198603401-7-17-2025-28-AS-FFIS-DLP2GS-20250919172332

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603401
Report Date: 07/17/2025
Date Signed: 07/17/2025 03:43:46 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

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: 199	DATE:	07/17/2025
		UNANNOUNCED	TIME BEGAN:	09:56 AM
MET WITH:	Gil Agas, Administrator		TIME COMPLETED:	03:57 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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Licensing Program Analyst (LPA) Vaid conducted 10-day unannounced complaint visit, was met by Gil Agas Administrator and the purpose of the visit was discussed.

The investigation consisted of the following: LPA Vaid requested, obtained and reviewed the staff/ residents roster, face-sheet, physicians report, medications list, admissions agreement, IPPs and pre-appraisals for two (2) residents’. List of shared and single rooms. Toured the facility interviewed staff/residents. Did not observe any health and safety concerns.

Regarding the allegation: Lack of staff supervision resulting in resident being physically abused by another resident. It is alleged that the due to lack of supervision by the staff resulted in resident being physically abused by another resident. Per allegation, one resident has been ‘throwing stuff’ at the other resident and staff is not doing anything to stop this behavior.
CONTINUED ON PAGE 9099C.........................

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Sanjay Vaid
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025

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: 07/17/2025

NARRATIVE

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. Five (5) out of five (5) staff interviewed deny this allegation. According to the staff, when residents argue and are not getting along the staff will separate the residents and speak to them and determine the issue. Six (6) out of seven (7) residents interviewed could not corroborate this allegation. According to residents when residents argue the staff will intervene and settle the problems. Residents interviewed claim that they have never seen residents get physically abusive to other residents. No 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 due to lack of staff supervision residents are verbally abusing one another and the staff is not stopping the residents. Five (5) out of five (5) staff interviewed deny this allegation. According to the staff there is one incident with a resident that occurred which involved verbal abuse from resident onto staff. Staff stated, the resident started to verbally abuse the staff because resident wanted a narcotic medication earlier than prescribed by the physician. Staff admits at times they raise their tone of voice to calm the resident, never to yell or speak angrily with. The resident was reported by another resident who claimed that the resident was acting crazy, yelling, screaming and throwing lots of stuff to the floor. Roommate resident feared residents’ behavior. 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 will intervene and speak to the resident and reason with them until they calm down and stop screaming. No indication of verbal abuse by the staff. 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: Staff did not provide a safe environment for resident. It is alleged that the facility staff are providing a safe environment for residents in care. Five (5) out of five (5) staff interviewed could not corroborate this allegation. . According to the staff interviewed, they provide the residents with respect, kindness and understanding, the staff stated that all residents are monitored by staff to provide needs and services to the residents in assisted living and hospice.
CONTINUED ON 9099C..................

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Sanjay Vaid
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025

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: 07/17/2025

NARRATIVE

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The staff stated, they try their best to keep the residents happy and healthy. Staff stated they attempt to resolve residents’ personal issues with residents’ neighbors and roommates. Six (6) out of seven (7) residents interviewed claimed that the staff caregivers and med-techs are providing a safe environment for their stay and that the residents’ feel safe and comfortable living at the facility. No 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 interview was conducted with Administrator, Gil Agas and copy of this report was given.

Due to printer issues, LPA will email the report to the facility administrator.

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Sanjay Vaid
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025

LIC9099 (FAS) - (06/04)

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