197606145-4-3-2025-28-AS-SVAD-DEMRBE-20250310125237

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197606145
Report Date: 02/27/2025
Date Signed: 04/03/2025 08:45:14 AM

Document Has Been Signed on 04/03/2025 08:45 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
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME:	ARCADIA GARDENS RETIREMENT HOTEL		FACILITY NUMBER:	197606145
ADMINISTRATOR/ DIRECTOR:	PAMELA PARSONS		FACILITY TYPE:	740
ADDRESS:	720 W. CAMINO REAL		TELEPHONE:	(626) 574-8571
CITY:	ARCADIA	STATE: CA	ZIP CODE:	91007
CAPACITY: 200	TOTAL ENROLLED CHILDREN: 0	CENSUS: 160	DATE:	02/27/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:51 AM
MET WITH:	Administrator, Pamela Parsons		TIME VISIT/ INSPECTION COMPLETED:	04:11 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) Vaid conducted an unannounced annual inspection visit. LPA met with Administrator, Pamela Parsons, and Director of Nursing Suzana Zadourian. Nursing director assisted LPA with the visit. The facility is licensed to serve for a capacity of 175 non- ambulatory residents including 25 bedridden residents, ages 60 and above. The facility has an approved Hospice Waiver on file for twenty-three (23) residents. Twenty -two (22) residents currently on Hospice. Facility has an approved Dementia Care Plan in their plan of operation and accept residents with dementia. Facility does not handle residents’ monies. Administrator certificate is current and expires on 07/31/2026. During the visit, a tour of the facility was conducted, food supply and medications were reviewed. The facility is located in a residential neighborhood, consists of three floors and has 186 resident bedrooms and bathrooms. Level 1 has resident bedrooms, memory care unit, recreation/activity rooms, beauty shop, storage rooms, employee lounge, library, and laundry rooms. 2nd level is memory care, reception/lounge area, resident bedrooms, dining room, kitchen, multiple offices, recreation/activity rooms and laundry rooms. 3rd level consists of resident bedrooms, nurse's office, penthouse, recreation/activity rooms and laundry rooms. A physical tour was conducted. LPA randomly toured resident rooms on each floor in building sections A, B, C, D, E and F. Residents’ rooms were well furnished and in compliance. Bathrooms inspected were clean, operable, with the required grab bars and non-skid materials in the shower. Hot water temperature was in a range of 105.0 – 120.0 degrees Fahrenheit which was within Title 22 Regulation guidelines. Adequate linen and personal hygiene supplies was observed. The resident rooms are equipped with a signal system located in each restroom and facility phones to call the front desk. The signal system was tested in various resident's room on each level and are operable. Average time for caregivers to assist residents is 2-4 minutes. (-continued in LIC 809 C-)

Fernando Fierros	TELEPHONE: (323) 981-3981
Sanjay Vaid	TELEPHONE: 916-215-7924
	DATE: 02/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2025

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

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: ARCADIA GARDENS RETIREMENT HOTEL	FACILITY NUMBER: 197606145
	VISIT DATE: 02/27/2025

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Facility had central air and heating accommodations in the common areas. Facility maintained a comfortable temperature for residents. Auditory alarm devices to monitor exits are operable at the memory care unit at the lower level. Interior and exterior space is available to permit residents to walk in safe and comfortable environment.

Sufficient supply of perishable and nonperishable foods is observed. Knives, tools, sharp items are inaccessible to residents. Food is stored in covered containers at the appropriate temperatures. No pesticides or poisons are stored in the food areas.

The last Fire/Emergency Drill is conducted on 02/10/2025 and 02/11/2025, PM shift and NOC shift. Smoke and carbon monoxide detectors are operable and in compliance. Fire extinguishers were last serviced on 02/06/25 are fully charged and in compliance. 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 was observed. The outdoor activity area has a shaded patio with ample seating.

Medications are centrally stored and locked in the nurse's office on the third floor. First aid kit is fully stocked. Mandated documents and signages are posted in common areas. Resident records are stored in a locked cabinet and inaccessible to residents. Toxic substances are inaccessible to residents.

No deficiencies were observed as per California Code of Regulations, Title 22.

Exit interview was conducted and copy of this report was provided to facility Administrator, Pamela Parsons.

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Sanjay Vaid	TELEPHONE: 916-215-7924
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2025

LIC809 (FAS) - (06/04)

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