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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603401
Report Date: 11/08/2025
Date Signed: 11/08/2025 12:29:14 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
10/31/2025 and conducted by Evaluator Alberto Lopez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251031144350
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:200CENSUS: 68DATE:
11/08/2025
UNANNOUNCEDTIME BEGAN:
11:22 AM
MET WITH: Gretchen Ilagan, Med-Tech TIME COMPLETED:
12:33 PM
ALLEGATION(S):
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Staff speak to a resident in an inappropriate manner.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alberto Lopez conducted subsequent unannounced complaint visit to deliver findings for the above allegations. LPA met with Gretchen Ilagan, Med- Tech and discussed the purpose of the visit.

On 11/04/2025 LPA interviewed nine (9) (staff S#1 - S#9), eight (8) residents (R#1 - R#8), LPA obtained copies of the following documents: staff roster, resident roster, R2 ‘s physicians report, and appraisal needs and service plan. LPA also inspected five (6) random rooms and took tour of common areas.

The investigation revealed regarding allegation: Staff speak to a resident in an inappropriate manner. It is alleged that staff member spoke to resident inappropriately. LPA interviewed eight (8) residents and six (6) of eight (8) residents could not corroborate the allegation. LPA interviewed nine (9) staff and seven (7) of nine (9) staff denied the allegation.
(Continued on 9099C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2025
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 5
Control Number 28-AS-20251031144350
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: ARCADIA RETIREMENT VILLAGE
FACILITY NUMBER: 198603401
VISIT DATE: 11/08/2025
NARRATIVE
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(continued from 9099)

On 10/30/2025 at 4:27PM S3 went to R2 room to take R2 to dinner. S3 stated S3 knocked on the resident’s door several times and did not hear a response. S3 then used master key to open the door and observed another resident (R8) in the room with R2. S3 stated she discussed the reason S3 was there was to take R2 to dinner. R8 then told S3 that R8 would take R2. S3 then started to leave the room and R8 asked S3 to close the door. S3 responded to S8 and told him “You close the door” S3 stated S3 said that because R8 was next to the door. S3 showed LPA where R8 was standing, and it was not that close to the door. Regardless, S3 went into the residents' room uninvited and should have closed the door when leaving and not told the resident to close the door after being asked by resident to close the door. Another staff member stated staff witness the incident and confirmed that S3 told resident “You close the door” There is sufficient evidence to support this allegation.

Based on staff and resident interviews, the preponderance of evidence has been met therefore the allegation is SUBSTANTIATED.

Exit interview conducted, copy of report 9099D and appeal rights provided.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5
Control Number 28-AS-20251031144350
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: ARCADIA RETIREMENT VILLAGE
FACILITY NUMBER: 198603401
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/18/2025
Section Cited
CCR
87468.1(a)(1)
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87468.1(a)(1) Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement is not met as evidenced by:
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Administrator will train all staff in personal rights and send signed roster of the training with the subject and duration of the training by POC date which is 11/18/2025
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When S3 was asked by resident to close the resident’s door as S3 was leaving the resident’s room S3 responded by saying “you close it” instead of closing door which poses/posed a potential health and safety or personal rights violation to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
10/31/2025 and conducted by Evaluator Alberto Lopez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251031144350

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:200CENSUS: 68DATE:
11/08/2025
UNANNOUNCEDTIME BEGAN:
11:22 AM
MET WITH:Gretchen Ilagan, Med- TechTIME COMPLETED:
12:33 PM
ALLEGATION(S):
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Staff leave resident unattended for extended periods of time.
Staff handle resident in a rough manner.
Staff smacked resident in the face.
Staff are retaliating against a resident in care
Staff do not assist a resident with residents need.
Staff do not safeguard residents’ personal belongings.
Staff do not ensure the residents’ room is clean and sanitary.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alberto Lopez conducted subsequent unannounced complaint visit to deliver findings for the above allegations. LPA met with Gretchen Ilagan, Med- Tech and discussed the purpose of the visit.

Staff handle resident in a rough manner. It is alleged that staff handle resident in rough manner. LPA interviewed nine (9) staff, and all nine (9) staff denied the allegations. LPA interviewed eight (8) residents and seven (7) of eight (8) residents could not corroborate the allegation.
(continued on 9099C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 28-AS-20251031144350
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: ARCADIA RETIREMENT VILLAGE
FACILITY NUMBER: 198603401
VISIT DATE: 11/08/2025
NARRATIVE
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(continued from 9099)
One resident stated that that one staff member is rough but could not provide details. One resident stated that he has seen staff handle R2 in rough manner. R2 denied the allegation. There is insufficient evidence to support this allegation.

Staff smacked resident in the face. It is alleged that a staff member smacked R2 in the face. LPA interviewed nine (9) staff members and all nine (9) denied the allegation. LPA interviewed eight (8) residents and five (7) of eight (8) residents could not corroborate the allegation. R2 demonstrated how R2 was smacked in the face. R2 could not identify the staff member that smacked him. One staff member that stated was with resident when incident allegedly occurred denied that any staff member smacked resident. One resident stated resident believed it happened but did not witness the incident. Staff that allegedly smack resident denied the allegation. There is insufficient evidence to support this allegation.

Staff are retaliating against a resident in care. It is alleged that staff are retaliating against resident by only providing resident 3 meals a day, not picking up resident’s food tray and not checking up on resident. LPA interviewed nine (9) staff, and all nine (9) staff denied the allegation. LPA interviewed eight (8) residents and five (5) of eight (8) resident’s could not corroborate the allegation. R2 stated that his food tray is not picked up for hours sometimes. One resident stated that one staff member does retaliate but did not provide details. Another resident stated that staff walk away and do not help but did not provide details. LPA observed the portable potty to be clean and no bad odors in room. Staff stated they always respond to resident’s call for help but stated resident is impatient and demands immediate assistance. During the entire visit, LPA observed staff attending R2. There is insufficient evidence to support this allegation.

Staff do not assist a resident with residents need. It is alleged that staff are not assisting resident with resident’s needs. LPA interviewed nine (9) staff, and all nine (9) staff denied the allegation. LPA interviewed eight (8) residents, and six (6) of eight (8) residents could not corroborate the allegation. R2 stated that they do not do R2 laundry. LPA observed R2 laundry done and folded on R2 dresser. One resident stated staff do not help without providing details. Administrator stated that he has even offered to assist resident if there is no immediate staff in the area. During the entire visit, LPA observed staff attending R2. There is insufficient evidence to support this allegation.

Staff do not safeguard residents’ personal belongings. It is alleged that staff are taking residents’ personal belongings like razors, wipes and deodorants. LPA interviewed nine (9) staff, and all nine (9) staff denied the allegation. LPA interviewed eight residents and six (6) of eight could not corroborate the allegation. R2 stated he knows it is the staff but could not provide details or evidence. One resident stated they take resident’s deodorant, wipes, food, shaving cream and change but did not provide details or evidence and has not witnessed staff taking the items. Several staff stated that they will go and buy residents supplies if they need them. There are no witnesses or evidence to support this allegation.

Staff do not ensure the residents’ room is clean and sanitary. It is alleged that resident’s room are not clean and sanitary. LPA interviewed nine (9) staff, and all nine (9) staff denied the allegation. LPA interviewed eight (8) residents, and all eight (8) residents could not corroborate the allegation. LPA took tour of facility and random rooms, and all were very clean and sanitized during the visit including R2 room. LPA observed several housekeepers cleaning rooms and facility during the visit.

Based on interviews conducted and observations, the findings indicate that, although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.

Exit interview conducted and copy of report provided

SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5