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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603566
Report Date: 12/05/2025
Date Signed: 12/05/2025 12:38:51 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
11/05/2025 and conducted by Evaluator Kimberly Ramirez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251105150508
FACILITY NAME:ASTORIA PARK SENIOR LIVINGFACILITY NUMBER:
198603566
ADMINISTRATOR:STEPHANIE FUNDERBURGFACILITY TYPE:
740
ADDRESS:925 EAST VILLA STREETTELEPHONE:
(626) 796-4303
CITY:PASADENASTATE: CAZIP CODE:
91106
CAPACITY:220CENSUS: DATE:
12/05/2025
UNANNOUNCEDTIME BEGAN:
12:17 PM
MET WITH:Administrator Maria QuizonTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff are retaliating against resident.
Staff are not ensuring that resident is provided meals in a timely manner.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced subsequent complaint investigation visit on 12/05/2025 regarding the above allegations. During today’s visit LPA Ramirez was greeted by Administrator Maria Quizon and explained the purpose of the visit. On 11/10/2025, LPA Ramirez conducted an initial visit and a needs further investigation was documented.

The investigation consisted of the following: LPA Ramirez requested and obtained a copy of Resident/Client Roster, Staff#1 - 6 interviews (S1 – S6), Resident#1-9 (R1-R9) interviews review of Resident#1-9 (R1-R9) facility file, review of staff#4-6 (S4-S6) personnel file, and tour of dining room area.

SEE 9099-C for continued report
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Kimberly Ramirez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025
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-20251105150508
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: 12/05/2025
NARRATIVE
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The investigation revealed the following: regarding the allegation “Staff are retaliating against resident.” It is alleged that staff are retaliating against a resident. Eight (8) out of the nine (9) residents interviewed did not corroborate this allegation. Interviews with eight (8) residents revealed that staff have never retaliated against them and have always been professional when providing care. Six (6) out of the six (6) staff interviewed denied this allegation. Staff interviewed revealed that any type of mistreatment or retaliation against residents is not allowed and would report retaliation if they observed it. Review of S4-S6 personnel files did not corroborate the allegation that staff are retaliating against a resident. 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.

“Staff are not ensuring that resident is provided meals in a timely manner.” It is alleged that staff are not ensuring that a resident is provided with meals in a timely manner. Eight (8) out of the nine (9) residents interviewed did not corroborate this allegation. R5 and R6 revealed they have received their meals late in the past, but it was within reason, and they felt that their meals were late due to their table placement. Six (6) out of the six (6) staff interviewed denied this allegation. Staff interviews revealed that the dining room is set up as a “restaurant” style dining experience and residents’ orders are taken by servers once the resident is seated. Staff interviews revealed that once a server takes a table’s order, servers place the tickets on holder in the kitchen for the cooks but sometimes the kitchen gets backed up by plating the orders or if a resident changes their mind and orders something different, the ticket gets placed in order received. On 11/10/25, LPA Ramirez observed servers taking lunch orders and bringing meals out to resident tables. LPA Ramirez observed most meals were delivered to tables within 4 to 6 minutes of orders being placed. 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.

No deficiencies were cited for this complaint investigation. A copy of this report was provided via email due to printer out of ink.

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Kimberly Ramirez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2