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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603162
Report Date: 08/05/2025
Date Signed: 08/05/2025 04:58:26 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 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
07/01/2025 and conducted by Evaluator Cynthia D Chan
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250701090048
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: 85DATE:
08/05/2025
UNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Itzayana Barba, AdministratorTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Staff do not ensure medications are dispensed as prescribed.
Staff does not ensure medications are properly managed.
Staff do not ensure call buttons are answered in a timely manner.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cynthia Chan conducted a subsequent complaint investigation for the allegations listed above. LPA arrived unannounced and met with Administrator, Itzayana Barba. The purpose of the visit was explained.

The investigation consisted of the following:
On 7/10/25, LPA toured the physical plant, random rooms, and reviewed medications. Interviews were held with the Administrator, Staff #1 - #9, and a resident. During the visit today, LPA continued interviews with two Staff and seven Residents.

The investigation revealed the following:
Allegations - Staff do not ensure medications are dispensed as prescribed, and Staff do not ensure medications are properly managed.
Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025
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 6
Control Number 28-AS-20250701090048
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: WHITTIER GLEN ASSISTED LIVING
FACILITY NUMBER: 198603162
VISIT DATE: 08/05/2025
NARRATIVE
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 It is alleged that staff often miss dispensing several residents’ medications daily. In addition, it is alleged that residents’ medications are not being managed properly, and Staff do not re-order medications timely when they see they are getting low. LPA reviewed medications for seven (7) residents on 7/10/25. There were discrepancies found in two (2) of the residents’ medications. Resident #2 did not have the Ascorbic Acid tablet available as indicated on the medication log. Resident #3 did not have the Multiple Vitamin tablet available as prescribed, but was marked as given, and Trazodone 50 MG was discontinued on 7/7/25. However, the medication was still being given to the resident until 7/10/25. Based on observation and review, the medications were not properly dispensed and/or missed. It could not be determined whether the medications unavailable for the residents were due to misplacement or not being refilled timely. Staff interviewed stated they would refill a few days before the meds ran low. Seven (7) out of eight (8) residents interviewed stated that their medications are given by the staff and have not missed any. One (1) stated that the staff had missed giving some of their medications.

Allegation - Staff do not ensure call buttons are answered in a timely manner. LPA interviewed a total of 12 staff. The administrator stated the average time that staff should respond to a call button is between 5-10 minutes. She stated sometimes it could take a little longer due to staff assisting another resident. She stated there are 2 caregivers and 2 Med Techs for the morning and afternoon shifts. There is 1 caregiver and 1 Med Tech in the overnight shift. The caregivers and med techs have phones with an app that alerts them when a resident presses the pendant or pulls the cord for assistance. Staff stated that they will acknowledge the resident’s call and then clear it after they finish assisting the resident. LPA reviewed the facility’s Alarm history, which indicates the times and dates when residents call for assistance. LPA pulled the history from 7/6/25 – 7/11/25, and the reports showed that the residents’ calls were acknowledged within a few seconds to as long as 59m 16s. Five (5) of the staff feel that there are not enough caregivers to assist the residents. Sometimes, there is one caregiver on shift if the other calls out. Two (2) out of the eight (8) residents interviewed stated they waited a long time before staff assist, and half of them feel there is a shortage of caregivers.

Based on LPA observations, interviews conducted, and record review, the preponderance of evidence standard has been met, therefore, the above allegations are found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6 and Chapter 8), are being cited on the attached LIC 9099D.
An exit interview was conducted. The Plan of Corrections were reviewed and developed with the administrator. A copy of this report and appeal rights were provided.
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 28-AS-20250701090048
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 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: 08/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/06/2025
Section Cited
CCR
87465(a)(4)
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87465 Incidental Medical and Dental Care(a) A plan for incidental medical and dental care shall be developed by each facility. (4) The licensee shall assist residents with self-administered medications as needed.
This requirement is not met as evidenced by:
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The licensee shall submit a plan to ensure that all the residents' medications are present, obtaining refills, and staff training. The plan is due by 8/6/25.
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Based on observation and record review, the medication for Resident #3 was not administered as prescribed by the physician which poses an immediate health and safety risks to residents in care.
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Type B
08/12/2025
Section Cited
CCR
87411(a)
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87411 Personnel Requirements - General(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs.
This requirement is not met as evidenced by:
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The licensee shall develop a plan to provide sufficient staffing to ensure residents are assisted in a timely manner and that their needs are met. Plan due to LPA by 8/12/25.
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Based on interview and record review, the facility did not employ sufficient caregivers to assist residents with their needs which poses a potential health, safety, and personal rights risk to residents in care.
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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.
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 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
07/01/2025 and conducted by Evaluator Cynthia D Chan
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250701090048

