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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603401
Report Date: 12/23/2025
Date Signed: 12/26/2025 03:01:02 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
11/25/2025 and conducted by Evaluator Sanjay Vaid
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251125155457
FACILITY NAME:ARCADIA RETIREMENT VILLAGEFACILITY NUMBER:
198603401
ADMINISTRATOR:VIRGILIO AGASFACILITY TYPE:
740
ADDRESS:607 WEST DUARTE RDTELEPHONE:
(626) 447-6070
CITY:ARCADIASTATE: CAZIP CODE:
91007
CAPACITY:0CENSUS: DATE:
12/23/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Administrator, Nirjara AcharyaTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Staff are charging a resident for monthly rent which is not due.
Staff mistreat resident.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Vaid conducted a subsequential visit to the facility and spoke to Administrator Nirjara Acharya and discussed the reason for the visit.

On 11/26/25, Licensing Program Analyst (LPA) Vaid conducted a 24- hour initial visit to the facility. LPA met with Gretchen ILagan Med-Tech, and Giselle Provencio, Concierge. Informed Justine Lee-House Manager via cell phone.

LPA obtained copy of ID/ face sheet. LPA Vaid took pictures of the Staff roster, client roster, Resident #1(R1) physician report, resident face sheet, Medicare health insurance card, California State ID benefits card. The copy machine has been removed; therefore, no copies were made, photos were taken.

Continued on 9099C.....................
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Sanjay Vaid
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
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-20251125155457
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: 12/23/2025
NARRATIVE
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Regarding the allegation: Staff are charging a resident for monthly rent which is not due. It is alleged that facility staff are charging a resident for monthly room rent that is not past due. Seven (7) of seven (7) staff interviewed denied this. Staff stated the monthly rent that is not due is not charged to the residents’ accounts. Residents may pay their rent from the first to the fifth of each month. Residents are not required to pay extra months’ facility room rent. According to the facility business office, all rents due in December 2025 have been accounted for, and the residents’ room rental accounts are all up-to date. All residents have a clear account with zero (0) balance as of 12/23/25, billing invoices communicated to residents and responsible parties for January 2026. Six (6) of seven (7) residents interviewed could not corroborate this allegation. Five (5) of seven (7) residents interviewed stated that their room rental is paid on time and facility does not ask for extra payments. Based on interviews and records review. Although the allegation 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 allegation is unsubstantiated.

Regarding the allegation: Staff mistreat resident. It is alleged that the staff mistreat residents by acting strangely towards residents and speaking rudely to residents. Seven (7) of seven (7) staff interviewed deny this, according to staff they treat all the residents with respect and dignity and provide a safe and comfortable environment for the residents in care. Six (6) of seven (7) residents interviewed could not corroborate this allegation. Residents interviewed stated the staff is not mistreating the residents, the staff are providing a comfortable and safe environment. Based on interviews with staff and residents. Although the allegation 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 allegation is unsubstantiated.


Copy of this report was mailed to Licensee Shin Kang for signature.
SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Sanjay Vaid
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2