198603401-5-9-2024-28-AS-RORN-D8YMNY-20240910094616

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603401
Report Date: 05/09/2024
Date Signed: 05/09/2024 04:42:08 PM

Unsubstantiated

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
05/06/2024 and conducted by Evaluator Bonnie Tao

COMPLAINT CONTROL NUMBER: 28-AS-20240506101920

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: 80	DATE:	05/09/2024
		UNANNOUNCED	TIME BEGAN:	08:14 AM
MET WITH:	Virgilio Agas, Administrator		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff are harassing resident in care.
Staff speak to resident in an inappropriate manner.
Staff do not ensure facility is free of bed bugs.
Staff did not provide resident with a 60 day notice of rate increases.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Tao 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: during the investigation visit, LPA obtained staff roster, resident roster, resident#1’s (R1) records, interviewed residents from resident#1 (R1) to resident#8 (R8), interviewed staff from staff#1 (S1) to staff#4 (S4), and conducted a facility tour.

The investigation revealed the following:

In regard of allegation that staff are harassing resident in care, it was alleged that staff harassed resident and said to resident to move out. LPA interviewed residents, seven (7) out of eight (8) residents could not corroborate the allegation. (-continued in LIC9099C-)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Bonnie Tao	TELEPHONE: (323) 981-3971
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024

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 3

Control Number 28-AS-20240506101920

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: 05/09/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

One (1) out of eight (8) residents stated staff harassing resident by talking to resident with a heavy tone when discussing the list of possible transfer to another facility. All four (4) staff interviewed denied the allegation. Staff interviews revealed resident requested to move out a few months ago which was resident’s own will. Therefore, staff assisted the resident on this transfer by providing resident with a facility list and discussed with the resident. Staff had no intend to harass the resident. LPA conducted a physical plant and observed staff did not harass residents at the facility. Thus, staff did not harass resident while in care.

In regard of allegation that staff speak to resident in an inappropriate manner, it was alleged that staff speak to resident aggressively. LPA interviewed residents, seven (7) out of eight (8) residents could not corroborate the allegation. One (1) out of eight (8) residents stated staff talked to resident about transferring to another facility in an aggressive way which made resident felt unhappy about staff's attitude. Residents interviews revealed that staff were nice and spoke to them with a nice manner. All four (4) staff interviewed denied the allegation. Staff stated facility staff was not allowed to speak inappropriately to residents. LPA observed staff were treating residents nicely. Thus, there was not preponderance of evidence to show staff speak to resident in an inappropriate manner.

In regard of allegation that staff do not ensure facility is free of bed bugs, it was alleged that facility has bed bugs because resident experienced biting sensation when laying down in bed. LPA interviewed residents, seven (7) out of eight (8) residents could not corroborate the allegation. One (1) out of eight (8) residents stated resident felt something were biting resident when lying in bed and believed those were from bed bugs. All four (4) staff interviewed denied the allegation. Staff interviews revealed no bed bugs was observed at the facility. LPA conducted a physical plant and did not observe bed bugs in the resident’s room at the facility. Per record review, the facility was contract with pest control company to maintain pest control services for the facility. Thus, the facility did not observe to have bed bugs.

In regard of allegation that staff did not provide resident with a 60 day notice of rate increases, it was alleged that resident’s rent increased in April 2024. LPA interviewed residents, seven (7) out of eight (8) residents could not corroborate the allegation. One (1) out of eight (8) residents stated the administrator provided insufficient time to notify resident about the rent increase. All four (4) staff interviewed denied the allegation. Staff interviews revealed staff had notified residents verbally about the rent increase for a few months and provided a written notification to residents for 1 month. Staff had explained the increase to residents.
(-continued in LIC9099C-)

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Bonnie Tao	TELEPHONE: (323) 981-3971
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 28-AS-20240506101920

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: 05/09/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Administrator had delayed the rent increase for 1 month and plus 1 month of notification to accommodate residents’ request. Thus, staff had provided sufficient time to notify residents about the rent increase.

Based on the information obtained during the investigation, interviews with staff, residents, review of resident files 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 allegation is UNSUBSTANTIATED.

An exit interview was conducted with Administrator, Gil Agas and findings were discussed. A copy this report was provided to Administrator at time of visit.

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Bonnie Tao	TELEPHONE: (323) 981-3971
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 3