198603566-2-23-2026-28-AS-RORN-DRW26R-20260305160733

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603566
Report Date: 02/23/2026
Date Signed: 02/23/2026 06:13:53 PM

Substantiated

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
02/17/2026 and conducted by Evaluator Bonnie Tao

COMPLAINT CONTROL NUMBER: 28-AS-20260217152644

FACILITY NAME:	ASTORIA PARK SENIOR LIVING		FACILITY NUMBER:	198603566
ADMINISTRATOR:	MARIA QUIZON		FACILITY TYPE:	740
ADDRESS:	925 EAST VILLA STREET		TELEPHONE:	(626) 796-4303
CITY:	PASADENA	STATE: CA	ZIP CODE:	91106
CAPACITY:	220	CENSUS: 146	DATE:	02/23/2026
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Maria Teresita Capito Quizon, administrator		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Facility staff do not respond to call bell in a timely manner.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tao conducted an unannounced 10-day complaint visit to this facility. Upon arriving at the facility, LPA met with Maria Teresita Capito Quizon, administrator. LPA explained the purpose of today’s visit and discussed the allegation mentioned above to administrator Maria Quizon.

The investigation consisted of resident interviews, staff interviews, facility tours, and review of facility records. LPA obtained resident roster, staff roster and residents’ facility files.

The investigation revealed the following:

In regards of facility staff do not respond to call bell in a timely manner, it was alleged that the night shift staff failed to respond to resident’s call bell. Per the resident interviews, one (1) out of eleven (11) residents interviewed stated that the resident had never used the call button / pendant to call staff for incontinent assistance at nighttime. (-continued in LIC 9099C-)

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Bonnie Tao
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2026

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-20260217152644

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: 02/23/2026

NARRATIVE

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One (1) out of eleven (11) residents interviewed stated staff would come timely to assist the resident when the staff was called. The staff would come to resident’s room in about 10 minutes after the call button was pressed. Nine (9) out of eleven (11) residents stated night shift staff did not come to assist them timely when staff were called. The interviews revealed that the night shift staff either did not show up in residents’ rooms to assist them or staff would come to assist them from 30 minutes to hours after they pressed the call pendants. It was a concern of short of staff at the night shift staff. Per staff interviews, one (1) out of four (4) staff interviewed could not corroborate the allegation. Three (3) out of four (4) staff interviewed corroborate the allegation which some staff failed to respond to the residents’ calls, especially during the night shift. During the facility tour, LPA tested the call pendants in seven (7) random residents’ rooms. LPA pressed the call button every five (5) minutes and waited in the residents’ rooms for 15 minutes to 25 minutes. Three (3) out of seven (7) residents’ rooms got no staff showed up. LPA spoke with staff to see if they received resident’s calls but staff stated they did not receive the calls. LPA and staff tried the call buttons multiple times to send the calls to front desk and finally, some calls were received by staff’s pagers. Based on the call button test, it showed some pendants were not working properly and staff failed to respond to resident’s calls in a timely manner.

Based on record review and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. Deficiencies are being cited according to California Code of Regulations, Title 22 and Health and Safety Code.

An exit interview was conducted with Administrator. A copy of this report and appeal rights were provided.

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Bonnie Tao
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2026

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20260217152644

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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/23/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/27/2026 Section Cited CCR 87468.2(a)(4)	1 2 3 4 5 6 7	(a) (4) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Licensee agree to hire more quailified staff to provide adequate assistance and care to residents. Also to ensure staff would respond to calls within 10 minutes. Proof of hiring additional staff will provide to licensing by the POC due date.
	8 9 10 11 12 13 14	Per interviews of residents and call button test, it showed that staff would take 15 min or did not respond to residents at all due to the call button was not working. This poses a potential health and safety risk to residents in care	8 9 10 11 12 13 14
Type B 02/27/2026 Section Cited CCR 87303(a)	1 2 3 4 5 6 7	The facility shall be clean, safe, sanitary and in good repair at all times. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Licensee agree to fix the call button to ensure it is in good repair at all times. Proof of repair will provide to licensing by the POC due date.
	8 9 10 11 12 13 14	Per call button tests, mulitple of call buttons were not working properly at the facility. This poses a potential health and safety risk to residents in care	8 9 10 11 12 13 14

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Bonnie Tao
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2026

LIC9099 (FAS) - (06/04)

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