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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603535
Report Date: 09/19/2025
Date Signed: 09/19/2025 02:06:41 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
09/12/2025 and conducted by Evaluator Christian Gutierrez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250912150740
FACILITY NAME:SANTA ANITA ASSISTED LIVINGFACILITY NUMBER:
198603535
ADMINISTRATOR:JACQUELINE CORTEZFACILITY TYPE:
740
ADDRESS:5600 GRACEWOOD AVENUETELEPHONE:
(626) 442-8410
CITY:TEMPLE CITYSTATE: CAZIP CODE:
91780
CAPACITY:150CENSUS: 149DATE:
09/19/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Jackie Cortez AdministratorTIME COMPLETED:
02:20 PM
ALLEGATION(S):
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Staff had inappropriate interactions with resident
Staff does not treat resident with respect
INVESTIGATION FINDINGS:
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Licensing Program Analyst’s (LPA’s) Christian Gutierrez, and Gabby Castro conducted a subsequent complain visit in regard to the allegations listed above. LPA’s met with Administrator Jackie Cortez and explained the purpose of the visit.

The investigation consisted of the following: During the initial visit conducted on 09/16/2025, LPA toured the facility and obtained copies of the following documents: staff roster, resident roster. During visit on 09/19/2025 LPA’s Gutierrez, and Castro interviewed: Administrator, staff #1-staff 6, residents #1-residents #10, obtained copies of R1 physician report, identification sheet, resident assessment, service plan, and R1’s intake notes. LPA’s also delivered findings.

See 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Christian Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2025
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-20250912150740
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: SANTA ANITA ASSISTED LIVING
FACILITY NUMBER: 198603535
VISIT DATE: 09/19/2025
NARRATIVE
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In regard to the allegation “Staff had inappropriate interactions with resident”, and ‘Staff does not treat resident with respect”, it is alleged that staff inappropriately touched resident in care and are aggressive. During interviews with Administrator and staff seven (7) out of seven (7) stated that to their knowledge no staff has had any inappropriate interactions with residents. Administrator stated no corrective actions or write ups have been given addressing these concerns. Seven (7) out of seven (7) staff all stated that they treat all residents with dignity and respect and have not been aggressive with residents. During interviews with residents seven (7) out of ten (10) residents stated that staff has not been inappropriate with them and that they are treated with respect. R4 stated that staff should knock on their doors and that it’s disrespectful for them just to come in.

Based on interviews conducted and records reviewed, there is insufficient evidence to support the allegations. 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. An exit interview was conducted, and a copy of this report was given to Jackie Cortez

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Christian Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2