198601953-5-1-2025-28-AS-RORN-DGGNRL-20250508104142

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601953
Report Date: 05/01/2025
Date Signed: 05/01/2025 02:59:27 PM

Unsubstantiated

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
04/22/2025 and conducted by Evaluator Bennette Pena

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20250422120638

FACILITY NAME:	KENSINGTON SIERRA MADRE, THE		FACILITY NUMBER:	198601953
ADMINISTRATOR:	CECILIA DEGRAFF		FACILITY TYPE:	740
ADDRESS:	245 W. SIERRA MADRE BLVD.		TELEPHONE:	(626) 355-5700
CITY:	SIERRA MADRE	STATE: CA	ZIP CODE:	91024
CAPACITY:	106	CENSUS: 89	DATE:	05/01/2025
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Cecilia Degraff - Executive Director		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Licensee is falsely advertising, promoting, and holding themselves out as providing special care.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Bennette Pena and Gabriela Castro conducted an unannounced 10-day complaint visit for the above-mentioned allegation. LPAs met with Cristina Quesada and explained the purpose of the visit. Shortly after, Cecilia DeGraff, Executive Director arrived and assisted LPAs with the investigation.
The investigation consisted of the following: LPAs obtained copies of the Resident & Staff Rosters, Staff
in-service training about Resident Rights, Elderabuse and Life Enrichment, Visitors Policy, Concierge Desk Personnel list and Schedule (April 2025) and list of newly admitted residents (Jan-Apr 2025). At 12:30pm, LPAs conducted a tour of the physical plant including Assisted living and Memory Care units. LPAs interviewed Staff #1 (S1) - Staff #5 (S5) and Resident #1 (R1) – Resident #7 (R7). ***CONTINUED ON LIC9099-C***

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Bennette Pena
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/01/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20250422120638

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: KENSINGTON SIERRA MADRE, THE	FACILITY NUMBER: 198601953
	VISIT DATE: 05/01/2025

NARRATIVE

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Allegation: Licensee is falsely advertising, promoting, and holding themselves out as providing special care. It is alleged that staff made several misleading statements regarding the operation of the facility and the behavior of the staff was unprofessional and disrespectful. (5) out of (5) staff interviewed denied the allegation. Staff interviewed stated this is the first time they heard someone complain about false advertising. Staff interviewed indicated all staff get along well and respect each other. Staff also indicated there are no restrictions on visiting family members. All staff interviewed stated the concierge staff have schedules with breaks. S2 stated that when the concierge staff take their breaks, they request another staff member to cover and manage the front desk to watch residents going in and out of the main entrance. (7) out of (7) interviewed residents denied the allegation and stated that the facility delivered what they promise. All residents interviewed stated they are happy, content and couldn't think of anything bad to tell about the facility. LPA's review of the facility's promotional packet showed that the services and amenities listed are being provided to the residents.

Based on statements and interviews conducted with residents and staff as well as reviewed files and documentation, there was not enough supportive evidence to corroborate the 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 conducted and a copy of this report was provided to Cecilia DeGraff, Executive Director.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Bennette Pena
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/01/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2025

LIC9099 (FAS) - (06/04)

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