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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603286
Report Date: 01/15/2026
Date Signed: 01/15/2026 12:52:51 PM

Unsubstantiated


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
01/12/2026 and conducted by Evaluator Daniel Konishi
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260112082142
FACILITY NAME:PASADENA VILLA SENIOR LIVINGFACILITY NUMBER:
198603286
ADMINISTRATOR:MURPHY, MICHAELFACILITY TYPE:
740
ADDRESS:1811 N. RAYMOND AVETELEPHONE:
(626) 791-6232
CITY:PASADENASTATE: CAZIP CODE:
91103
CAPACITY:97CENSUS: 67DATE:
01/15/2026
UNANNOUNCEDTIME BEGAN:
09:29 AM
MET WITH:Bryanna Luke, AdministratorTIME COMPLETED:
01:05 PM
ALLEGATION(S):
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Staff do not ensure the facility is in good repair.
Staff do not provide towels to dry hands in the bathroom.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA) Daniel Konishi conducted an unannounced initial 10-Day complaint visit to investigate the above allegations. LPA met with Bryanna Luke, Administrator and explained the purpose of the visit.
The investigation consisted of the following: LPA obtained and reviewed the staff & resident rosters. LPA also obtained Resident #8 (R8’s) copy of the Admission Agreement. LPA interviewed the Administrator, Maintenance Director, Staff #1 (S1) - Staff #6 (S6), and Resident #1 (R1) - Resident #7 (R7).

The investigation revealed the following: In regards to the allegations "Staff do not ensure the facility is in good repair." It is alleged that the facility has ceiling tiles that have fallen and when it rains the staff are putting buckets in the hallway to catch the water and the ceiling tiles have not been fixed. LPA interviewed the Administrator, Maintenance Director and six (6) out of six (6) staff that denied the allegation stating that there are no leaks and any leaks are fixed right away.

[Continued in LIC9909-C]
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Daniel Konishi
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 2
Control Number 28-AS-20260112082142
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: PASADENA VILLA SENIOR LIVING
FACILITY NUMBER: 198603286
VISIT DATE: 01/15/2026
NARRATIVE
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Administrator stated that the leaks were reported to the Maintenance Director on 01/05/2026 and was repaired on 01/05/2026 but buckets and yellow warning signs were placed as a safety measure until the rain stopped. LPA interviewed five (5) out of seven (7) residents that denied the allegation who all stated they didn't observe any leaks. LPA interviewed two (2) out of seven (7) residents could not confirm nor deny the allegation stating that there were leaks from the ceiling hallways but stated that there were buckets and yellow warning signs until the leaks stopped. LPA observed minimally damaged ceiling tiles and no leaks during the tour of the facility. There is not enough supportive evidence to concur with the reported allegation.
Allegation: “Staff do not provide towels to dry hands in the bathroom.” It is alleged that the bathrooms for the residents have empty paper towel dispensers and the residents must take their own towels with them to the bathroom to dry their hands. LPA toured common bathrooms and seven (7) residents’ bathrooms. LPA observed sufficient paper towels in towel dispensers in the common bathrooms. However, LPA observed cloth hand towels hanging but no paper towels in the towel dispensers in four (4) out of seven (7) residents’ bathrooms. LPA observed no towel dispensers but cloth hand towels hanging in three (3) out of seven (7) residents’ bathrooms. LPA interviewed the Administrator and five (5) out of seven (7) staff that denied the allegation stating that the facility provides cloth towels since paper towels have been thrown in the toilets frequently causing the drains to be clogged. Per Administrator, the facility does keep a sufficient supply of paper hand towels which the facility provides when it’s requested by residents. Two (2) out of seven (7) staff could not confirm nor deny the allegation since they are not involved in this matter. LPA also observed sufficient cloth paper towel and paper towel supply in the facility storage room. LPA interviewed one (1) out of seven (7) residents that corroborated with the allegation stating on not being provided a paper or cloth towel and the resident reported to a staff that resident was unable to identify. LPA interviewed one (1) out of seven (7) residents that corroborated with the allegation stating that they are not provided paper or cloth hand towels but they did not report this to staff. LPA interviewed five (5) out of seven (7) residents that denied the allegation stating the staff provides cloth or paper hand towels and would get the clean cloth towels frequently. There is not enough supportive evidence to concur with the reported allegation.

Based on statements and interviews conducted with staff, residents, review of residents’ files and facility file records, there was not enough supportive evidence to concur with the reported allegations. Although the allegations 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 allegations are UNSUBSTANTIATED. An exit interview was held, and a copy of this report was provided to Administrator, Bryanna Luke.
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Daniel Konishi
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)
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