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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603648
Report Date: 06/27/2024
Date Signed: 06/27/2024 09:54:24 AM

Substantiated


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
06/20/2024 and conducted by Evaluator Elizabeth Irra
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240620103859
FACILITY NAME:OMEO ARCADIA LIVINGFACILITY NUMBER:
198603648
ADMINISTRATOR:ZHANG, JINGFANGFACILITY TYPE:
740
ADDRESS:601 SUNSET BLVDTELEPHONE:
(323) 422-8030
CITY:ARCADIASTATE: CAZIP CODE:
91007
CAPACITY:99CENSUS: 85DATE:
06/27/2024
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Lucy Alonso/S-1/Administrator Assistant/Jennifer ZhangTIME COMPLETED:
10:00 AM
ALLEGATION(S):
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Licensee does not ensure the facility is free from pests.
Licensee does not ensure the facility is in good repair.
Licensee does not ensure the facility is clean.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Elizabeth Irra conducted an initial visit to investigate the above allegations. LPA met with Lucy Alonso and discussed the purpose of today's visit. Jennifer Zhang (Administrator) arrived at approximately 9:30 A.M..

During this visit, LPA obtained a copy of the staff and resident rosters, conducted a tour, interviewed and reviewed the deficiencies/findings of the report dated 06/15/24 provided by Los Angeles Department of Public Health with S-1. Per S-1, the deficiencies/findings noted on the above mentioned report are accurate. Per S-1, S-1 was present during the 06/15/24 inspection.

Refer to LIC 9099C for the continuation of this report.


Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2024
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 3
Control Number 28-AS-20240620103859
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: OMEO ARCADIA LIVING
FACILITY NUMBER: 198603648
VISIT DATE: 06/27/2024
NARRATIVE
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Allegation: Licensee does not ensure the facility is free from pests. It is alleged that rodent droppings were seen throughout various rooms of the facility, including the kitchen, laundry room, activity room, and second floor break room. Per S-1, Los Angeles County Department of Public Health conducted an inspection on 06/15/24 and identified the above mentioned deficiencies. Per S-1, S-1 was present during the 06/15/24 inspection. Allegation is corroborated.

Allegation: Licensee does not ensure the facility is in good repair. It is alleged there is a clogged drain in the sink in the break room and loose boards patching the ceiling in the laundry room. Per S-1, Los Angeles County Department of Public Health conducted an inspection on 06/15/24 and identified the above mentioned deficiencies. Per S-1, S-1 was present during the 06/15/24 inspection. Allegation is corroborated.

Allegation: Licensee does not ensure the facility is clean. It is alleged that various surfaces have dirt and rodent droppings. Per S-1, Los Angeles County Department of Public Health conducted an inspection on 06/15/24 and identified the above mentioned deficiencies. Per S-1, S-1 was present during the 06/15/24 inspection. Allegation is corroborated.

Based on interview conducted and documents reviewed, the preponderance of evidence standard has been met, therefore the allegation is found SUBSTANTIATED. California Code of Regulations Title 22, Division 6, and Chapter 8 are being cited on the attached LIC 9099-D.

Exit interview conducted, copy of Appeal Rights and a copy of this report was provided to Jennifer Zhang (Administrator).

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20240620103859
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: OMEO ARCADIA LIVING
FACILITY NUMBER: 198603648
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/27/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/28/2024
Section Cited
CCR
87555(b)(27)
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General Food Service Requirements: (b) The following food service requirements shall apply: (27) All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects.

This standard is not met at evidence by:
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Administrator to provide a plan as to how the facility will be monitored and maintained free of rodents and submit plan to LPA Irra by POC due date.
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Los Angeles County Department of Public Health conducted an inspection on 06/15/24 and observed rodent droppings throughout various rooms of the facility, including the kitchen, laundry room, activity room, and second floor break room.
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Type B
07/08/2024
Section Cited
CCR
87303(a)
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Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This standard is not met as evidence by:
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Administrator to provide a plan as to how the facility will be monitored and maintained clean, safe, sanitary and in good repair at all times and submit plan to LPA Irra by POC due date.
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Los Angeles County Department of Public Health conducted an inspection on 06/15/24 and observed a clogged drain in the sink in the break room, loose boards patching the ceiling in the laundry room and dirt on various surfaces.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/27/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3