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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198601672
Report Date: 02/03/2026
Date Signed: 02/06/2026 08:13:14 AM

Unsubstantiated


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
01/30/2026 and conducted by Evaluator Gabriela Castro
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260130100706
FACILITY NAME:CLAREMONT MANORFACILITY NUMBER:
198601672
ADMINISTRATOR:ROBERT BARTONFACILITY TYPE:
740
ADDRESS:650 W. HARRISON AVE.TELEPHONE:
(909) 626-1227
CITY:CLAREMONTSTATE: CAZIP CODE:
91711
CAPACITY:360CENSUS: 264DATE:
02/03/2026
UNANNOUNCEDTIME BEGAN:
09:11 AM
MET WITH:Tanya Madrid, Director of Resident Services and Minerva Naranjo, Director of Heatlh Services TIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff do not meet a resident's incontinence needs
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Gabriela Castro conducted an unannounced complaint visit on 02/03/2026 to deliver findings related to the above allegation. LPA met with Tanya Madrid, Director of Resident Services and explained the purpose of the visit.

The investigation included a review of the resident roster, staff roster, resident face sheet, R1 Physician’s Report, R1 hospice care plans, copies of signage posted in R1’s room, R1 incontinence schedules, call pendant logs, and caregiver notes. Additionally, LPA conducted interviews with six (6) staff members (S1–S6), one (2) witness (W2) and seven (7) residents (R1–R7).

(Continued on 9099C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Gabriela Castro
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2026
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 2
Control Number 28-AS-20260130100706
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: CLAREMONT MANOR
FACILITY NUMBER: 198601672
VISIT DATE: 02/03/2026
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Allegation: Staff do not meet a resident's incontinence needs

It is alleged that the facility does not change R1’s diapers frequently enough, which is causing R1 to get urinary tract infections. During staff interviews, staff consistently stated that they assist R1 with ADLs, including grooming, showers, and incontinence care, and that residents requiring increased incontinence care are checked regularly. Staff stated that care provided is documented, including toileting and brief changes, and that staff respond to R1’s requests for assistance as promptly as possible. Staff stated that care plans and hospice plans are available and followed, and that care is individualized based on R1’s preferences and needs. Staff denied concerns of neglect and stated that R1 has not complained about incontinent care. During the resident interview, R1 stated that the facility provides her with everything she needs and that staff treat her well. R1 expressed satisfaction with her living environment and stated that her overall health is good. R1 stated she does not like hospice services and would prefer to return to her prior routine. R1 acknowledged the history of UTIs and reported she is currently taking antibiotics. During resident interviews, residents R2–R7 stated they are satisfied with the care being provided and reported no concerns regarding incontinence care. During W1 interview, W1 stated that R1 has resided at the facility for over eight years and expressed no concerns regarding the services provided. W1 reported regular communication with the hospice nurse and stated that a new incontinence care plan was developed to help reduce recurrent UTIs, noting that UTIs can be common with aging. W1 stated they will continue to communicate with hospice and facility staff and reported no additional concerns.

Based on the investigation conducted, including interviews with staff, witness and residents and review of relevant records, there was insufficient evidence to support 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 was held, and a copy of this report was provided.

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Gabriela Castro
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2