198602098-3-16-2023-28-AS-RORN-CQ5VCN-20230321161924

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602098
Report Date: 03/16/2023
Date Signed: 03/16/2023 03:31:00 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
02/03/2020 and conducted by Evaluator Luis Mora

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20200203142651

FACILITY NAME:	ARCADIA RETIREMENT VILLAGE		FACILITY NUMBER:	198602098
ADMINISTRATOR:	LOURDES GARCIA		FACILITY TYPE:	740
ADDRESS:	607 WEST DUARTE ROAD		TELEPHONE:	(626) 447-6070
CITY:	ARCADIA	STATE: CA	ZIP CODE:	91007
CAPACITY:	0	CENSUS: 80	DATE:	03/16/2023
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Virgilio Agas - Current Administrator		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Staff failed to notify residents of change in ownership.
Facility is advertising false claims regarding services provided.
Facility is not abiding by admission agreement.
Facility violated resident's personal rights while in care.
Resident's medication was mishandled while in care.
Facility is not properly maintained.
Resident's personal belongings were not properly secured while in care.
Facility elevator is in disrepair.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Luis Mora conducted an unannounced subsequent complaint visit to determine the validity of the above-mentioned allegations. LPA met with Virgilio Agas - Current Administrator and explained the reason for the visit.

On 02/12/20, LPA Katrdzhyan interviewed Resident 1 (R1), toured R1's room & room 102. On 02/24/20, LPA interviewed the Current Administrator Virgilio Agas, reviewed a random selection of medication records and files for staff 1 - 3. LPA also toured the kitchen and rooms 102 & 223. On 02/25/20, LPA Katrdzhyan interviewed the current Administrator Virgilio Agas, the prior Administrator Lourdes Garcia (via telephone) and Resident 2 (R2). LPA also toured the lobby area & the library. On 03/10/2020, LPA Katrdzhyan interviewed Residents 3 - 5 (R3 - R5) and Staff 1 - 3 (S1 - S3). Also, a tour of resident rooms 223 and 246 were conducted. On 03/15/2023, LPA Mora obtained staff and resident rosters, attempted to interview previous administrator via phone, interviewed current administrator Virgilio Agas & Staff 4 - 7 (S4 - S7). LPA requested for R1's admission agreement, R1's December 2019 & January 2020 medication records, and reviewed January & February 2020 elevator maintenance invoices. Today's visit LPA Mora interviewed Resident 6 - 12 (R6 - R12), reviewed R1's file and conducted a tour of the facility. (Continued to LIC 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3969
LICENSING EVALUATOR NAME: Luis Mora	TELEPHONE: 323-981-3964
LICENSING EVALUATOR SIGNATURE:	DATE: 03/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023

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-20200203142651

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: ARCADIA RETIREMENT VILLAGE	FACILITY NUMBER: 198602098
	VISIT DATE: 03/16/2023

NARRATIVE

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The investigation revealed the following: regarding the allegation "staff failed to notify residents of change in ownership”, it is alleged that the facility had a change of ownership and residents were not notified. However, based on staff interviews and Community Care Licensing Division (CCLD) records the change of ownership did not occurred during the time this complaint was filed. The new licensee submitted the application on 08/25/2020 to CCLD and their license was made effective on 02/24/2021. Residents interviewed confirmed being notified of the change of ownership when it actually occurred.

Regarding the allegation "facility is advertising false claims regarding services provided" and "facility is not abiding by admission agreement”, it is alleged that facility provides no transportation to the doctor, housekeeping is not daily and laundry facilities are available, but at an expense of $1.50 per wash and per drying cycle. Per the admission agreement the facility provides assistance in arranging transportation to medical and dental appointments and provide weekly housekeeping and laundry services. Staff interviewed stated that facility arranges transportation to medical and dental appointment through Access Services. They also stated that housekeeping is done daily, but deep cleaning of the rooms is once a week, and laundry services is done once a week, but there is a coin laundry for residents to do additional laundry at their own expense. The admission agreement does state that additional housekeeping and laundry services, as needed or requested, are available for an additional fee. Residents interviewed confirmed that transportation is arranged for them and they stated that housekeeping is daily and they get laundry services once a week.

Regarding the allegation "facility violated resident's personal rights while in care”, it is alleged that housekeeping is unprofessional and that there is little dignity and respect towards residents. Staff interviewed denied the allegation. Residents interviewed could not corroborate with the allegation.

Regarding the allegation "resident's medication was mishandled while in care”, it is alleged that the delivery of medication has been inconsistent for R1. Staff interviewed denied the allegation and stated that R1 actually would refuse to take his medication. Per facility notes R1 refused to take medication on 01/8/2020 - 01/10/2020. Residents interviewed could not corroborate the allegation and stated they have had no issues with receiving their medication.

(Continued to LIC 9099C)

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3969
LICENSING EVALUATOR NAME: Luis Mora	TELEPHONE: 323-981-3964
LICENSING EVALUATOR SIGNATURE:	DATE: 03/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20200203142651

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: ARCADIA RETIREMENT VILLAGE	FACILITY NUMBER: 198602098
	VISIT DATE: 03/16/2023

NARRATIVE

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Regarding the allegation "facility is not properly maintained”, it is alleged that the floor at the entrance is not cleaned, the door from lobby to patio is not operating properly, and the shower room has old and ineffective tile which is causing water to leak through the floor and into the TV room floor. Staff interviewed denied the allegations and stated that the facility does their best to maintained the facility clean and in good repair. Residents interviewed could not corroborate the allegation. During the visits, the LPA observed a clean floor at the entrance, patio door was operable and did not noticed any issues with the shower room tile.

Regarding the allegation "resident's personal belongings were not properly secured while in care”, it is alleged that R1's watch, 4 flash drives and wallet with passport and cards were stolen from R1's room. Staff interviewed denied the allegation and stated that the things R1 reported stolen to the facility are a slight different than the allegation. According to the facility's notes, R1 was admitted on 12/31/2019 and R1 did not have a check available to pay the rent and staff offered R1 transportation to the bank to get a check, but R1 refused and stated that R1 would go on 01/02/2020 to the bank. On 01/02/2020, R1 reported to the front desk that R1's wallet was stolen from the room and refused the staff to go in the room to assist in finding the wallet. On the morning of 01/03/2020. R1 called the police reporting that R1's wallet, laptop and footrest were stolen. R1 talked to the police, but refused to file a police report. On that same day 01/03/2020, caregivers found R1's laptop and footrest inside R1's closet and a picture was taken (LPA reviewed the picture). Residents interviewed could not corroborate the allegation and stated they have not experience theft of their personal belongings.

Regarding the allegation "facility elevator is in disrepair”, it is alleged that the facility's elevator #2 has been declared out of order on 7 occasions during the month of January 2020. Staff interviewed confirmed that one of the elevators kept getting stuck in early 2020, but that the facility took immediate action by contacting Amtech Elevator Services. Amtech would either come on the same day or the following business day. While the elevator was not working all residents were instructed to use elevator #1. Facility has invoices dated 01/03/2020, 01/21/2020, 01/31/2020 and 02/07/2020 of the repairs done to the elevator. Residents interviewed confirmed that elevator #2 did have issues before and to their knowledge they believe that the facility took immediate action. They were instructed to use the other elevator.

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 the report was provided

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3969
LICENSING EVALUATOR NAME: Luis Mora	TELEPHONE: 323-981-3964
LICENSING EVALUATOR SIGNATURE:	DATE: 03/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023

LIC9099 (FAS) - (06/04)

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