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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603162
Report Date: 11/17/2025
Date Signed: 11/17/2025 05:46:42 PM

Substantiated


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
10/28/2025 and conducted by Evaluator Tena Herrera
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251028084138
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:
11/17/2025
UNANNOUNCEDTIME BEGAN:
08:47 AM
MET WITH:Monica Guardian - Operations ManagerTIME COMPLETED:
06:00 PM
ALLEGATION(S):
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Staff do not ensure facility elevator is maintained in good repair.

INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced subsequent complaint visit to address the allegations listed above. LPA met with Monica Guardian and explained the purpose of the visit.


The investigation consisted of the following:
On 10/30/25 LPA Daniel Konishi conducted a unannounced initial 10-day complaint visit obtained a copy of the staff/resident roster and interviewed 1 Staff. Further investigation was needed.
During todays visit 11/17/25 LPA Herrera conducted a subsequent visit, LPA toured facility, obtained copies of the following Physician Reports for R1 and R2, Food Menu, House Rules, Showering Schedule, Elevator Repair Invoices and Staff/Resident Rosters.

Continued on LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Tena Herrera
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2025
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 5
Control Number 28-AS-20251028084138
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: 11/17/2025
NARRATIVE
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The investigation revealed the following:

Allegation: Staff do not ensure facility elevator is maintained in good repair.
It is alleged that the elevator went out on 10/13/25 and R1 who utilizes a wheelchair to ambulate, had no way of getting downstairs during this time. LPA interviewed 4 staff and each confirmed the allegation, stating that the elevator was down for a few weeks. Interview with S1 and review of Invoices, confirmed that the elevator was in disrepair from 10/13/2025 – 10/31/2025. LPA tested the elevator, and it was in operating condition. LPA interviewed 8 residents, and each confirmed the above allegation and stated that although the elevator was in disrepair they were not affected by the outage.


Based on LPAs observations and interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6 and Chapter 8 are being cited on the attached LIC 9099D. Exit interview held, and a copy of this report and appeal rights were provided.
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Tena Herrera
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
10/28/2025 and conducted by Evaluator Tena Herrera
COMPLAINT CONTROL NUMBER: 28-AS-20251028084138

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:
11/17/2025
UNANNOUNCEDTIME BEGAN:
08:47 AM
MET WITH:Monica Guardian - Operations ManagerTIME COMPLETED:
06:00 PM
ALLEGATION(S):
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9
Staff do not ensure food is of good quality and quantity.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced subsequent complaint visit to address the allegations listed above. LPA met with Monica Guardian and explained the purpose of the visit.


The investigation consisted of the following:
On 10/30/25 LPA Daniel Konishi conducted a unannounced initial 10-day complaint visit obtained a copy of the staff/resident roster and interviewed 1 Staff. Further investigation was needed.
During todays visit 11/17/25 LPA Herrera conducted a subsequent visit, LPA toured facility, obtained copies of the following Physician Reports for R1 and R2, Food Menu, House Rules, Showering Schedule, Elevator Repair Invoices and Staff/Resident Rosters.

Continued on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Tena Herrera
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 28-AS-20251028084138
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: 11/17/2025
NARRATIVE
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The investigation revealed the following:

Allegation: Staff do not ensure food is of good quality and quantity.
It is alleged that the food served at the facility are in small portions and cold. LPA interviewed 4 staff and each denied the allegation and stated that although some residents may consider portions to be small, they are provided with second servings if requested, staff also stated that if the temperature is too cold for the residents staff will reheat the food for them. LPA interviewed 8 residents and 7 out of 8 residents denied the allegation and stated that the portions are sometimes small but they can ask for a second serving once everyone has been served and that if the food is cold staff will reheat it for them with no issues.

Based on statements and interviews conducted with staff/residents, and review of client files, and LPA observations, there was not enough supportive evidence to concur with the reported 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 held and a copy of report was provided.
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Tena Herrera
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 28-AS-20251028084138
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/17/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/18/2025
Section Cited
CCR
87303(a)
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87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This standard was not met as evidence by:
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Durining visit LPA tested the elevator and it was in operating condition. LPA reviewed Invoices for the repairs made and due to facility already addressing the issue and making needed repairs there is no POC needed and POC will be cleared and emailed to Administrator by end of day tomorrow 11/18/25.
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Per Interviews with 4 staff and 8 residents each confirmed the above allegation stating that the elevator was in disrepair for weeks during the month of October 2025. Invoices for repairs were also provided.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Tena Herrera
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5