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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198600539
Report Date: 12/12/2025
Date Signed: 12/12/2025 11:15:37 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
07/23/2025 and conducted by Evaluator Erik Zaragoza
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250723133744
FACILITY NAME:PICO RIVERA GARDENSFACILITY NUMBER:
198600539
ADMINISTRATOR:JOYCE GARCIAFACILITY TYPE:
735
ADDRESS:6525 ROSEMEAD BLVD.TELEPHONE:
(562) 949-8489
CITY:PICO RIVERASTATE: CAZIP CODE:
90660
CAPACITY:185CENSUS: 151DATE:
12/12/2025
UNANNOUNCEDTIME BEGAN:
09:12 AM
MET WITH:Julias Elias - Med Tech SupervisorTIME COMPLETED:
11:28 AM
ALLEGATION(S):
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Facility staff changed clients healthcare provider without clients permission
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Erik Zaragoza and Gabriela Castro conducted a subsequent unannounced complaint visit to investigate the allegation listed above. LPAs met with Julia Elias, Med Tech Supervisor for the facility, and explained the purpose of the visit. Administrator Joyce Garcia arrived shortly thereafter.

The investigation consisted of the following: On 7/31/2025, LPA Zaragoza interviewed Clients #1 - 16 (C1 - C16), Staff #1 - 4 (S1 - S4), obtained the staff and client rosters, and also obtained the FACE Sheets, physician's reports, and appraisals for C1 - C3. Since the initial visit, LPA obtained the Request for primcary care provider (PCP) Change Forms for Clients #17 - 19 (C17 - C19) from the administrator. During today's visit, LPAs are delivering the findings of the investigation.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Erik Zaragoza
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2025
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 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
07/23/2025 and conducted by Evaluator Erik Zaragoza
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250723133744

FACILITY NAME:PICO RIVERA GARDENSFACILITY NUMBER:
198600539
ADMINISTRATOR:JOYCE GARCIAFACILITY TYPE:
735
ADDRESS:6525 ROSEMEAD BLVD.TELEPHONE:
(562) 949-8489
CITY:PICO RIVERASTATE: CAZIP CODE:
90660
CAPACITY:185CENSUS: 151DATE:
12/12/2025
UNANNOUNCEDTIME BEGAN:
09:12 AM
MET WITH:Julias Elias - Med Tech SupervisorTIME COMPLETED:
11:28 AM
ALLEGATION(S):
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3
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8
9
Facility staff does not ensure clients are allowed to choose their own healthcare provider
INVESTIGATION FINDINGS:
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13
Licensing Program Analysts (LPAs) Erik Zaragoza and Gabriela Castro conducted a subsequent unannounced complaint visit to investigate the allegation listed above. LPAs met with Julia Elias, Med Tech Supervisor for the facility, and explained the purpose of the visit. Administrator Joyce Garcia arrived shortly thereafter.

The investigation consisted of the following: On 7/31/2025, LPA Zaragoza interviewed Clients #1 - 16 (C1 - C16), Staff #1 - 4 (S1 - S4), obtained the staff and client rosters, and also obtained the FACE Sheets, physician's reports, and appraisals for C1 - C3. Since the initial visit, LPA obtained the Request for PCP Change Forms for Clients #17 - 19 (C17 - C19) from the administrator. During today's visit, LPAs are delivering the findings of the investigation.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Erik Zaragoza
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 28-AS-20250723133744
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: PICO RIVERA GARDENS
FACILITY NUMBER: 198600539
VISIT DATE: 12/12/2025
NARRATIVE
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The investigation revealed the following: In regards to the allegation that "Facility staff does not ensure clients are allowed to choose their own healthcare provider," it is alleged that clients are not given a choice in who their primary healthcare provider is. During interviews with the clients, none of them corroborated the allegation. One of the clients interviewed stated that they have requested to have the primary care provider (PCP) changed in the past and the facility assisted them with the change. Another client interviewed stated that they have never requested to have their primary medical provider changed. During interviews with the staff, none of them corroborated the allegation. One of the staff interviewed stated that by all means clients are able to choose who their primary medical provider is. Another staff interviewed stated that clients are allowed their choice of PCP if they request to make a change.

Based on statements and interviews conducted with staff, clients, review of client files and facility file records, there was not enough supportive evidence to concur with the reported allegations. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

Exit interview held, and a copy of this report will be emailed to the administrator.
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Erik Zaragoza
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 28-AS-20250723133744
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: PICO RIVERA GARDENS
FACILITY NUMBER: 198600539
VISIT DATE: 12/12/2025
NARRATIVE
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The investigation revealed the following: In regards to the allegation that "Facility staff changed clients healthcare provider without clients permission," it is alleged that at least three (3) clients have had their medical provider changed to the in-house facility medical provider without their permission. During interviews with the clients, five (5) out of sixteen (16) interviewed corroborated the allegation. One of the clients interviewed stated that their primary doctor had been changed to the in-house facility provider, and they had no idea how or why the change was made. Another client interviewed stated that their primary provider was also changed to the in-house facility provider, that they had no idea why this was the case, and they believe it was probably the facility staff that made the change. During interviews with staff none of them corroborated the allegation. One staff member explained that they utilize PCP Change forms that are signed by the client and sent to the in-house physician to process the PCP change. Another staff member stated that sometimes they complete the PCP change over the phone with the client's health insurance after the client provides consent to the insurance for the staff member to speak on their behalf. During record review of the PCP Change forms for C17 - C19, it was determined that none of these clients were the ones identified in the original complaint report as having had their provider changed without their consent.

Based on LPA interviews conducted with the clients and staff, the preponderance of evidence standard has been met for the above allegations, therefore the allegation is found to be SUBSTANTIATED. California Code of Regulations Title 22, Division 6, Chapter 1 is being cited on the attached LIC9099D pages.

Exit interview was held and a copy of the report along with the appeal rights were provided and will be emailed to the administrator.
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Erik Zaragoza
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 28-AS-20250723133744
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: PICO RIVERA GARDENS
FACILITY NUMBER: 198600539
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/12/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type B
01/05/2026
Section Cited
CCR
80072(a)(1)
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(a) Except for children’s residential facilities, each client shall have personal rights which include, but are not limited to, the following: (1) To be accorded dignity in his/her personal relationships with staff and other persons.
The regulation is not met as evidenced by:
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Licensee/Administrator is to ensure that clients are made fully aware of the reason for their PCP changes moving forward. Administrator is to create a written plan on how the facility will document the PCP changes and the reasons for them and submit it to LPA by the POC due date.
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Based on interview and record review, LPAs determined that some of the clients in the facility have had their medical provider change without their full knowledge of the change, which poses a potential health and safety threat to clients 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.
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Erik Zaragoza
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5