197606145-2-26-2023-28-AS-VMAO-CPDUFA-20230225143224

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197606145
Report Date: 02/25/2023
Date Signed: 02/26/2023 08:13:40 AM

Document Has Been Signed on 02/26/2023 08:13 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

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
ADMINISTRATOR:	PAMELA PARSONS		FACILITY TYPE:	740
ADDRESS:	720 W. CAMINO REAL		TELEPHONE:	(626) 574-8571
CITY:	ARCADIA	STATE: CA	ZIP CODE:	91007
CAPACITY:	200	CENSUS: 170	DATE:	02/25/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Pamela Parsons- Executive Director and Julie Chirikian- Licensee		TIME COMPLETED:	02:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) V. Maldonado made an unannounced visit at the facility for the purpose of conducting the required annual inspection using the Infection Control tool to evaluate the facility. LPA Maldonado met with Licensee, Julie Chirikian and Executive Director, Pamela Parsons, and explained the purpose for the visit. LPA conducted a tour of the physical plant, observed COVID-19 procedures, reviewed resident's medications and records, observed food supply, and reviewed staff records. The facility cares for elderly residents of ages 60 and above and is approved to care for (200) non-ambulatory residents, of which (25) may be bedridden. The facility also has a memory care unit with approved delayed egress and an approved hospice waiver for (23). The facility is a three-story building, located in a residential neighborhood. It consists of 186 resident bedrooms and private bathrooms. Resident bedrooms, memory care unit, recreation/activity rooms, beauty shop, storage rooms, employee lounge, library and laundry rooms are located at the lower level. Reception/lounge area, resident bedrooms, dining room, kitchen, multiple offices, recreation/activity rooms and laundry room are located at main level. Upper level consists of resident bedrooms, nurse's office, penthouse, recreation/activity rooms and laundry room. LPA toured random resident bedrooms on each floor in building sections A, B, C, D, E and F. Each room had the required furniture and sufficient closet space for storage. Bathrooms inspected were equipped with a toilet, shower, and wash basin. They were clean, operable, and had the required grab bars and non-skid mats. The hot water temperature was in a range of 105.6F- 110.4F, which is within Title 22 Regulation guidelines. Adequate linen and personal hygiene supplies were observed. The kitchen was toured and a sufficient supply of perishable and nonperishable foods is observed. Knives, tools, sharp items are inaccessible to residents. Fire extinguishers were observed throughout the facility to be fully charged and with recent inspections. The front grounds of the facility are well landscaped and have a leveled walkway to the entrance. Outside grounds were toured and pool/spa area with self latching fenced gate is observed. The outdoor activity area has a shaded patio with ample seating. (Report Continued on LIC809-C...)

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Valeria Maldonado	TELEPHONE: 323-981-3342
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2023

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

LIC809 (FAS) - (06/04)

Page: 1 of 2

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 02/25/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

There is a screening station at the entrance of the facility for universal symptom screening/temperature check. A 30-day supplies of Personal Protective Equipment (PPE) was observed in storage and throughout the facility, readily available for client/staff/visitor use. COVID-19 signange was observed at the entrance and throughout the facility to promote mask wearing, social distancing, hand washing, and cough/sneeze etiquette.

LPA reviewed (17) client files for updated emergency contact information and current health screenings- confirmed to be on file. LPA reviewed (6) staff files for health screenings, proof of required annual training, and fingerprint clearances- confirmed to be on file. LPA reviewed (17) clients' medications and were observed to be documented properly and given as prescribed.

Per California Code of Regulations, Title 22, no deficiencies were observed or cited during today's visit.

An exit interview was held with Licensee, Julie Chirikian and Executive Director, Pamela Parsons and a copy of the report and appeal rights were provided.

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Valeria Maldonado	TELEPHONE: 323-981-3342
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2023

LIC809 (FAS) - (06/04)

Page: 2 of 2