<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197607820
Report Date: 09/15/2022
Date Signed: 09/15/2022 01:41:33 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
09/12/2022 and conducted by Evaluator Alma Gonzalez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20220912131044
FACILITY NAME:REGENCY PARK ASTORIAFACILITY NUMBER:
197607820
ADMINISTRATOR:ANNABELLE ARGENALFACILITY TYPE:
740
ADDRESS:925 EAST VILLA STREETTELEPHONE:
(626) 796-4303
CITY:PASADENASTATE: CAZIP CODE:
91106
CAPACITY:220CENSUS: 81DATE:
09/15/2022
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Brianna GoodlettTIME COMPLETED:
02:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Resident is being physically abused by another resident in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Alma Gonzalez conducted an unannounced complaint visit to gather information pertaining to the above-mentioned allegation. LPA met with Assistant Administrator Brianna Goodlett and explained the reason for the visit.

The investigation consisted of: LPA conducted interviews with Assistant Administrator Brianna Goodlett, Staff 1-2 (S1-2), Residents 1-8 (R1-8) and attempted to interview S3 by telephone. LPA obtained copies of Staff and Resident Rosters and conducted a tour of the facility with S2 which included observations of a random selection of resident rooms and facility lobby. LPA additionally attempted to review video footage of the incident in question but was not able to as the surveillance system was not operating at the time.



(See LIC9099C for continuation)
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Stefanie CoronelTELEPHONE: (323) 981-3961
LICENSING EVALUATOR NAME: Alma GonzalezTELEPHONE: (323) 981-3973
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022
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 2
Control Number 28-AS-20220912131044
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: REGENCY PARK ASTORIA
FACILITY NUMBER: 197607820
VISIT DATE: 09/15/2022
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
Investigation revealed the following: Regarding allegation, Resident is being physically abused by another resident in care, it is alleged that R1 was possibly being physically abused by R2. Interviews conducted with Assistant Administrator and S1 revealed that the incident reported on 9/9/22 was a misinterpretation of how R2 communicates with R1. Assistant Administrator and S1 stated that R2 is very animated with their arms when speaking to R1. S1-2 stated that R1 and R2 are married and R2 is very hands on with the care of R1. S1-2 stated that R2 likes to assist with the care for R1 and R1 is very dependent on the care received from R2 and when R2 is not around R1 tends to push their pendant button to find out where R2 is. Assistant Administrator and S1-2 stated that they have not witnessed any resident being physically abused by another resident and stated that if any facility staff observes any sign of physical abuse or receives a report of a resident being physically abused by another resident, staff will immediately intercede the situation and redirect the residents. Assistant Administrator and S1-2 stated that there are enough staff on schedule to properly oversee and care for facility residents. Interviews conducted with 8 out of 8 residents revealed that they have not observed any facility resident being physically abused by another resident. 2 out of 8 residents interviewed stated that they were not involved in a physical altercation that can be described as physical abuse and stated that the incident that was reported was misinterpreted by whoever made the report. R2 stated that they are very hands on with the care of R1 and that they use hand and arm gestures as it is a cultural custom of theirs. R1 stated that they are not being physically abused by R2. 8 out of 8 residents stated that they are satisfied with they services that they receive at the facility and did not have any concerns about the facility or the facility staff. R1-8 also stated that the staff are very nice, are very helpful and there are enough staff on schedule to properly meet their needs. LPA toured the facility including a random sample of resident rooms and did not observe anything of concern. Based on statements gathered from interviews conducted with staff, and facility residents and LPA observations, there was not enough supportive evidence to concur with the reported allegation.

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.

Exit interview held. A copy of the report was provided to Assistant Administrator Brianna Goodlett.
SUPERVISOR'S NAME: Stefanie CoronelTELEPHONE: (323) 981-3961
LICENSING EVALUATOR NAME: Alma GonzalezTELEPHONE: (323) 981-3973
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2