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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197606145
Report Date: 06/23/2022
Date Signed: 06/23/2022 12:26:24 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
12/23/2020 and conducted by Evaluator Elizabeth Ceniceros
COMPLAINT CONTROL NUMBER: 28-AS-20201223122514
FACILITY NAME:ARCADIA GARDENS RETIREMENT HOTELFACILITY NUMBER:
197606145
ADMINISTRATOR:PAT REDNERFACILITY TYPE:
740
ADDRESS:720 W. CAMINO REALTELEPHONE:
(626) 574-8571
CITY:ARCADIASTATE: CAZIP CODE:
91007
CAPACITY:200CENSUS: DATE:
06/23/2022
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Administrator, Pamela ParsonsTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Resident's are not being provided activities.

Staff are not providing adequate food service.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA)/Retired Annuitant (RA) Elizabeth Ceniceros made an unannounced visit to the facility and was greeted by Administrator (Pamela Parsons). The purpose of today’s visit is to conduct a subsequent visit and deliver the findings pertaining to the above-mentioned allegations. LPA/RA toured the facility’s commercial kitchen, dining room area, and observed residents in the Activity Room.

LPA Bonnie Tao conducted a virtual 10-Day visit on 01/04/21. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19) and to implement mitigation measures, the complaint investigation was conducted telephonically with Administrator (Pamela Parsons). During the virtual, video conference call with Administrator Parsons, LPA Tao had conducted a virtual tour of the facility’s physical plant which included the kitchen, dining area, and activity room. LPA interviewed Staff #1 (former Administrator) and Resident #1. LPA requested pertinent documents: Residents & Staff Rosters, Staff Work Schedules, House Rules, Alternative Meal Delivery Procedure, Facility Menus (November 29, 2020 - January 2, 2021),
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Araceli RamirezTELEPHONE: (323) 980-4925
LICENSING EVALUATOR NAME: Elizabeth CenicerosTELEPHONE: (916) 264-1579
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2022
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 3
Control Number 28-AS-20201223122514
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: 06/23/2022
NARRATIVE
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Appraisal/Needs and Services Plan, Resident Assessment (06/02/20), Narrative Charting (05/04/20, 06/02/20, 06/03/20, 06/04/20, 06/05/20, 07/18/20), Individual Service Plan (IPP) (dated 06/02/20), and Assessment Plan.

Regarding Allegation #1: this investigation revealed that the facility was following all state/county recommendations during the COVID-19 pandemic protocol. It included limiting the number of residents in activities, facilitate social distancing, and outings. The residents were to limit their trips out of the community in accordance with local guidelines. The facility modified events (i.e., in-room activities and limited small groups). The caregivers provided activities to the residents by going around each of the residents’ rooms and offering activities; such as: Zen coloring, exercises, word search/sudoku, music/guitar playing, in-room games (Uno, dice games, cards), various room crafts, and movies. A review of the facility’s Activity Calendar (December 2020) documented activities for the residents – including a holiday schedule of events on 11/12/20, 11/26/20, 12/10/20, 12/17/20, 12/18/20, 01/01/21. The majority of interviews conducted, corroborated that it was understood that this was a way for the facility to provide activities and still keep social distancing within the pandemic protocol.

Based on the evidence gathered and interviews conducted and records reviewed, 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 of OTHER: Residents are not being provided activities is found to be UNSUBSTANTIATED.

Regarding Allegation #2: this investigation revealed to ensure meals reached the residents as hot as possible, insulation boxes were used to keep the food warm. The meal trays were delivered in smaller batches per trip. Facility staff would make half trip deliveries instead of whole trip deliveries. The majority of interviews conducted, corroborated that the meal delivery was being served in “to-go” style (Styrofoam containers with plastic utensils, cups, and paper napkins) during the situation surrounding the Coronavirus when the dining room was shut down for communal dining. The majority of staff interviewed, corroborated that they did not receive complaints from residents regarding his/her meal being served cold. During the holiday a special meal was provided on Christmas Day; and, the residents had been notified prior to this holiday event – which included Christmas caroling to the residents. A virtual tour of the facility’s physical plant included the kitchen, dining area, food supply; and, a review of the facility’s menus were all in compliance.

Based on the evidence gathered and interviews conducted and records reviewed, although the allegation

SUPERVISOR'S NAME: Araceli RamirezTELEPHONE: (323) 980-4925
LICENSING EVALUATOR NAME: Elizabeth CenicerosTELEPHONE: (916) 264-1579
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20201223122514
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: 06/23/2022
NARRATIVE
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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 of FOOD SERVICE: Staff are not providing adequate food service is found to be UNSUBSTANTIATED.

An exit interview has been conducted and a copy of the Complaint Report was provided to Administrator (Pamela Parsons).

SUPERVISOR'S NAME: Araceli RamirezTELEPHONE: (323) 980-4925
LICENSING EVALUATOR NAME: Elizabeth CenicerosTELEPHONE: (916) 264-1579
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3