198603401-6-7-2024-28-AS-LHIS-D67PE4-20240613111429

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603401
Report Date: 06/07/2024
Date Signed: 06/07/2024 04:47:57 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
06/05/2024 and conducted by Evaluator Noemi Galarza

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20240605114404

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: 86	DATE:	06/07/2024
		UNANNOUNCED	TIME BEGAN:	09:12 AM
MET WITH:	Virgilio Agas, Administrator		TIME COMPLETED:	04:50 PM

ALLEGATION(S):

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Facility laundry machine is in disrepair.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Galarza conducted an initial 10-day complaint investigation visit regarding the above allegation. LPA discussed the purpose of the visit with Administrator Virgilio Agas and Facility Manager Justin Lee.

The investigation consisted of: A physical plant tour of exterior and interior common areas, laundry rooms, and special focus on resident rooms [107, 202, 220, 221, 222, 223 312, 313, 317, 320, 321] HVAC system. Staff (S1- S6), residents (R1- R8), and Arcadia Fire Department Inspector. Copies of laundry dry repair estimate/invoice dated 6/5/2024, LIC 500 Pesonnel Report, and resident roster were obtained.

***See narrative summary on next page.***

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Noemi Galarza	TELEPHONE: (323) 981-3974
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024

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 6

Control Number 28-AS-20240605114404

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: ARCADIA RETIREMENT VILLAGE	FACILITY NUMBER: 198603401
	VISIT DATE: 06/07/2024

NARRATIVE

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Allegation: Facility laundry machine is in disrepair. It is alleged that the commercial dryer is not working and as result housekeeping staff are currently using the resident coin operated dryer machine to dry towels, bedding, and resident clothing. LPA inspected the staff laundry room and the resident laundry room. Based on observation, the commercial dryer is not operable. The resident laundry room has 2 coin washers and 2 coin dryers, only 1 washer and dryer are in working condition. Since housekeeping staff are utilizing the resident's coin dryer most of the day, resident's are unable to launder/dry their clothes. A total of 6 staff were interviewed, of which all confirmed the allegation. Administration staff stated that the laundry machine stopped working on Monday, June 3, 2024, and they immediately contacted a technician. The estimate/ invoice was approved by the Facility Manager on June 5, 2024, and technicians have placed an order; at this time the dryer parts are pending arrival. A total of 8 residents were interviewed, the majority stated staff wash their clothes, but had knowledge of the laundry machine disrepair. Title 22 requires that facilities make at least one machine available for use by residents who are able and who desire to do their own personal laundry. Therefore, there is sufficient evidence to corroborate the allegation.

Based on observation and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. A deficiency is being cited. See LIC 9099D.
Exit interview was conducted with Administrator Virgilio Agas. A copy of the report and appeal rights was provided.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Noemi Galarza	TELEPHONE: (323) 981-3974
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 6

Control Number 28-AS-20240605114404

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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: 06/07/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 06/28/2024 Section Cited CCR 87303(g)(2)	1 2 3 4 5 6 7	Maintenance and Operation. Facilities which have machines and do their own laundry shall: Make at least one machine available for use by residents who are able and who desire to do their own personal laundry. This machine shall be maintained in good repair. Equipment in good repair shall be provided to residents who are capable and desire to iron their own clothes.	1 2 3 4 5 6 7	Administrator provided proof that the repair work order and dryer parts have been ordered. Submit: 1. A written plan of correction that states how the facility will address the deficiency 2. A copy of the technician’s completed work order.
	8 9 10 11 12 13 14	Based on observation and interviews, the residents coin operated dryer is presently being used by staff all day because the commercial dryer stopped working on 6/3/24, and has not been repaired, which poses a potential health and safety risks to persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Noemi Galarza	TELEPHONE: (323) 981-3974
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
06/05/2024 and conducted by Evaluator Noemi Galarza

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20240605114404

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: 86	DATE:	06/07/2024
		UNANNOUNCED	TIME BEGAN:	09:12 AM
MET WITH:	Virgilio Agas, Administrator		TIME COMPLETED:	04:50 PM

ALLEGATION(S):

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Staff are not providing a comfortable temperature for residents.
Staff did not ensure the facility ventilation system is not in disrepair.
Staff are not ensuring the facility yard is maintained.
Staff are not providing adequate water to residents.
Staff are inappropriately video monitoring residents.

