198603535-11-7-2025-28-AS-FFIS-DNB2SN-20251110163926

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603535
Report Date: 10/09/2025
Date Signed: 11/07/2025 01:21:01 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
04/18/2025 and conducted by Evaluator Sanjay Vaid

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20250418090103

FACILITY NAME:	SANTA ANITA ASSISTED LIVING		FACILITY NUMBER:	198603535
ADMINISTRATOR:	JOEL NIBBLET		FACILITY TYPE:	740
ADDRESS:	5600 GRACEWOOD AVENUE		TELEPHONE:	(626) 442-8410
CITY:	TEMPLE CITY	STATE: CA	ZIP CODE:	91780
CAPACITY:	150	CENSUS: 148	DATE:	10/09/2025
		UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Jacqueline Cortez-Excutive Director		TIME COMPLETED:	02:05 PM

ALLEGATION(S):

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Staff did ensure resident was provided a safe environment while in care.
Licensee is financially abusing resident in care.

INVESTIGATION FINDINGS:

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***This report supersedes the report delivered on 10/28/25. The reason for the amendment is to remove confidential information listed on the initial report. The findings will remain unsubstantiated. ***

On 10/28/25, Licensing Program Analyst (LPA) S Vaid conducted a subsequential complaint investigation visit for the above allegations. LPA met with Jacqueline Cortez-Administrator, and the purpose of the visit was discussed.
On 4/22/25, LPA Vaid conducted an initial 10-day complaint investigation visit for the above allegations. LPA met with Ruth Villa, Wellness Director and Joel Niblett, Administrator. The investigation consisted of the following: LPA toured the physical plant. LPA Interviewed staff #1-#6 (S1-S6) and residents #1-#15 (R1-R15). LPA requested, collected, and reviewed documents from R1's face sheet, physicians reports, residential admissions agreement, medication, physicians’ orders, residents' facility financial history for R1. Staff and client rosters were obtained. LPA collected six (6) random residents files.
The investigation revealed the following: CONTINUED ON 9099C.......................

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Sanjay Vaid
LICENSING EVALUATOR SIGNATURE:	DATE: 11/07/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2025

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-20250418090103

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: 10/09/2025

NARRATIVE

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***This report supersedes the report delivered on 10/28/25. The reason for the amendment is to remove confidential information listed on the initial report. The findings will remain unsubstantiated. ***

Regarding the allegation: Staff did ensure resident was provided a safe environment while in care. It is alleged that the facility staff are not providing a safe environment for the residents that reside at the facility. R1 was placed with an aggressive resident/roommate who was verbally abusive and R1 felt uncomfortable and unsafe. Six (6) out of six (6) staff deny this. The staff stated they provide all residents with comfortable living accommodations and safety throughout the facility. Staff determine compatibility when placing residents together. The staff stated they ensure that all residents are provided with a safe environment by settling disputes between residents and keeping residents comfortable and treating the residents with respect and dignity. Fourteen (14) out of fifteen (15) residents interviewed could not corroborate this allegation. Nine (9) out of fifteen (15) residents interviewed stated they feel safe and comfortable living here and the staff assist with residents’ well-being. According to interviews with residents, R3, R14 and R15 have not resided in room #131 with R1 as a roommate. Based upon observations and interviews conducted the findings indicate that, although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Regarding the allegation: Licensee is financially abusing resident in care. It is alleged that the licensee is financially abusing resident #1(R1) in care by charging R1 with services not provided while resident was at Westwood Acute Care in another facility. Per co-complaint, the business office is not providing residents with copies of residents facility financial records. It is further alleged that staff are stealing monies from residents banking accounts by making residents sign blank pieces of paper. Six (6) out of six (6) staff interviewed deny this allegation. According to R1’s admissions agreement, ‘Residents are obligated to pay rent when on vacation or transferred temporarily to an outside health care facility’. Admissions agreement, pages 8-9, section VI-Fees, subsection D-Adjustments to fees and services, item 4- Absence from the Community. Signed by R1 on 05/03/2024 acknowledging the rules and responsibilities for residing in the facility. Staff interviewed stated that financial transactions related to the monthly rent and financial records are handled by the corporate accounting office to ensure proper billing and payments are received and correctly posted to residents’ accounts. The accounting office sends financial receipts to all residents for monthly rent and residents can receive a copy of their financial records upon written request. Staff stated they are not making any residents sign blank sheets of paper to gain access to the residents’ bank accounts. Thirteen (13) out of fifteen (15) residents could not corroborate licensee financially abusing residents. Seven (7) out of fifteen (15) residents stated they are not having monies stolen by staff. Most residents have their family handling money matters. Based upon records reviewed and interviews conducted the findings indicate that, although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Copy od this report was provided to Jacqueline Cortez -Administrator.

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Sanjay Vaid
LICENSING EVALUATOR SIGNATURE:	DATE: 11/07/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2025

LIC9099 (FAS) - (06/04)

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