198603374-4-11-2023-28-AS-RORN-CRRLXV-20230512090921

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603374
Report Date: 04/11/2023
Date Signed: 04/11/2023 05:26:39 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
04/03/2023 and conducted by Evaluator Bonnie Tao

COMPLAINT CONTROL NUMBER: 28-AS-20230403124823

FACILITY NAME:	ARCADIA LIVING LLC		FACILITY NUMBER:	198603374
ADMINISTRATOR:	JINGFANG JENNIFER ZHANG		FACILITY TYPE:	740
ADDRESS:	601 SUNSET BOULEVARD		TELEPHONE:	(626) 447-0106
CITY:	ARCADIA	STATE: CA	ZIP CODE:	91007
CAPACITY:	130	CENSUS: 59	DATE:	04/11/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Jennifer Zhang, administrator		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Facility is in disrepair.
Residents’ televisions are not working.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tao conducted an unannounced initial complaint visit to the facility
regarding the above-mentioned allegations. Upon arrival at the facility, LPA met Jennifer Zhang, Administrator and explained the purpose of today’s visit.

The investigation consisted of interviews of staff from Staff #1 (S1) through Staff #3 (S3); interviews of
residents from resident#1 (R1) through resident #4 (R4); reviews of residents record; and tour of the facility. LPA obtained copies of the staff and resident rosters, and residents' records with relevant information.

The investigation revealed the following:

Regarding the allegation “facility is in disrepair," it was alleged that facility dining room’s ceiling and resident room#304's ceiling are leaking.
(- continued in LIC 9099 C-)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Bonnie Tao	TELEPHONE: (323) 981-3971
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023

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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Control Number 28-AS-20230403124823

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: ARCADIA LIVING LLC	FACILITY NUMBER: 198603374
	VISIT DATE: 04/11/2023

NARRATIVE

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All four (4) residents interviewed and all three (3) staff interviewed stated the facility dining room ceiling had leaked after the heavy rain from rainstorm hit southern CA in the past few months. LPA toured the facility with administrator. As observed, the dining room ceiling was no longer leaking but a few pieces of ceiling covers near the kitchen entrance were removed. Administrator stated ceiling's leaking was due to the non-stop heavy rain and rainstorm in the past few months. Administrator explained that they were aware of it and had hired general construction contractor to repair the ceiling since October 2022. Contractor came monthly to check the ceiling. However, the progress was delayed due to the heavy rainstorm that came on and off. Per record review, the repairing documents showed the dining room ceiling was under repairing since Oct 27,2022. The expected completion date would be on July 1, 2023. Incident reports were filed to Licensing regarding the water leak at the dining room's ceiling and its repairing plan. Therefore, facility had been working on repairing the dining room ceiling on the leaking issue.

LPA toured resident room# 304 with administrator. Room #304 was vacant. The door had a sign posted saying "Re-Model". The room was under remodel which a few pieces of ceiling covers were removed and a section of floor carpet was removed. LPA did not observe any water stains or trace of water leak on the ceiling. Administrator stated the remodelling would be done in about two months. Therefore, the facility is not in disrepair.

Regarding the allegation “residents’ televisions are not working,” it was alleged that residents’ televisions are not working. Four (4) out of four (4) residents interviewed stated their TVs were working. All staff interviewed stated they were not aware of residents’ TV being not working. LPA toured residents’ rooms with administrator and observed residents’ TV were working. Administrator stated some residents need to pay certain cable services out of their own pocket. If they don't pay, that cable services is not provided even their TVs are working. Facility provided free WiFi to all residents. Therefore, residents’ TVs are working.

Although the allegation may have happened or is valid, there is not preponderance of evidence to prove the alleged violation did or did not occur, therefore, the allegation is UNSUBSTANTIATED.

No deficiencies are being cited according to California Code of Regulations, Title 22, Division 6, Chapter 8. An exit interview was conducted with Administrator. A hard copy of this report was provided.

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Bonnie Tao	TELEPHONE: (323) 981-3971
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023

LIC9099 (FAS) - (06/04)

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