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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603401
Report Date: 12/23/2025
Date Signed: 01/15/2026 04:54:39 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
11/26/2025 and conducted by Evaluator Sanjay Vaid
COMPLAINT CONTROL NUMBER: 28-AS-20251126172726
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 did not safeguard resident’s personal belongings
Staff threatened residents with retaliation if they file complaints
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Vaid conducted a collateral visit to the facility, met with Administrator Acharya Nirjara and discussed the reason for the visit.

On 12/01/25, LPA Vaid conducted initial 10-day complaint visit and gathered the following documents- staff and resident rosters, Resident #1-#5: face sheet, physicians report, resident pre-placement, residents personal property and valuables log, Individual service plan. LPA toured the facility and did not observe any health and safety concerns.

Regarding the allegation: Staff did not safeguard resident’s personal belongings. It is alleged that the staff are not safeguarding residents’ belongings from going missing. Three (3) of three (3) interviewed denied this. Staff interviewed stated the residents are responsible for keeping their doors locked. Staff stated they observe the hallway surveillance to determine the validity of the accusation.
(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-20251126172726
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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Administrator will question people seen in surveillance videos. Residents are encouraged to keep their personal items secured by listing contents in the personal property and valuables log. To help locate items with description. Five (5) of five (5) residents interviewed could not corroborate this. According to records reviewed R1 waived to provide a list for their valuables, therefore locating unlisted items proves difficult. Based on interviews conducted, records reviewed. 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 threatened residents with retaliation if they file complaints. It is alleged that the staff are sending residents to the hospital on a psychiatric hold (51/50) when residents argue with the staff and file complaints against the facility. Three (3) of three (3) staff interviewed denied this allegation. Psychiatric holds are determined by the physician and law enforcement present when residents are a danger to themselves and others. Police are notified and transport is done by paramedics. Staff stated residents are not being sent to psychiatric evaluations because of a complaint filed. Five (5) of five (5) residents interviewed could not corroborate this. Based on interviews conducted, records reviewed. 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.


FInding delivered to Licensee Shin Khan.
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)
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