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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603183
Report Date: 01/15/2026
Date Signed: 01/15/2026 03:27:02 PM

Unsubstantiated


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
01/09/2026 and conducted by Evaluator Nune Margaryan
COMPLAINT CONTROL NUMBER: 28-AS-20260109082302
FACILITY NAME:COUNTRY VIEW ASSISTED LIVINGFACILITY NUMBER:
198603183
ADMINISTRATOR:DENNISE TORRESFACILITY TYPE:
740
ADDRESS:824 W. CAMERON AVETELEPHONE:
(626) 962-3511
CITY:W. COVINASTATE: CAZIP CODE:
91790
CAPACITY:136CENSUS: 111DATE:
01/15/2026
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Claudia Cordoba - Wellness DirectorTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff removed notice of licensing visit (LIC9213) from wall.
Staff threatened to evict residents in retaliation for filing complaints.
Staff do not ensure the facility is at a comfortable temperature for residents.
Staff did not transport resident to medical appointment .
Staff do not ensure facility is free of insects .
Staff do not keep the facility free of odor.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Nune Margaryan conducted a complaint visit to investigate the allegations listed above. LPA met with Claudia Cordoba. Administrator arrived shortly after and assisted with the visit. Reason for the visit was explained.

The investigation consisted of the following: LPA Margaryan toured the facility, conducted interviews with Administrator, Staff 1 to Staff 4 (S1 to S4) and Resident 1 to Resident 10 (R1 to R10). Staff and residents roster were requested. LPA also obtained copies of invoices from "Orkin" pets control company.

Continue 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Nune Margaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026
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 4
Control Number 28-AS-20260109082302
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: COUNTRY VIEW ASSISTED LIVING
FACILITY NUMBER: 198603183
VISIT DATE: 01/15/2026
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Regarding the allegation: Staff removed notice of licensing visit (LIC9213) from wall. It was alleged that the staff tore down and crumpled up the papers that was instructed them to hang up in the activity room.

Interviewed Administrator and staff denied the allegation. They stated that they are not familiar with the above-mentioned form and all required licensing notices are properly posted in prominent areas. LPA reviewed LIC9213 form and determined that this form is specific to Child Care program. As such, the facility is not required to have this form posted in a public / common area of the facility, including the activity room.

Regarding the allegation: Staff threatened to evict residents in retaliation for filing complaints. It was alleged that facility staff threatened to evict resident for filing complaints.

Interviewed Administrator and staff denied the allegation. They stated that they have never threatened any resident with eviction for reporting an incident or filing a complaint. They did not hear or witness that any staff retaliated or threatened to evict any resident for complaints. All residents interviewed could not corroborate this allegation. They stated they are not retaliated by staff for making complaints and staff never threatened them with eviction.

Regarding the allegation: Staff do not ensure the facility is at a comfortable temperature for residents. It was alleged that facility is extremely cold.

Interviewed Administrator and staff denied the allegation. They stated that the temperature in the facility is comfortable setting and didn't hear complaints about facility is cold. LPA observed that the facility temperature was comfortable at the time of the visit (Thermostat in the hallway shows 78-degree F). Interviewed Administrator and staff stated that facility has a centralized AC unit, and the front office manages the temperature and can adjust temperature at any time using company tablets or phones. Administrator stated that when residents report a concern about the temperature, they can adjust quickly and easily. Also, facility provide individual heaters or fans to any residents who request them, ensuring their personal comfort. Residents interviewed were not able to corroborate the allegation. At the time of visit LPA toured the facility and checked the temperature in common areas, activity areas and 6 resident rooms (Rooms #4, 44, 45,48, 53, 63). LPA observed the temperature on the thermostats between 73-degree F - 78-degree F which is within Title 22 regulations. Residents interviewed stated that the facility maintains a comfortable temperature for residents and they don't have any complaints about this matter. Continue 9099C

SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Nune Margaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 28-AS-20260109082302
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: COUNTRY VIEW ASSISTED LIVING
FACILITY NUMBER: 198603183
VISIT DATE: 01/15/2026
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Regarding the allegation: Staff did not transport resident to medical appointment. It was alleged that Staff failed to take resident to a medical appointment, causing resident to miss it.

Interviewed Administrator and staff denied the allegation. Interviewed Administrator and staff stated medical appointments are scheduled and handled in an efficient manner and the facility has consistently made every effort to ensure residents attend all scheduled medical appointments. Interviewed staff stated that staff utilize multiple transportation options based on availability and resident’s needs, including Access, Dial-A -Ride, Medical transportation services, and Uber when necessary. Facility staff ensures that all residents attend their appointments. Also staff ensures that residents that are less independent have a companion to their appointment for their safety and support. Residents interviewed could not corroborate this allegation. Nine (9) out of ten (10) residents stated that facility staff assist them with their medical appointments and transportation arrangements and they didn't miss their appointments. They stated that staff will accompany them if needed. One (1) resident out of ten (10) stated that they make their own appointments and staff are not aware of them.

Regarding the allegation: Staff do not ensure facility is free of insects .It was alleged that the facility has roaches.

Interviewed Administrator and staff denied the allegation. They stated that the facility has a contract with a pest control company, and the facility is serviced every month. Administrator stated that they use "Orkin" pest control services, and the company perform routine treatments throughout the facility twice a month and are available for additional visits as needed (Copies of Invoices were provided to LPA). Residents interviewed were unable to corroborate the allegation. Interviewed residents stated that they have not seen any roaches in their rooms and at the facility. LPA did not observe roaches during facility tour. LPA toured the common areas and found no evidence of roaches. LPA inspected randomly chosen rooms and did not observe any roaches in the residents’ rooms.

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SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Nune Margaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 28-AS-20260109082302
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: COUNTRY VIEW ASSISTED LIVING
FACILITY NUMBER: 198603183
VISIT DATE: 01/15/2026
NARRATIVE
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Regarding the allegation: Staff do not keep the facility free of odor. It was alleged that facility smells strongly of urine.

Interviewed Administrator and staff denied the allegation. They stated there is nor has there been any strong urine odor in the facility. Interviewed Administrator and staff stated the facility maintains a regular housekeeping and maintenance schedule to ensure cleanliness throughout the facility / building. If resident has an accident, staff respond promptly by assisting the resident with hygiene needs, thoroughly cleaning the affected area. Facility staff make sure facility maintains a fresh and clean environment for the residents. LPA toured the facility and entered some residents’ rooms but did not notice any smell of urine. Residents interviewed were unable to corroborate the allegation. Interviewed residents denied the allegation and stated that the facility does not strongly smell urine.

Based on interviews, observation, and document review conducted, there was insufficient evidence to prove the allegation(s). Although the allegation(s) may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation(s) occurred, therefore the allegations are Unsubstantiated.

Exit interview was conducted with Administrator and a copy of this report was provided.

SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Nune Margaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 4