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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603162
Report Date: 04/08/2025
Date Signed: 04/08/2025 11:23:00 AM

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
04/04/2025 and conducted by Evaluator Erik Zaragoza
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250404091749
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: 76DATE:
04/08/2025
UNANNOUNCEDTIME BEGAN:
09:14 AM
MET WITH:Kathleen McDonald - Welness DirectorTIME COMPLETED:
11:45 AM
ALLEGATION(S):
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Staff are not ensuring residents are provided a safe environment
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Erik Zaragoza conducted an unannounced complaint visit to investigate the allegation listed above. LPA met with Kathleen Mcdonald, Wellness Director for the facility, and explained the purpose of the visit. Executive Director Itzayan Barba Aguirre arrived shortly thereafter.

The investigation consisted of the following: LPA Erik Zaragoza toured the facility, obtained copies of the staff and resident roster, obtained the Physician's Report and Pre-Placement Appraisals for Residents #1 - 2 (R1 - R2), interviewed Staff #1 - 5 (S1 - S5), and also interviewed R1, along with Residents #3 - 10 (R3 - R10). LPA attempted to interview R2, however they are currently hospitalized as of the time of this visit.

The investigation revealed the following: In regards to the allegation that "Staff are not ensuring residents are provided a safe environment," it is alleged that roommates R1 and R2 had gotten into a physical altercation with each other amidst growing tensions with each other, which was causing the facility to not provide a safe environment for either of them.
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Erik Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2025
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-20250404091749
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: 04/08/2025
NARRATIVE
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During interviews with the residents, eight (8) out of ten (10) did not corroborate the allegation. During an interview with R1, they explained that the staff have taken appropriate action towards addressing the issues between themselves and R2 by moving them into separate rooms, and that besides this R1 had no safety concerns regarding the facility. Other residents interviewed during the visit also stated that from their experience the staff have been providing them and everyone else a safe environment at the facility. During interviews with the staff members, none of them corroborated the allegation. One of the staff members explained that after becoming aware of the incident that occurred between R1 and R2 they took the next steps of separating the two residents to ensure that further escalations between the them are prevented. Another staff member interviewed stated that they have also moved their assigned seats in the dining room to separate areas in order to avoid future potential conflicts. During the tour of the facility, LPA did not observe any potential hazards or threats to the residents and determined the facility to be safe.

Based on statements and interviews conducted with staff, residents, review of resident files and facility file records, there was not enough supportive evidence to concur with the reported allegations. 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 this report was provided.
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Erik Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2