198603401-1-13-2025-28-AS-RORN-DDCP45-20250128095833

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603401
Report Date: 01/13/2025
Date Signed: 01/13/2025 04:28:44 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
12/23/2024 and conducted by Evaluator Bonnie Tao

COMPLAINT CONTROL NUMBER: 28-AS-20241223114623

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: 75	DATE:	01/13/2025
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Virgilio Agas, administrator		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Licensee removed the portable air conditioning units from residents’ rooms.
Licensee interfered with the smooth transition of operation to the prospective, new operator.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tao conducted a subsequent unannounced complaint investigation for the allegations listed above today. LPA met with Gil Agas, Administrator and Justin Lee, administrator assistant. The purpose of today's visit was explained.

On 12/23/24, LPA Tao conducted the initial investigation visit. On 12/24/24, LPA conducted a subsequent visit. On 01/13/25, LPA conducted another subsequent visit. LPA obtained copies of staff and resident rosters, interviewed staff/residents, reviewed staff records, and conducted a facility tour.

The investigation consisted of interviews with staff#1 (S1), staff#2 (S2), staff#11 (11), staff#12 (S12) and staff#13 (S13); reviewed staff files from staff#3 (S3) to staff#9 (S9); interviews with residents from resident#1 (R1) to resident#6 (R6) and conducted a physical plant.

(-continued in LIC 9099 C-)

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Bonnie Tao
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2025

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-20241223114623

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: 01/13/2025

NARRATIVE

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In regard of the allegation that Licensee removed the portable air conditioning (AC) units from residents’ rooms, it was alleged that the portable air conditioning units were removed from residents’ room. The investigation revealed the following: Per resident interviews, all six (6) residents interviewed stated their portable AC units were removed from their rooms but they did not need the portable AC during winter. They felt comfortable residing in their rooms. Per staff interviews, staff could not corroborate the allegation. Staff interviewed indicated the portable ACs were removed from the residents’ rooms and stored in the facility’s storage during winter. Per LPA’s observation, the portable AC units were stored in the Licensee’s room / storage area in the facility. Therefore, the portable AC units were removed from residents’ rooms and stored in the facility storage during winter.

In regard of the allegation that Licensee interfered with the smooth transition of operation to the prospective, new operator, it was alleged that the current licensee did not allow the prospective operator’s staff obtain the facility’s records and access to the facility maintenance storage. The investigation revealed the following: Per resident interviews, residents had no knowledge about the allegation. Per staff interviews, staff could not corroborate the allegation. Staff interviewed indicated the prospective operator’s staff were attempted to gain the access of the current facility’s records, such as staff records, vendor information and billing information, and changed the facility maintenance room’s door lock without asking for a prior permission from the current licensee. Thus, Licensee stopped the prospective operator’s staff to proceed. Per record review, the facility was licensed under the Licensee when those incidents occurred. Therefore, there was not preponderance of evidence to prove Licensee interfered with the smooth transition of operation to the prospective operator.

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.

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Bonnie Tao
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2025

LIC9099 (FAS) - (06/04)

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