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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603162
Report Date: 11/15/2025
Date Signed: 11/15/2025 12:16:37 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
11/05/2025 and conducted by Evaluator Alberto Lopez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251105142214
FACILITY NAME:WHITTIER GLEN ASSISTED LIVINGFACILITY NUMBER:
198603162
ADMINISTRATOR:BARBA AGUIRRE, ITZAYANAFACILITY TYPE:
740
ADDRESS:10615 JORDAN RDTELEPHONE:
(562) 943-3724
CITY:WHITTIERSTATE: CAZIP CODE:
90603
CAPACITY:93CENSUS: 89DATE:
11/15/2025
UNANNOUNCEDTIME BEGAN:
11:48 AM
MET WITH:Maddison Guardian, Medical Technician TIME COMPLETED:
12:29 PM
ALLEGATION(S):
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Staff did not address a change in resident’s condition in a timely manner.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alberto Lopez conducted subsequent unannounced complaint visit to deliver fidnings for the above allegation. LPA met with Maddison Guardian, Medical Technician and discussed the purpose of the visit.

11/10/2025 - The investigation consisted of LPA interviewing five (5) (staff S#1 - S#5), nine (9) residents (R#1 - R#9), one witness, LPA obtained copies of the following documents: staff roster, resident roster, R1 ‘s physicians report, and appraisal needs and service plan, doctor’s order for R1, MAR for 11/2025 and other medical records. LPA also took tour of facility common areas.

The investigation revealed regarding allegation: Staff did not address a change in resident’s condition in a timely manner. It is alleged that staff are not addressing resident’s change of condition on a timely basis. LPA interviewed five (5) staff, and all five (5) staff denied the allegation. LPA interviewed eight (8) residents and all eight (8) could not corroborate the allegation.
(continued on 9099C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2025
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-20251105142214
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: WHITTIER GLEN ASSISTED LIVING
FACILITY NUMBER: 198603162
VISIT DATE: 11/15/2025
NARRATIVE
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(continued from 9099)

R1 was sent to hospital on 11/05/2025 and it was of concern that that facility did not notice change of condition because resident arrived to the hospital in an altered and confused state and had elevated glucose levels when admitted. LPA spoke with resident’s doctor’s office and learned that resident has no standing order for glucose testing and there was no way facility staff would know it was elevated. Resident was sent to hospital in prompt manner right after resident had an un-witnessed fall in R1 restroom. It was discovered at hospital that resident had a urinary tract infection. There is not enough evidence to support this 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.

An exit interview was conducted with Maddison Guardian, Medical Technician, A copy of this report, along with the appeal rights, was provided.

SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2