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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198601845
Report Date: 12/27/2022
Date Signed: 12/27/2022 05:03:35 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
12/19/2022 and conducted by Evaluator Valeria Maldonado
COMPLAINT CONTROL NUMBER: 28-AS-20221219172710
FACILITY NAME:A SPLENDOR LIVING - THE GLENDORA INCFACILITY NUMBER:
198601845
ADMINISTRATOR:CHRIS JENGFACILITY TYPE:
740
ADDRESS:452 SELLERS ST.TELEPHONE:
(626) 594-0152
CITY:GLENDORASTATE: CAZIP CODE:
91741
CAPACITY:34CENSUS: 13DATE:
12/27/2022
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Jason Chuang- AdministratoTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Facility not following COVID-19 protocol.
Facility allowed adults to film inside of the facility without obtaining permission from licensing.
Staff did not ensure that a comfortable temperature was maintained in the facility.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) V. Maldonado made an unannounced complaint visit to the facility for the purpose of investigating the above-mentioned allegations. LPA Maldonado met with the Administrator, Jason Chuang, and explained the purpose for the visit.

During today's visit, LPA Maldonado obtained a copy of the resident and staff roster, and conducted a tour of the physical plant with Adminstrator, Jason. LPA also interviewed Staff# 1-3 (S1-S3) and Residents# 1-4 (R1-R4)

The investigation revealed the following:



(Report Continued on LIC9099-C...)
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Fernando FierrosTELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Valeria MaldonadoTELEPHONE: 323-981-3342
LICENSING EVALUATOR SIGNATURE:

DATE: 12/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/27/2022
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-20221219172710
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: A SPLENDOR LIVING - THE GLENDORA INC
FACILITY NUMBER: 198601845
VISIT DATE: 12/27/2022
NARRATIVE
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Regarding allegation: Facility not following COVID-19 protocol.
It is alleged that a filming crew that was allowed to film inside the facility, was not adhering to COVID-19 protocols by wearing their face masks while in the facility. Based on interviews held, (3) of (3) staff state that the filming crew were wearing face masks while in the facility. The filming crew was seen at times not wearing the masks and staff stated to have requested them to put them on and keep them on while at the facility, to which they were said to have been compliant. (4) of (4) residents interviewed stated they witnessed the film crew to wear face masks while in the facility. This allegation is unsubstantiated.

Regarding allegation: Facility allowed adults to film inside of the facility without obtaining permission from licensing.
It is alleged that the facility allowed a film crew to film inside the facility, without obtaining permission from the licensing agency. All staff and residents interviewed confirmed that a film crew was present at the facility a couple of weeks ago and were filming inside. S1 stated to be unaware that the facility was supposed to notify the licensing agency about a filming crew being given permission to film inside the facility. (4) of (4) residents stated they had no issues with the filming crew being present. Per California Code of Regulations, Title 22, there is no regulation indicating that the licensing agency should be notified of such occurrences in the facility. This allegation is unsubstantiated.

Regarding allegation: Staff did not ensure that a comfortable temperature was maintained in the facility.
It is alleged that some residents had complaints of the facility being too cold due to the filming crew keeping doors open to bring in and remove equipment being used. Based on interviews conducted, (2) of (3) staff stated they received no concerns of residents being too cold while the filming crew was there. (4) of (4) residents stated to not have any concerns of the facility temperature while the filming crew was present. This allegation is unsubstantiated.

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.

An exit interview was conducted with Administrator Jason Chuang and a copy of the report was provided.
SUPERVISOR'S NAME: Fernando FierrosTELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Valeria MaldonadoTELEPHONE: 323-981-3342
LICENSING EVALUATOR SIGNATURE:

DATE: 12/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/27/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2