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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603535
Report Date: 05/07/2026
Date Signed: 05/07/2026 05:36:34 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
04/28/2026 and conducted by Evaluator Blanca Gonzalez
COMPLAINT CONTROL NUMBER: 28-AS-20260428092146
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: 146DATE:
05/07/2026
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Executive Director Alisa DeanTIME COMPLETED:
05:45 PM
ALLEGATION(S):
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Staff did not prevent resident from engaging in inappropriate behavior.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Blanca Gonzalez conducted an unannounced initial 10-day complaint visit regarding the above allegations. LPA Gonzalez met with Executive Director Alisa Dean and the purpose of the visit was explained.

The investigation consisted of the following: LPA collected rosters for staff and clients. LPA obtained copies of files for Resident #1 (R1) consisting of Face sheet, Resident Agreement, Identification and Emergency Information, medical assessment, Resident Handbook, house rules, History and Physical noted dated 03/05/26. LPA toured the facility and interviewed staff #1-#8 (S1-S8) and residents #2-15? (R2-R15).

continued on LIC9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Blanca Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2026
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 2
Control Number 28-AS-20260428092146
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: 05/07/2026
NARRATIVE
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The investigation revealed the following: regarding “Staff did not prevent resident from engaging in inappropriate behavior,” it was reported that there is a resident who engages in indecent exposure by pulling out his private part and urinating all over inside the facility and outside near the facility patio, in front of other residents and residents have to walk around the puddles of urine. 6 out of 8 staff interviewed denied the allegation. S2 stated R1 has had accidents in their room but did not intentionally urinate in the patio or any other facility common areas. S3, S4 and S5 stated they had not received any complaints about any resident urinating in the facility patio or any other common areas, nor had they witnessed any residents urinating in the facility patio or common areas. 9 out of 14 residents interviewed stated they have not witnessed any residents urinating outside in the facility patio or any other common areas. R9 stated yesterday was the first time they had to walk around a puddle, possibly urine, but they thought someone had an accident and it was not done intentionally. R10 and R11 stated residents sometimes have accidents but do not think they are intentionally urinating around the facility.

Based on interviews and record review, although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

An exit interview was conducted, and a copy of this report was provided to Alisa Dean Executive Director.

SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Blanca Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2026
LIC9099 (FAS) - (06/04)
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