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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603401
Report Date: 07/08/2024
Date Signed: 07/08/2024 03:48:39 PM

Unsubstantiated


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
07/03/2024 and conducted by Evaluator Alberto Lopez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240703091731
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: 88DATE:
07/08/2024
UNANNOUNCEDTIME BEGAN:
10:29 AM
MET WITH:Virgilio AgasTIME COMPLETED:
03:58 PM
ALLEGATION(S):
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Staff yelled at resident in care.
Staff are not accommodating resident with roommate choice.
Staff did not safeguard resident's personal belongings.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Lopez conducted an unannounced complaint investigation for the allegations listed above. LPA met Administrator, Gil Agas and explained the purpose of today's complaint investigation visit.

The investigation consisted of the following: LPA obtained staff roster, resident roster, resident#1’s (R1) admission agreement, interviewed residents from resident#1 (R1) to resident#9 (R9), interviewed staff from staff#1 (S1) to staff #4 (S4), and conducted a facility tour.

The investigation revealed the following:
Regarding Allegation: Staff yelled at resident in care. It is alleged that facility administrator yelled at resident. LPA interviewed nine (9) residents and eight (8) of nine (9) residents could not collaborate the allegation. LPA interview four (4) staff and four (4) of (4) staff denied the allegation including administrator.
(Continue on 9099C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Lisa HicksTELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Alberto LopezTELEPHONE: 323-980-4926
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2024
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 2
Control Number 28-AS-20240703091731
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: 07/08/2024
NARRATIVE
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Most residents stated that staff is very respectful and has never yelled at them or seen any staff yell at residents. During the tour of the facility and during entire visit, LPA did not observe any staff yelling or being disrespectful to any residents. There is no evidence to substantiate this allegation.

Regarding Allegation: Staff are not accommodating resident with roommate choice. It is alleged that resident has requested to have his roommate moved due to roommate’s uncleanliness. LPA interviewed four (4) staff and four (4) of four staff denied the allegation. All four staff stated that resident has not made any recent complaints or request regarding his roommate or the have roommate moved. Several staff stated that resident may want to have private room and that is the motive for the complaints. Administrator stated that resident was moved once so far and if they want to be moved and there is availability, the residents just need to make request. LPA interviewed nine (9) residents and nine (9) of (9) residents could not collaborate the allegation. R2 who is roommate of R1 stated R2 wants R1 to move because R1 is mean to R2 but has never asked facility to move R1. R1 stated R1 has not asked to be moved or to have R2 moved and that allegation is not accurate. Also, R1 stated that staff has asked R1 to use another toilet if the one in room 106 is uncleaned. All four (4) staff denied the allegation. For emergency, residents can use the toilet in the hallway. LPA observed room and toilet to be clean at several different times of the day during today's visit. Based on interviews of residents and staff. There is no evidence to substantiate this allegation.

Regarding Allegation: Staff did not safeguard resident's personal belongings. It is alleged that someone stole six (6) dollars of eleven (11) dollars that residents had in his room. LPA interviewed four staff (4) and all four staff denied the allegation. LPA interviewed nine (9) residents and eight (8) of nine (9) residents could not collaborate the allegations. Most of the residents stated that they feel their property is very safe at facility. There is no evidence to substantiate this allegation.

Based on the information obtained during the investigation, interviews with staff, residents, and LPA's observation, the investigation did not reveal any evidence to support the allegations mentioned above. Although the allegations may have happened or are valid, there is not preponderance of evidence to prove the alleged violations did or did not occur, therefore, the allegations are UNSUBSTANTIATED.

SUPERVISOR'S NAME: Lisa HicksTELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Alberto LopezTELEPHONE: 323-980-4926
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2024
LIC9099 (FAS) - (06/04)
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