bonnie Tao	TELEPHONE: (323) 981-3971
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2022

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 28-AS-20211025125712

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: ARCADIA GARDENS RETIREMENT HOTEL	FACILITY NUMBER: 197606145
	VISIT DATE: 02/14/2022

NARRATIVE

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Seven (7) out of seven (7) residents could not corroborate the allegation. Resident interviews revealed that residents did not fell off bed and being left on the floor for an hour. Five (5) out of five (5) staff denied the allegation. Staff interviews revealed no residents were left on the floor for an extended period of time. File review did not reveal incident happened on R1 related to the allegation. LPA did not observe residents were fell off the bed and left on the floor for an extended period of time during the visit. 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 UNSUBSTANTIATED.

In regard to allegation "Facility staff do not allow residents to have visitors", it was alleged that facility staff did not allow resident #1 to have a visitor, a former resident. Seven (7) out of seven (7) residents could not corroborate the allegation. Resident interviews revealed that five (5) out of seven (7) residents stated they have no issue with visitors coming for visits. Two (2) out of seven (7) residents stated their visitors may meet residents at the outside areas. Five (5) out of five (5) staff denied the allegation. All five staff interviews revealed that visitor was acting aggressively at the entrance and therefore, that person was not allowed for entry due to the safety concern. 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 UNSUBSTANTIATED.

An exit interview was conducted with Administrator and a hard copy was provided.

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Bonnie Tao	TELEPHONE: (323) 981-3971
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2022

LIC9099 (FAS) - (06/04)

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