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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603225
Report Date: 03/27/2025
Date Signed: 03/27/2025 11:23:46 AM

Unfounded


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
03/21/2025 and conducted by Evaluator Bennette Pena
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250321153543
FACILITY NAME:CRISTO REY COTTAGE ASSISTED LIVINGFACILITY NUMBER:
198603225
ADMINISTRATOR:KLEIN, KATHRYNFACILITY TYPE:
740
ADDRESS:1216 ROYAL OAKS DRIVETELEPHONE:
(626) 408-7802
CITY:MONROVIASTATE: CAZIP CODE:
91016
CAPACITY:28CENSUS: 18DATE:
03/27/2025
UNANNOUNCEDTIME BEGAN:
09:44 AM
MET WITH:Sister Cecilia Marie, OCD - Care Assistant
Sister Magdalene Grace, OCD - BSN Care Coordinator		TIME COMPLETED:
11:15 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff is refusing to accept resident back after hospital stay.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced complaint visit to investigate the above-mentioned allegation. LPA met with Sister Cecilia Marie, OCD, Care Assistant and explained the purpose of the visit. Shortly after, Sister Magdalene Grace, OCD, BSN Care Coordinator arrived and assisted LPA with the investigation.
The investigation consisted of the following: LPA toured the facility's common areas and obtained/reviewed a copy of the current Staff/Resident rosters and interviewed Staff #1 (S1).
In regards to the allegation: "Staff is refusing to accept resident back after hospital stay." LPA reviewed the Resident roster (dated 03/25/2025) and found Resident #1 (R1) who was allegedly referred to in the complaint is not included in the list of residents on the facility's roster. LPA interviewed Staff #1 (S1) who confirmed that R1 does not live at this facility and stated that R1 resides at the sister facility that is adjacent to this licensed facility. Therefore, the complaint was filed against the incorrect facility.
This agency has investigated the complaint alleging " Staff is refusing to accept resident back after hospital stay." Based on the information gathered during this visit, and the staff interviews, the allegation is deemed UNFOUNDED.
A finding of UNFOUNDED means that the allegation is either false, could not have happened, and/or is without a reasonable basis. We have therefore dismissed the complaint.
No deficiency cited. An exit interview was conducted, and a copy of this report was provided to Sister Magdalene Grace, OCD, BSN Care Coordinator.
Unfounded
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Bennette Pena
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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