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: 85DATE:
08/05/2025
UNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Itzayana Barba, AdministratorTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
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9
Staff do not ensure residents receive their laundry in a timely manner.
Staff allow resident to be in soiled clothing for an extended period of time.
Staff do not ensure facility is kept free of malodors.
Staff do not ensure floors in residents rooms are kept clean.
Staff did not ensure resident phone conversation was kept private.
INVESTIGATION FINDINGS:
1
2
3
4
5
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7
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9
10
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13
Licensing Program Analyst (LPA) Cynthia Chan conducted a subsequent complaint investigation for the allegations listed above. LPA arrived unannounced and met with Administrator, Itzayana Barba. The purpose of the visit was explained.

The investigation consisted of the following:
On 7/10/25, LPA toured the physical plant, random rooms, and reviewed medications. Interviews were held with the Administrator, Staff #1 - #9, and a resident. During the visit today, LPA continued interviews with two Staff and seven Residents.

The investigation revealed the following:
Allegation - Staff do not ensure residents receive their laundry in a timely manner. It is alleged that residents do not get their clean laundry back in a timely manner.
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 28-AS-20250701090048
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: WHITTIER GLEN ASSISTED LIVING
FACILITY NUMBER: 198603162
VISIT DATE: 08/05/2025
NARRATIVE
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 Staff interviewed stated the residents have a day of the week when the housekeepers do their laundry. They normally get their clean clothing back the same day or the next. If the residents have soiled clothing, staff will do an extra load. LPA interviewed eight (8) residents, and seven (7) of them receive their clean clothes back the same day or the next day. They do not have any issues regarding their clothes not being returned timely or not being cleaned properly.

Allegation - Staff allow resident to be in soiled clothing for an extended period of time. It is alleged that residents who are incontinent get left in their soiled clothing for a long time. LPA interviewed Staff regarding this allegation. All the staff stated they do not allow residents to sit in soiled diapers or clothing for a long time. Once they observe their diapers soiled, staff will change them right away to prevent getting into their clothing. However, some residents refuse to be changed, but the staff would try to convince them. Residents interviewed have observed staff immediately tend to residents if they notice a smell or if their clothing is soiled.

Allegation - Staff do not ensure facility is kept free of malodors. It is alleged that the facility smells of feces and urine in certain hallways and the elevator. Staff interviewed stated that when they smell any unpleasant odor, they will immediately check to see where it is coming from. If the resident has an accident, the staff will call for a caregiver to assist with changing the resident. If the odor is coming from a certain area, they will request a housekeeper to clean and sanitize the area, or they will do it themselves. LPA interviewed eight (8) residents. Seven (7) out of the eight (8) stated that the staff do a good job in keeping the facility clean. They do not allow any smells to linger in the facility. During LPA visits, there were no malodorous smells at the facility.

Allegation - Staff do not ensure floors in residents’ rooms are kept clean. LPA interviewed housekeepers and caregivers who stated they clean the residents’ floors when they see any dirt or if there are any spills. Housekeepers clean the residents’ rooms, which include sweeping and mopping the floors and taking out the trash. Each resident gets their room cleaned once a week and upon request. Care staff stated that if they see the floor wet or dirty, they will help clean it up. LPA interviewed eight (8) residents, and seven (7) of them stated that staff clean their rooms and will clean the floor if they see it dirty. LPA selected a few rooms to inspect, and the floors did not appear to have any stains.
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 28-AS-20250701090048
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: WHITTIER GLEN ASSISTED LIVING
FACILITY NUMBER: 198603162
VISIT DATE: 08/05/2025
NARRATIVE
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Allegation - Staff did not ensure resident phone conversation was kept private. It is alleged that the resident’s personal information was heard by others in the activity room when a staff was helping the resident on the speaker phone. None of the staff interviewed has heard or observed any staff sharing personal information of a resident in the activity room. The family advisor coordinators who assist residents with medical or social security calls are done privately in their office. LPA interviewed eight (8) residents, and none have had their personal information heard by others at the facility.

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.

An exit interview was conducted with the administrator. A copy of this report, along with the appeal rights, was provided.
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 6