198603535-4-3-2026-28-AS-FFIS-DTKM6Z-20260428092041

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603535
Report Date: 04/03/2026
Date Signed: 04/03/2026 05:34:44 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
10/15/2025 and conducted by Evaluator Bonnie Tao

COMPLAINT CONTROL NUMBER: 28-AS-20251015145335

FACILITY NAME:	SANTA ANITA ASSISTED LIVING		FACILITY NUMBER:	198603535
ADMINISTRATOR:	JACQUELINE CORTEZ		FACILITY TYPE:	740
ADDRESS:	5600 GRACEWOOD AVENUE		TELEPHONE:	(626) 442-8410
CITY:	TEMPLE CITY	STATE: CA	ZIP CODE:	91780
CAPACITY:	150	CENSUS: 143	DATE:	04/03/2026
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Jacqueline Cortez, administrator		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Staff does not ensure contact information on filing a complaint is posted in the facility.
Staff do not ensure residents care plan is being followed.
Staff do not respond to call signal system for resident in care.
Staff do not ensure resident is spoken to in an appropriate manner.
Staff does not ensure proper food service sanitation practices are followed.
Staff served contaminated food to residents in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tao conducted an unannounced subsequent complaint visit to this facility. The initial visit was conducted by Luis DeLeon on 10/21/25. Upon arriving at the facility, LPA met with Jacqueline Cortez, administrator. LPA explained the purpose of today’s visit and discussed the allegations mentioned above to Administrator.

The investigation consisted of residents/staff interviews, physical plant tour and facility records review. LPA obtained residents/staff roster, and residents’ facility files. The investigation revealed the following:

In regards of facility staff does not ensure contact information on filing a complaint is posted in the facility, it is alleged that facility did not post contact information for filing complaints. Per resident interviews, one (1) out of ten (10) residents interviewed stated the corporate office contact information for filing complaints is not posted.
(- continues on LIC 9099C -)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Bonnie Tao
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2026

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 4

Control Number 28-AS-20251015145335

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: 04/03/2026

NARRATIVE

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Nine (9) out of ten (10) residents could not corroborate with the allegation. It revealed that residents have resident meetings regarding any issues and those issues can be sent to the facility management directly. Posters with the contact information for filing complaint are posted on the wall at the lobby entrance. Per staff interviews, seven (7) out of seven (7) staff interviewed could not corroborate with the allegation. Administrator would provide the corporate office’s contact information to residents when residents request it. In addition, posters with the contact information of Ombudsman and Licensing are posted in the entrance where residents can file a complaint. Per observation, posters with contact information for filing complaints are displayed at the lobby entrance where residents can easily see them. Each poster is in a size of 2.5ft (H) x 1.5ft (W). Therefore, the contact information on filing a complaint is available and posted in the facility’s public area.

In regards of facility staff do not ensure residents care plan is being followed, it is alleged that staff do not follow resident’s care plan when providing care assistance to residents. Per resident interviews, one (1) out of ten (10) residents interviewed stated the staff did not follow resident’s care plan when providing care to resident. Nine (9) out of ten (10) residents could not corroborate with the allegation. It revealed that residents receive care as stated on their care plan and as needed. Per staff interviews, seven (7) out of seven (7) staff interviewed could not corroborate with the allegation. The Administrator and staff stated they followed residents’ care plans when providing care assistance to residents. Thus, staff follow residents’ care plans when providing care to residents.

In regards of facility staff do not respond to call signal system for resident in care, it is alleged staff did not respond to residents’ calls while in care. Per resident interviews, four (4) out of ten (10) residents interviewed stated the staff did not respond to their calls on a timely basis. Six (6) out of ten (10) residents interviewed could not corroborate with the allegation. Residents stated staff responded to their call within 10 minutes. Per staff interview, all seven (7) staff interviewed could not corroborate with the allegation. The Administrator stated all call systems are working. As staff indicated, the front office would inform caregivers or housekeepers to go to a resident’s room when a resident presses the call button. Front offices use walkie talkies to communicate with staff. The respond time would not be more than five (5) minutes and staff would always respond to residents’ calls. LPA conducted a random signal system test during today’s visit. LPA tested the signal system in multiple rooms. Staff responded to the calls within a minutes and staff arrived at the residents’ rooms in less than ten (10) minutes. Therefore, staff would respond to residents’ calls.
(- continues on LIC 9099C -)

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Bonnie Tao
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2026

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20251015145335

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: 04/03/2026

NARRATIVE

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In regards of facility staff do not ensure resident is spoken to in an appropriate manner, it is alleged staff did not show respect to residents when speaking to them. Per resident interviews, two (2) out of ten (10) residents interviewed stated staff did not speak to them with a good manner. Eight (8) out of ten (10) residents interviewed could not corroborate with the allegation. It revealed staff are nice and show respect to the residents when speaking to them. Per staff interview, all seven (7) staff interviewed could not corroborate with the allegation. Staff treat residents with respect and dignity. Per observation, LPA observed residents in the hallway, dining room and activity room. Staff’s interaction with residents is friendly. Staff are nice to residents and residents look happy. Some residents would say hi to staff and staff would initiate a short conversation. Therefore, there is not observed that staff are talking inappropriately to residents.

In regards of facility staff does not ensure proper food service sanitation practices are followed, it is alleged that dietary staff did not wear hair nets and gloves while working in the dietary areas. Per resident interviews, two (2) out of ten (10) residents interviewed stated dietary staff did not wear hair nets and gloves. Eight (8) out of ten (10) residents interviewed could not corroborate with the allegation. It revealed dietary staff were wearing hair nets and gloves when serving food. Per staff interviews, all seven (7) staff interviewed could not corroborate with the allegation. Staff stated that wearing hair nets, putting on gloves, washing hands and changing gloves were required all time. Staff were trained in proper food handling. All leftover food and refused food trays are disposed. Disciplinary action would be taken if staff did not follow the protocol. Per observation, kitchen looked clean, food was all covered, and staff wore hair nets/ gloves. Therefore, no sanitation issues in the kitchen were observed.

In regards of facility staff served contaminated food to residents in care, it was alleged hair was found in residents’ food plates. Per resident interviews, two (2) out of ten (10) residents interviewed stated they found hair in their food plates. Eight (8) out of ten (10) residents interviewed could not corroborate with the allegation. It revealed residents did not observe their food was contaminated. Per staff interview, all staff have not heard of any residents having hair in their food. Staff are required to wear hair nets. Per observation, dietary staff wear hairnets while working in the kitchen and serving food. Per file review, a communication notes reported the hair found in the food was placed by residents, not from the kitchen staff. Therefore, residents’ food was not observed to be contaminated.

(- continues on LIC 9099C -)

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Bonnie Tao
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 28-AS-20251015145335

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: 04/03/2026

NARRATIVE

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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 no preponderance of evidence to prove the alleged violations did or did not occur, therefore, the allegations are UNSUBSTANTIATED.

An exit interview was conducted with Jacqueline Cortez, administrator. The findings were discussed and a copy of this report was provided.

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Bonnie Tao
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2026

LIC9099 (FAS) - (06/04)

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