INVESTIGATION FINDINGS:

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Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Noemi Galarza	TELEPHONE: (323) 981-3974
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 4 of 6

Control Number 28-AS-20240605114404

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: ARCADIA RETIREMENT VILLAGE	FACILITY NUMBER: 198603401
	VISIT DATE: 06/07/2024

NARRATIVE

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Allegation: Staff are not providing a comfortable temperature for residents. It is alleged that depending on the weather outside the hallways and lobby areas are too hot or too cold. Based on physical plant inspection of all the common areas, lobby, floors 1-3, and a total of 11 resident rooms inspected it was observed the facility temperature was comfortable for residents. A total of 8 residents were interviewed, of which only 1 resident stated that sometimes it feels too hot or too cold because the HVAC system does not work. However, the resident stated that their room's temperature is fine. All staff denied the allegation. Staff stated that licensee purchased last Summer space heater and portable air conditioning units in order to maintain a comfortable temperature in the facility. The average temperature in the facility during the visit was 75 Degrees Fahrenheit. There is insufficient evidence to corroborate the allegation.

Allegation: Staff did not ensure the facility ventilation system is not in disrepair. According to information obtained, the facility HVAC system has been in disrepair for months, and it has not been repair or replaced. It is alleged that the Licensee placed space heaters in resident rooms during Winter time, and placed portable air conditioning window units in rooms whose HVAC system is in disrepair. LPA toured the physical plant and observed both space heaters and portable air conditioning units in 11 resident rooms. Currently, the office room, and approximately 19 resident rooms are using space heaters and portable a/c units as a provision to meet the needs of the residents. All residents and staff interviewed confirmed the HVAC system is in disrepair in some areas and resident rooms. According to Facility Manager and Administrator, the licensee does not want to repair or replace the inoperable HVAC system, and instead are offering portable air conditioners and heaters for all rooms that do not have working central heating and air. Per local fire department, as long as building heating is no less than 68 DF, it meets fire code. However, the facility must have adequate ventilation and energy efficiency.

Allegation: Staff are not ensuring the facility yard is maintained. According to information obtained staff are not watering the patio grass area because Licensee does not want a high cost water bill. Based on interviews conducted, the findings indicate that housekeeping staff only water the grass approximately once a week, and a gardener maintains the grass and yard on a weekly basis. Staff denied the allegation. The majority of the residents interviewed stated that the grass and yard appear minimally maintained, but that the grass has been observed to be relatively green. LPA observed the yard to be clean and the patches of grass appeared green with some small areas of discoloration. Based on observation, the allegation cannot be supported.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Noemi Galarza	TELEPHONE: (323) 981-3974
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024

LIC9099 (FAS) - (06/04)

Page: 5 of 6

Control Number 28-AS-20240605114404

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: ARCADIA RETIREMENT VILLAGE	FACILITY NUMBER: 198603401
	VISIT DATE: 06/07/2024

NARRATIVE

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Allegation: Staff are not providing adequate water to residents. It is alleged that the quality of tap water has an odd smell and taste to it. LPA inspected and tasted the two filtered water stations in the building, one is located in the kitchen and the other is located in the 1st floor hallway. LPA did not find the drinking water supply to be inadequate with a bad taste or smell. Staff stated they have not received resident complaints about the drinking water, and some staff said they drink the water as well. None of the resident's interviewed corroborated the allegation, but many stated they prefer to drink bottle water and buy their own for personal use. There is insufficient evidence to corroborate the allegation.

Allegation: Staff are inappropriately video monitoring residents. It is alleged that there are visible close circuit cameras in the exterior physical plant and that there may be pin hole cameras inside the facility and/or in resident rooms. LPA walked through the exterior and interior physical plant, and inspected 11 resident rooms. No camera surveillance was observed inside the facility or in resident rooms. Cameras were observed in the exterior of the building. However, per staff interviews approximately 2 years ago the Assisted Living Waiver asked the facility to remove all interior video surveillance cameras, and the licensee obliged. Administration staff stated that the outdoor cameras are still mounted but not in working condition. None of the resident or staff interviewed confirmed the allegation. Based on observation, no inappropriate video monitoring of residents was observed during the visit.

Although the allegations 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 with Administrator Virgilio Agas. A copy of the report was issued.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Noemi Galarza	TELEPHONE: (323) 981-3974
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024

LIC9099 (FAS) - (06/04)

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