<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603535
Report Date: 02/03/2026
Date Signed: 02/03/2026 12:04:53 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
01/26/2026 and conducted by Evaluator Mayra Cota
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260126094305
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: 147DATE:
02/03/2026
UNANNOUNCEDTIME BEGAN:
10:33 AM
MET WITH:Jacqueline Cortez, Executive DirectorTIME COMPLETED:
12:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff changed residents care plan without residents consent.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Mayra Cota conducted an unannounced subsequent complaint visit to investigate the above-mentioned allegation. LPA met with Jaqueline Cortez, Executive Director, and the reason for the visit was explained.

The investigation consisted of the following:

During initial visit on 1/30/2026, LPA obtained copies of staff and resident rosters, toured the common areas of the facility, conducted interviews with Staff 1 - Staff 3 and Resident 1 - Resident 12. LPA also obtained copies of R1's Care Plan.

During today’s visit, LPA obtained staff and resident rosters and toured the common areas of the facility. LPA also conducted interviews during the span of the investigation with Staff 4 – Staff 9 (S4-S9).
The investigation revealed the following:
*****Continues on LIC 9099-C*****
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Mayra Cota
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2026
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 2
Control Number 28-AS-20260126094305
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: 02/03/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Regarding: Staff changed resident’s care plan without resident’s consent.

It is alleged that staff changed resident’s care plan without resident’s consent.

Staff deny the allegation. Interviews with Staff 1 – Staff 4 (S1-S4) revealed that staff have not changed resident’s (R1) Care Plan without their consent. Staff indicated that staff have not made changes to R1’s Care Plan. Staff indicated that in order to make changes to a resident’s Care Plan, a re-evaluation from the wellness staff must be conducted before determining if changes to residents’ Care Plan need to be made to best meet their needs. Interview with S1-S3 indicated that R1 has not been re-evaluated to determine if a change to their Care Plan is warranted. S1-S3 further indicated that R1’s Care Plan continues to stand since R1 was last assessed by staff on 10/21/2025. Interview with S5-S9 indicated that they are not part of the team who determines if changes need to be made to residents’ Care Plans and were unable to provide information regarding the allegation. Interview with R1 indicated that staff are trying to make changes to R1’s Care Plan without R1’s consent. However, file review conducted by LPA revealed that R1’s Care Plan is still current and there have been no changes since 10/21/2025. Interviews with R2 – R12 indicated that their needs are being met by facility staff and have no concerns regarding their Care Plan being changed without their consent. Based on interviews and record review, the allegation that staff changed resident’s Care Plan without resident’s consent could not be corroborated.

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: 02/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2