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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198204376
Report Date: 08/07/2026
Date Signed: 08/07/2026 06:27:21 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 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
08/03/2026 and conducted by Evaluator Cynthia D Chan
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260803153029
FACILITY NAME:MOUNTAIN VIEW COTTAGES - IVFACILITY NUMBER:
198204376
ADMINISTRATOR:TRUPTI MODYFACILITY TYPE:
740
ADDRESS:21027 WEST COVINA BLVD.TELEPHONE:
(626) 966-4842
CITY:COVINASTATE: CAZIP CODE:
91724
CAPACITY:6CENSUS: 5DATE:
08/07/2026
UNANNOUNCEDTIME BEGAN:
03:10 PM
MET WITH:Elly Norsati, CaregiverTIME COMPLETED:
05:30 PM
ALLEGATION(S):
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Staff did not maintain a comfortable temperature for residents in care.
Physical plant is in disrepair.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cynthia Chan conducted a complaint investigation regarding the allegation listed above. LPA arrived unannounced and met with Staff, Elly Norsati. The purpose of the visit was explained. Administrator Jas Singh was informed of the visit via telephone.

LPA toured the facility and interviewed two (2) staff and three (3) residents.

The investigation revealed the following:
Allegation – Staff did not maintain a comfortable temperature for residents in care. It is alleged that the house thermometer read at 97 degrees F on 8/1/26. LPA interviewed staff and residents regarding this allegation. Staff stated that there is a window air conditioner in each resident room but no central air conditioning. Staff stated that the residents appear comfortable with the indoor temperature. The house thermostat read at 90 degrees F during the visit today.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Cynthia D Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2026
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-20260803153029
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: MOUNTAIN VIEW COTTAGES - IV
FACILITY NUMBER: 198204376
VISIT DATE: 08/07/2026
NARRATIVE
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LPA interviewed three (3) residents, and they stated they are okay with the temperature in the house. However, a resident (Resident #1 - R1) was transported to the hospital earlier this month and was diagnosed with dehydration. LPA was unable to interview R1 as the resident is non-verbal. Staff stated that they cannot tell if R1 was comfortable or not since the resident is unable to express their needs. Based on information obtained, this allegation is substantiated.

Allegation - Physical plant is in disrepair. It is alleged that the air conditioner is not working. LPA interviewed staff who acknowledged that the air conditioner in one of the residents’ rooms is not working. Two (2) out of the three (3) residents interviewed stated the air conditioners in their rooms work. LPA tested the wall air conditioner units in the three resident rooms, and (2) were not working properly. One did not turn on, and the other was not blowing out cool air. Therefore, the allegation is substantiated.

Based on LPA observations and interviews conducted, the preponderance of evidence standard has been met, therefore, the above allegations are found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6 and Chapter 8), are being cited on the attached LIC 9099D.
SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Cynthia D Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20260803153029
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: MOUNTAIN VIEW COTTAGES - IV
FACILITY NUMBER: 198204376
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/07/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/08/2026
Section Cited
CCR
87303(b)(2)
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87303 Maintenance and Operation(b) A comfortable temperature for residents shall be maintained...(2)The facility shall cool rooms to a comfortable range, between 78 degrees F (26 degrees C) and 85 degrees F (30 degrees C)...
This requirement is not met as evidenced by:
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The licensee shall ensure the facility temperature is at a comfortable range, between 78 and 85 degrees F. A plan to ensure the temperature will stay in the range shall be submitted to LPA by 8/8/26.
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Based on interviews and observations, the faciity's indoor was measured at 90 degrees F and resident went to the hospital for dehydration which posed a immediate health and safety risk to residents in care.
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Type B
08/14/2026
Section Cited
CCR
87303(a)
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87303 Maintenance and Operation(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.
This requirement is not met as evidenced by:
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The licensee shall ensure that all air conditioning units in the facility are working properly. The licensee shall submit proof of installation of new air conditioners or air conditioners in working order by POC due date 8/14/26.
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Based on observation and interviews, 2 out of the 3 resident rooms do not have air conditioners properly working which poses a potential health and safety risks to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Cynthia D Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3