197606145-6-18-2024-28-AS-RORN-D6KUTA-20240625155136

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197606145
Report Date: 06/18/2024
Date Signed: 06/18/2024 05:36:19 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
10/06/2023 and conducted by Evaluator Bonnie Tao

COMPLAINT CONTROL NUMBER: 28-AS-20231006122743

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: 159	DATE:	06/18/2024
		UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Pamela Parsons, administrator		TIME COMPLETED:	05:15 PM

ALLEGATION(S):

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Lack of care resulted in resident requiring medical treatment.
Resident was neglected while in care at the facility.
Resident's responsible party was not provided resident's document.
Resident was not provided services per agreement.
Illegal eviction.
Facility did not adhere to admission policy.
Staff threatened resident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tao conducted an unannounced subsequent complaint visit to the facility. LPA met with Administrator, Pamela Parsons and explained the purpose of today’s visit of the above-mentioned allegations.

LPA Tao conducted the initial complaint investigation visit on 10/12/23 and a subsequent complaint visit on 06/07/24. LPA obtained resident/staff rosters, interviewed staff/residents/visitor, conducted physical plant, and obtained resident #1’s (R1)’s facility records and related documents.

The investigation consisted of the following: resident interviews from resident #2 (R2) to resident #10 (R10); attempted but unable to interview resident#1 (R1) due to resident had deceased; staff interviews from staff#1 (S1) to staff#4 (S4); interview of visitor #1 (V1); conducted physical plant; and review of facility records.

(-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: 06/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2024

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 4

Control Number 28-AS-20231006122743

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: 06/18/2024

NARRATIVE

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The investigation revealed the following:

In regard to the allegation, lack of care resulted in resident requiring medical treatment, it was alleged staff did not provide care to resident which resulted resident was transferred to a hospital for medical care. Per resident interviews, nine (9) out of nine (9) residents interviewed could not corroborate the allegation. Resident interviews revealed that facility staff had provided care to residents timely which did not lead residents to seek medical treatments. All four (4) out of four (4) staff denied the allegation. Staff interviews revealed that staff would assist residents to meet residents’ care needs. Mostly, residents’ needs for seeking medical treatment were due to residents’ physical conditions. Per LPA’s observation, staff provided care to residents timely as residents called for assistance using the signal systems and when residents requested assistance from the caregivers in person. Therefore, facility staff assisted residents timely to meet residents care needs.

In regard to the allegation, resident was neglected while in care at the facility, it was alleged staff failed to check on resident until after resident missed two meals. Per resident interviews, nine (9) out of nine (9) residents interviewed could not corroborate the allegation. Resident interviews revealed that facility staff would check on residents if they did not come to the dining rooms for meals or declined food tray services. All four (4) staff denied the allegation. Staff interviews revealed that staff had to do round in each shift to check on residents, assist residents to meet residents’ care needs and observe residents’ physical conditions. When staff doing round, staff would knock on residents’ room doors, call out residents’ names, wait for residents’ responses if they were in their rooms, and check on residents even if residents declined staff going into their rooms. Per record review, there was an incident report, dated 08/24/23, indicated resident was observed to be weak and need medical attentions while staff was checking on resident. Per LPA’s observation, staff did round to check on residents, responded to residents’ call signals, and asked residents if they needed helps. Thus, facility staff did not neglect residents while in care.

In regard to the allegation, resident's responsible party was not provided resident's document, it was alleged the administrator did not provide a signed copy of the resident’s admission agreement to resident’s responsible party upon admission. Per resident interviews, nine (9) out of nine (9) residents interviewed could not corroborate the allegation. Resident interviews revealed that residents and/or responsible parties received a copy of the residents’ admission agreements after admissions. (-continued in LIC 9099 C-)

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Bonnie Tao	TELEPHONE: (323) 981-3971
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 28-AS-20231006122743

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: 06/18/2024

NARRATIVE

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All four (4) staff denied the allegation. Administrator’s interviews revealed that the administrator had to go over the admission agreements with residents and/or responsible parties upon admission. The copies of the admission agreements were provided to them accordingly. Residents who claimed the facility did not provide them copies could had been misplaced or lost the copies instead not provided. Per record review, it revealed the residents’ admission agreements had multiple signature pages (signed and dated) to show residents/responsible parties had received a copy of the admission agreements and records. Thus, facility staff did not fail to provide resident’s admission agreements.

In regard to the allegation, resident was not provided services per agreement, it was alleged that staff did not assist resident with the second shower of the week and did not change resident’s clothes. Per resident interviews, nine (9) out of nine (9) residents interviewed could not corroborate the allegation. Resident interviews revealed that staff assisted residents with bathing as scheduled and as needed. Staff would change residents’ clothes after showers and as needed. All four (4) staff denied the allegation. Staff interviews revealed that staff assisted residents with bathing as scheduled; however, residents had rights to decline of being bathed/changed clothes. Staff could not force residents to take baths and/or change clothes if they did not want to. Per LPA’s observation, residents’ clothes looked clean with no foul odor. Thus, facility staff did not fail to provide services per agreement.

In regard to the allegation, illegal eviction, it was alleged that the facility’s 30-day notice policy was provided to resident#1 (R1) while resident was in the hospital and may not be able to return within 30 days. Per resident interviews, nine (9) out of nine (9) residents interviewed could not corroborate the allegation. Resident interviews revealed that residents were not aware of any evictions happening at the facility. All four (4) staff denied the allegation. Staff interviews revealed that no eviction notices had even issued and sent to R1. Resident deceased, therefore, no eviction could happen. Thus, facility did not illegally evict resident.

In regard to the allegation, facility did not adhere to admission policy, it was alleged that administrator charged resident#1 (R1) for services not received and billed resident for $3,000 more on R1’s final rent statement. Per resident interviews, nine (9) out of nine (9) residents interviewed could not corroborate the allegation. Resident interviews revealed that residents did not observe services charged but not provided on their rent statements. All four (4) staff denied the allegation. Staff interviews revealed that administrator had adjusted the remaining unpaid balance down to $0 upon resident#1’s discharge due to death. The alleged $3,000 service charge was never paid by the resident / responsible party. (-continued in LIC 9099 C-)

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Bonnie Tao	TELEPHONE: (323) 981-3971
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 28-AS-20231006122743

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: 06/18/2024

NARRATIVE

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Per visitor interview, resident#1 (R1)'s final rent statement was adjusted down to $0 and no payment was required. Per record review, resident#1’s final bill, dated 09/19/23, all remaining balance was wrote-off to $0 and the book was closed. Therefore, facility did not fail to adhere to admission policy.

In regard to the allegation, staff threatened resident, it was alleged that staff scolded and threatened the resident severely while in care. Per resident interviews, nine (9) out of nine (9) residents interviewed could not corroborate the allegation. Resident interviews revealed that staff did not scold or threaten residents. Since residents may had hearing problems, residents would ask the staff to speak louder, therefore, residents could hear the staff. All four (4) staff denied the allegation. Staff interviews revealed that the facility policy did not allow staff scold or threaten residents. Staff had in-service training on resident’s rights and proper care. Per observation, LPA did not observe staff had talk down, disrespect or threaten residents in care. Therefore, staff did not threaten residents.

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. A hard copy of the report and appeal rights were provided.

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Bonnie Tao	TELEPHONE: (323) 981-3971
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2024

LIC9099 (FAS) - (06/04)

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