198602098-2-12-2021-28-AS-MVAO-BZMQH5-20210331121033

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602098
Report Date: 02/12/2021
Date Signed: 02/12/2021 04:59:30 PM

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
07/29/2020 and conducted by Evaluator LaJean Nicole Spencer

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20200729125826

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:	149	CENSUS: 71	DATE:	02/12/2021
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Virgilio Agas, co-administrator		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Resident not permitted to form a resident council meeting without the presence of facility staff
Resident was given unlawful eviction notice

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Nicole Spencer initiated a subsequent complaint investigation for the allegations listed above. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, today’s complaint investigation was conducted telephonically with Vergilio Agas, the facility co-administrator.

The initial tele-visit was conducted on 8/7/20 and consisted of the following: LPA Spencer conducted telephone interviews with the co-administrator Virgilio Agas and Resident #1-3. A video Facetime call was conducted including a tour of the facility grounds and the LPA received copies of the requested documents: staff roster, resident roster, face sheet for resident #2, Needs and Services plan for resident #2, Admissions Agreement, pest control service agreement, staff contact information, copy of check payment for August rent for resident #2, and past due balance letter for resident #2. Additional staff and resident interviews were conducted during the investigation. The subsequent tele-visit to deliver findings was conducted on 2/12/21 with co-administrator Virgilio Agas. *See LIC 9099C for continuation of this report.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Christine Yee	TELEPHONE: (323) 981-3978
LICENSING EVALUATOR NAME: LaJean Nicole Spencer	TELEPHONE: (323)981-3342
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2021

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-20200729125826

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: ARCADIA RETIREMENT VILLAGE	FACILITY NUMBER: 198602098
	VISIT DATE: 02/12/2021

NARRATIVE

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The investigation revealed the following:

Resident not permitted to form a resident council meeting without the presence of facility staff
The two facility administrators stated that resident council meetings are usually attended by a staff member in order to take notes and pass the grievances along to management. However, they stated that residents are allowed to meet without staff and staff can leave the meeting if asked. Due to COVID-19, the formal resident council meetings have not taken place in person. The president of the resident council was interviewed and revealed that the council has not met in months due to COVID-19 but that residents have met to discuss concerns without the presence of staff. 9 residents were interviewed: 1 resident stated that the meetings required facility staff but informal meetings take place among residents without staff, 3 residents stated that staff members were not required to be there but usually one staff is there to take notes, and 5 were unsure about resident council.

Resident was given unlawful eviction notice
LPA Spencer reviewed the past due notice for resident #2, august check stub payment, and old eviction letter dated in 2019. The past due letter did not mention an eviction. The eviction dated in 2019 was attached to the past due notice of 2020. Based on interviews with administrator Lourdes Garcia, the 2019 eviction letter was attached to the 2020 past due notice but was not an eviction letter. Resident #2 was interviewed and stated that she had a past due amount for rent and that letter she received was actually not an eviction letter but a notice of past due rent. Upon review of the records, the 2020 letter was not an eviction notice.

Based upon interviews conducted the findings indicate although the allegation(s) may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation(s) are Unsubstantiated.

A telephonic exit interview was conducted with the co-administrator Virgilio Agas. A hard copy of the report and appeal rights were provided.

SUPERVISOR'S NAME: Christine Yee	TELEPHONE: (323) 981-3978
LICENSING EVALUATOR NAME: LaJean Nicole Spencer	TELEPHONE: (323)981-3342
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2021

LIC9099 (FAS) - (06/04)

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