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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603535
Report Date: 07/16/2026
Date Signed: 07/16/2026 01:44:53 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
06/15/2026 and conducted by Evaluator Mayra Cota
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260615091158
FACILITY NAME:SANTA ANITA ASSISTED LIVINGFACILITY NUMBER:
198603535
ADMINISTRATOR:ALISA DEANFACILITY TYPE:
740
ADDRESS:5600 GRACEWOOD AVENUETELEPHONE:
(626) 442-8410
CITY:TEMPLE CITYSTATE: CAZIP CODE:
91780
CAPACITY:150CENSUS: 145DATE:
07/16/2026
UNANNOUNCEDTIME BEGAN:
09:04 AM
MET WITH:Alisa Dean, Executive DirectorTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff slammed resident's foot in door.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Mayra Cota, conducted a subsequent complaint visit to deliver findings regarding the above-mentioned allegation. LPA met with Alisa Dean, Executive Director, and the reason for the visit explained.

The investigation consisted fo the following:

On 6/19/2026, LPA conducted an intial investigation visit and interviewed Staff 1 (S1) and obtained charting notes for R1.

During today's visit, LPA toured the common areas of the facility, obtained staff and resident rosters, and during the course of the investigation, LPA interviewed Staff 2 - Staff 3 (S2-S3) and attempted to conduct interview R1 and Person 1 (P1).
***Continues on LIC 9099-C***
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Mayra Cota
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2026
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-20260615091158
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: 07/16/2026
NARRATIVE
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Regarding: Staff slammed resident's foot in door.

It is alleged that staff slammed door on resident's food and resident does not feel safe around staff.

Interview with S1 revealed that R1 was admitted to the facility on 11/14/2025; however, R1 had to be sent out to hospital on the same day they were admitted. S1 indicated that R1 was at the facility less than a day after being admitted to the facility. S1 further indicated that R1 remained in the hospital until 12/22/2025 and returned to the facility on 12/27/2025 but was then sent out to hospital again and did not come back to the facility due to serious illness. S1 indicated that during the initial day of admission and the four days R1 was at the facility, thereafter, R1 did not complain about staff slamming a door on their foot nor observed any injuries on R1. Interview with (2) out of (4) staff who were on shift when R1 resided at the facility indicated that R1 was not hurt by staff by a slammed door on their food or in any other way because residents are treated with care and dignity. Two (2) out of (4) staff indicated that they do not recall meeting R1 during their shift on 11/14/2025 and days between 12/22/2025 through 12/27/2025. Four (4) out of (4) staff stated that they do not slam doors on residents. Staff further indicated that they treat all residents with dignity and respect and any sign of resident abuse is reported immediately to the proper authorities. Interviews with (10) out of (10) residents indicated that they are treated with dignity and respect by staff and feel safe living at the facility. LPA attempted to conduct interviews with R1 and P1; however, call attempts were unsuccessful. Charting notes for R1 confirmed the days R1 lived at the facility; however, notes do not indicate noted injuries on R1 or complaint regarding an incident in which R1 had a door slammed on their foot by anyone. Based on interviews and record review, there is not enough evidence to corroborate with this allegation that staff slammed a door on resident's foot.

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.
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Mayra Cota
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2