198603566-12-22-2025-28-AS-LHIS-DPQQ2V-20251226104744

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603566
Report Date: 12/22/2025
Date Signed: 12/22/2025 02:04:52 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
12/16/2025 and conducted by Evaluator Alberto Lopez

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20251216142626

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: 149	DATE:	12/22/2025
		UNANNOUNCED	TIME BEGAN:	09:16 AM
MET WITH:	Maria Quizon, Executive Director		TIME COMPLETED:	02:13 PM

ALLEGATION(S):

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Staff do not prevent a resident from pulling the fire alarm

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Alberto Lopez conducted an unannounced complaint visit to investigate the above allegation. LPA met Maria Quizon, Executive Director and discussed the purpose of the visit.

The investigation consisted of the following: LPA obtained and reviewed staff and resident rosters, staff rosters, interviewed four (4) staff, ten (10) residents, took tour of facility including memory care.
The investigation revealed regarding: Staff do not prevent a resident from pulling the fire alarm. It is alleged that resident is setting off the fire alarm and staff do not prevent resident from doing it.
LPA interviewed five (5) staff and three (3) of five staff confirmed that someone pulled the fire alarm. The three (3) staff stated it only happened once on 12/18/2025. LPA interviewed ten (10) residents and seven (7) of ten (10) residents stated they heard the alarm at least once and several residents stated they heard it more than once. All ten (10) residents could not identify the person or witness the person that set off the fire alarm.
(continued on 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2025

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-20251216142626

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: ASTORIA PARK SENIOR LIVING	FACILITY NUMBER: 198603566
	VISIT DATE: 12/22/2025

NARRATIVE

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(Continued from 9099)

Facility staff were unable to identify the resident or person setting the alarm. The Executive Director stated that she will be having refresher training for staff to be able to monitor the residents to prevent this from happening again. She also stated that she will hold a meeting with the residents to answer any questions they may have. The person responsible for setting off the fire alarm has not been identified, and facility is addressing the issue. Executive Director stated she will install covers for the alarms in assisted living like they have in memory care to address the issue. There is insufficient evidence to substantiate this allegation.

Based on interviews conducted, there is insufficient evidence to support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.
An exit interview was conducted, technical advisory issued and a copy of this report was provided along with appeal rights.

SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2025

LIC9099 (FAS) - (06/04)

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