198603401-9-16-2025-28-AS-FFIS-DLP2GR-20250919172332

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603401
Report Date: 09/16/2025
Date Signed: 09/16/2025 04:38:12 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
07/11/2025 and conducted by Evaluator Sanjay Vaid

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20250711125928

FACILITY NAME:	ARCADIA RETIREMENT VILLAGE		FACILITY NUMBER:	198603401
ADMINISTRATOR:	VIRGILIO AGAS		FACILITY TYPE:	740
ADDRESS:	607 WEST DUARTE RD		TELEPHONE:	(626) 447-6070
CITY:	ARCADIA	STATE: CA	ZIP CODE:	91007
CAPACITY:	200	CENSUS: 99	DATE:	09/16/2025
		UNANNOUNCED	TIME BEGAN:	04:13 PM
MET WITH:	Administrator Virgilio 'Gil' Agas		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Lack of staff supervision resulting in resident being physically abused by another resident.
Lack of staff supervision resulting in resident being mentally/verbally abused by another resident.
Staff did not provide a safe environment for resident

INVESTIGATION FINDINGS:

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***This licensing report supersedes the licensing report issued on 7/17/2025. The licensing report is being redelivered in order to clarify information obtained during the investigation. The findings remain the same***

On today’s visit, Licensing Program Analyst (LPA) Vaid conducted a follow-up unannounced complaint visit and met with Administrator Gil Agas, the purpose of the visit was discussed.
On 07/17/25, LPA Vaid conducted 10-day unannounced complaint visit and met with Administrator Gil Agas Administrator. The investigation consisted of the following: LPA Vaid requested, obtained and reviewed the staff/ resident’s roster, face-sheet, physicians report, medications list, admissions agreement, IPPs and pre-appraisals for two (2) residents. List of shared and single rooms. LPA toured the facility and interviewed staff/residents and did not observe any health and safety concerns.

CONTINUED ON PAGE 9099C.........................

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Sanjay Vaid
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2025

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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Control Number 28-AS-20250711125928

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: ARCADIA RETIREMENT VILLAGE	FACILITY NUMBER: 198603401
	VISIT DATE: 09/16/2025

NARRATIVE

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Regarding the allegation: Lack of staff supervision resulting in resident being physically abused by another resident. It is alleged that due to lack of staff supervision, a resident is being physically abused by another resident. Per the allegation, one resident has been throwing stuff at another resident and staff are not doing anything to stop the residents behavior’s. Five (5) out of five (5) staff interviewed deny this allegation. According to staff, when residents argue and are not getting along with one another, staff separate residents and speak to residents to resolve the issue. Staff have not observed residents get physically abusive towards other residents. Six (6) out of seven (7) residents interviewed could not corroborate this allegation. According to residents, when the residents argue with one another, staff intervene and settle the residents’ problems. Residents interviewed claim that they have never seen residents get physically abusive to other residents. The investigation did not reveal any indication of physical abuse occurring between residents. Based upon record review and interviews conducted the findings indicate that, although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Regarding the allegation: Lack of staff supervision resulting in resident being mentally/verbally abused by another resident. It is alleged that residents are verbally abusing one another and staff are preventing residents from abusing one another. Interviews with five (5) out of five (5) staff interviewed deny this allegation. According to staff, there was one incident that occurred, where a resident was verbally abusive towards staff. Staff reported that the resident was verbally abusive toward staff because resident wanted a medication earlier than prescribed by the resident’s physician. Staff admitted to speaking to residents in a raised voice in order to calm residents, however, staff stated they never yell or speak angrily with residents. A resident reported the incident to staff, the resident claimed to have observed another resident behaving in an irrational manner, by yelling, screaming and throwing lots of items onto the floor. Interviews with six (6) out of seven (7) residents were not able to corroborate this allegation. Four (4) out of seven (7) residents interviewed stated they have heard the resident yelling and screaming at staff, the staff intervene and speak and reason with the resident to calm the resident down and prevent the resident from continuing to scream. The investigation did not reveal any indication that residents are verbally abusing one another and staff are not addressing the residents verbal abuse. Based upon record review and interviews conducted the findings indicate that, although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Continued on 9099C....................

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Sanjay Vaid
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2025

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20250711125928

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: ARCADIA RETIREMENT VILLAGE	FACILITY NUMBER: 198603401
	VISIT DATE: 09/16/2025

NARRATIVE

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Regarding the allegation: Staff did not provide a safe environment for residents. It is alleged that the facility staff are not providing a safe environment for residents in care and a resident believes their life could be in danger. Interviews with five (5) out of five (5) staff did not corroborate the allegation. According to the staff interviews, staff provide the residents with respect, kindness and understanding. Staff stated that all residents are monitored by staff to meet the needs and provide services to the residents in assisted living and/or hospice. Staff stated that staff try their best to keep the residents safe, happy and healthy. Staff stated they attempt to resolve residents’ personal issues with other residents’ and roommates. Interviews with six (6) out of seven (7) residents revealed that staff, caregivers and med-techs provide a safe environment for residents and the residents feel safe and comfortable at the facility. The investigation did not reveal any indication of staff providing an unsafe environment to the residents in care. Based upon record review, interviews conducted, and observations made the findings indicate that, although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

An exit interview was conducted with the Administrator, Gil Agas and copy of the licensing report was given at time of the visit.

Due to printer issues, LPA Vaid will mail report to administrator via USPS.

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Sanjay Vaid
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2025

LIC9099 (FAS) - (06/04)

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