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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603401
Report Date: 11/10/2025
Date Signed: 11/10/2025 01:44:29 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
11/07/2025 and conducted by Evaluator Bennette Pena
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251107115351
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: 65DATE:
11/10/2025
UNANNOUNCEDTIME BEGAN:
09:29 AM
MET WITH:Virgilio Agas - AdministratorTIME COMPLETED:
01:45 PM
ALLEGATION(S):
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Staff are not allowing residents to have visitors.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced complaint visit regarding the above stated allegation.LPA met with Administrator, Virgilio Agas and explained the reason for the visit.

The investigation consisted of the following: LPA obtained copies of Resident & Staff Rosters. LPA toured the facility including the common areas. LPA reviewed and obtained copies of the following documents: Visitation policy, House rules, Sign in/out sheet (November 2025), files of Resident #1 (R1) Identification and Emergency Information/Face sheet, Pre-appraisal information, Appraisal Needs and Services Plan, and Physician's Report, Staff #1 (S1) files such as Criminal Background/Exemption (August 13, 2024), Court proceedings (June 27, 2024), Unusual Incident/Injury Report (SIR dated 11/03/2025), and text message screenshot (Nov. 2025). Between 10:00am - 12:15pm, LPA interviewed Staff #2 (S2) - Staff #6 (S6) and Resident #1 (R1) - Resident #7 (R7). LPA also interviewed former staff/Staff #1 (S1) telephonically. *****CONTINUED ON LIC9099-C*****

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Bennette Pena
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2025
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-20251107115351
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: 11/10/2025
NARRATIVE
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The investigation revealed the following:

Allegation: "Staff are not allowing residents to have visitors." It is alleged that former staff was kicked out and was told that they are not allowed in the facility because of the results of a criminal background check. (5) out of (6) staff interviewed were aware that the facility's visitor policy restricts terminated staff who failed the criminal background check to be in the premises, in order to protect the safety of the residents. S2 stated that because of a conviction, S1 was disqualified from obtaining a background clearance, even though they had asked for an exemption. S2 indicated that the reason for the restriction is because they have a duty to protect the health and safety of residents. According to S2, the facility manager informed S1 during the exit interview that they are prohibited from reentering the facility and visiting residents as well. (7) out of (7) interviewed residents denied the allegation. All (7) residents stated that they have not been told they cannot have visitors and aware of their right to have visitors. Some residents stated that if a family member comes to see them outside of visiting hours, the staff will still let them in as long as they ask for permission in advance. Documents reviewed revealed that S1 failed a criminal background check because of a criminal offense (06/05/2018) which pose a potential risk to the health and safety of the residents. Documentation reviewed and interviews conducted do not corroborate this allegation.

Based on statements and interviews conducted with residents and staff as well as reviewed files and documentation, there was not enough supportive evidence to corroborate the allegation.

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.

Exit interview conducted and a copy of this report was provided to Virgilio Agas, Administrator.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Bennette Pena
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2025
LIC9099 (FAS) - (06/04)
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