198603566-7-24-2025-28-AS-LHIS-DKFTW2-20250811150450

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603566
Report Date: 07/24/2025
Date Signed: 07/24/2025 11:52:34 AM

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
06/16/2025 and conducted by Evaluator Christian Gutierrez

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20250616114202

FACILITY NAME:	ASTORIA PARK SENIOR LIVING		FACILITY NUMBER:	198603566
ADMINISTRATOR:	STEPHANIE FUNDERBURG		FACILITY TYPE:	740
ADDRESS:	925 EAST VILLA STREET		TELEPHONE:	(626) 796-4303
CITY:	PASADENA	STATE: CA	ZIP CODE:	91106
CAPACITY:	220	CENSUS: 147	DATE:	07/24/2025
		UNANNOUNCED	TIME BEGAN:	09:34 AM
MET WITH:	Administrator Stephanie Funderburg		TIME COMPLETED:	12:05 PM

ALLEGATION(S):

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Staff retained resident that requires a higher level of care
Staff do not ensure that resident is transported to medical appointments
Staff do not ensure that resident's hygiene needs are met
Staff do not accord resident dignity in their relationship with staff
Staff handle resident in a rough manner

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Christian Gutierrez conducted a subsequent complain visit in regard to the allegations listed above. LPA met with Administrator Stephanie Funderburg and explained the purpose of the visit.

The investigation consisted of the following: During the initial visit conducted on 06/19/2025, LPA toured the facility and obtained copies of the following documents: staff roster, resident roster, R1’s preplacement appraisal information, physicians reports, admission/record admission, identification information (LIC 601), orders for medication and facility assessment. During visit on 07/10/2025 LPA’s interviewed Administrator, staff 1-staff 5 (S1-S5), resident one (R1) by telephone and residents 2-9 (R2-R9). During todays visit LPA delivered findings.

See 9099C

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Christian Gutierrez
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/24/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2025

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-20250616114202

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: ASTORIA PARK SENIOR LIVING	FACILITY NUMBER: 198603566
	VISIT DATE: 07/24/2025

NARRATIVE

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In regard to the allegation “Staff retained resident that requires a higher level of care “, it is alleged that staff did not adequately meet R1’s needs. During interviews with Administrator and staff six (6) out of six (6) staff stated that facility meets all the needs of all residents. Administrator stated that facility provides end of life services for residents and are more than qualified to handle non ambulatory residents and residents who require a high level of care. It was also stated that R1 did go from a level 1 care to a level 5 care therefore more services were provided but at no time did a physician state that he needed a higher level of care than what the facility could provide. During interviews with residents eight (8) out of nine (9) residents felt they received good quality of care by staff. R4 stated that overall, all needs have been met and staff is cordial to residents.

In regard to the allegation “Staff do not ensure that resident is transported to medical appointments “, It is alleged staff did not provide transportation to resident due to nonpayment of rent. During interviews with Administrator and staff six (6) out of six (6) staff stated that transportation is arranged with front desk and residents are never denied service regardless of nonpayment of rent. Administrator stated there are many residents that don’t pay, and facility has never stopped rendering services because of that. During interviews with residents three (3) residents stated that they have never needed transportation, two (2) residents stated that they need to make arrangement a week in advance, and four (4) residents stated they have had no problems with transportation.

In regard to the allegation “Staff do not ensure that resident's hygiene needs are met “, it is alleged that R1 smelled strongly of urine as well as wheelchair. During interviews with Administrator and staff four (4) out of six (6) stated that residents are always changed and showered. Two (2) staff stated that there has been a couple of incidents that they have found residents soiled in the morning shift and that gets reported right away. During interviews with residents seven (7) out of nine (9) stated that they have never had any problems with being left soiled nor ever witnessed residents being left soiled. R2 stated that they had witnessed R1 being changed 2 or 3 times a day by staff.

SEE 9099C

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Christian Gutierrez
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/24/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2025

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20250616114202

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: ASTORIA PARK SENIOR LIVING	FACILITY NUMBER: 198603566
	VISIT DATE: 07/24/2025

NARRATIVE

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In regard to the allegation “Staff do not accord resident dignity in their relationship with staff “, it is alleged staff can be mean and rude to residents. During interviews with Administrator and staff six (6) out of six (6) stated that they have never witnessed staff treat residents rude. Administrator stated there has been no write ups or disciplinary actions for this type of behavior. During interviews with residents eight (8) out of nine (9) residents stated that staff has not been rude or disrespectful to them. R3 stated that staff shows him/her the “most respect”.

In regard to the allegation “Staff handle resident in a rough manner”, it is alleged that staff jerks’ residents around. During interviews with Administrator and staff six (6) out of six (6) stated that no residents has ever told them that staff jerks them around. All staff stated that if they had heard staff was mistreating residents that it would be reported. During interviews with residents eight (8) out of nine (9) residents stated that staff has never handled them in a rough manner nor have they witnessed other residents being handled rough.

Based on interviews conducted and records reviewed, there is insufficient evidence to support the allegations. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. An exit interview was conducted, and a copy of this report was given to Administrator.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Christian Gutierrez
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/24/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2025

LIC9099 (FAS) - (06/04)

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