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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603648
Report Date: 09/20/2024
Date Signed: 09/20/2024 03:58:28 PM

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
09/13/2024 and conducted by Evaluator Cynthia D Chan
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240913160527
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: 80DATE:
09/20/2024
UNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Lucy Angel, med techTIME COMPLETED:
04:10 PM
ALLEGATION(S):
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Licensee does not ensure the facility is in good repair.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cynthia Chan conducted a complaint investigation on the allegation listed above. LPA arrived unannounced and met with Lucy Angel, the med tech. The purpose of the visit was explained. Administrator, Jennifer Zhang, arrived shortly after.

LPA obtained copies of the staff and resident rosters, flyers regarding changes within the facility, and reviewed the admission agreement. Interviews were held with the Administrator, Staff #1 - #4, and Residents #1 - #8.

For allegation - Licensee does not ensure the facility is in good repair. It is alleged that the gate on California street near the basement parking lot is broken. During the visit today, LPA noticed the garage electrical gate was open and had not close after entering. The administrator and staff acknowledged the garage gate has been in disrepair for several months.
Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2024
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 5
Control Number 28-AS-20240913160527
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: 09/20/2024
NARRATIVE
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Per the administrator, they are in the process of getting a quote to repair the gate. Meanwhile, the gate remains open during the day and is closed at night to prevent trespassers from entering the premises. One of the residents noticed that the garage gate has been left open during the day and is using it to enter and exit the facility.

Based on LPA observations and interviews conducted, the preponderance of evidence standard has been met, therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6 and Chapter 8), are being cited on the attached LIC 9099D.

An exit interview was conducted. The Plan of Correction was reviewed and developed with the Administrator. A copy of this report and appeal rights were provided.

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 28-AS-20240913160527
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: 09/20/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/18/2024
Section Cited
CCR
87303(a)
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87303 Maintenance and Operations (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 requirement is not met as evidenced by:
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The licensee shall provide repair the electrical gate. A copy of the repair receipt shall be submitted to LPA by 10/18/24.
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Based on observation and interviews, the licensee did not ensure the garage gate is working properly which poses a potential health and safety concern to residents in care.
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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: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
09/13/2024 and conducted by Evaluator Cynthia D Chan
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240913160527

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: 80DATE:
09/20/2024
UNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Lucy Angel, Med TechTIME COMPLETED:
04:10 PM
ALLEGATION(S):
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Licensee does not ensure residents receive contracted services.
Staff do not ensure residents are able to receive phone calls.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cynthia Chan conducted a complaint investigation on the allegations listed above. LPA arrived unannounced and met with Lucy Angel, the Med Tech. The purpose of the visit was explained. Administrator, Jennifer Zhang, arrived shortly after.

LPA obtained copies of the staff and resident rosters, flyers regarding changes within the facility, and reviewed the admission agreement. Interviews were held with the Administrator, Staff #1 - #4, and Residents #1 - #8.

The investigation revealed the following:
For allegation - Licensee does not ensure residents receive contracted services. It is alleged that the internet service is listed as a provided service for residents under the admission agreement but have not been working for at least the past year. LPA interviewed Staff and Residents regarding allegation.
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 28-AS-20240913160527
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: 09/20/2024
NARRATIVE
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Per the administrator, internet service is not listed on their admission agreement, but the facility provides Wi-Fi to residents. They also do not get cable services. Staff stated that in the past residents had to share the Wi-Fi and could have caused the connection to be spotty for some areas. However, they have recently upgraded to individual Wi-Fi routers in each residents’ rooms. LPA interviewed 8 residents. Five out of the eight residents stated there are no issues with the internet. Two indicated they purchased their own internet package to have access to cable. One stated he/she does not go online. LPA reviewed the admission agreement and it did not indicate that internet service is provided.

For allegation - Staff do not ensure residents are able to receive phone calls. It is alleged that the facility phone number changed 4 times and families are not notified when it had changed. In addition, they do not answer the calls. Administrator and staff stated the facility phone line has changed a few times. However, when the number changes, they inform residents and flyers are posted throughout the facility. They would also inform families verbally when they visit. The administrator also mentioned that the families all have her cell phone number and would sometimes contact her or the Administrator Assistant directly. If anybody calls the facility line and is busy, they have caller ID and would return the calls. During the tour, LPA observed notices regarding the change of the facility phone line posted in the hallway bulletins and doors. The residents interviewed stated when the phone number changes, it is posted in the lobby and other places in the facility. Six out of the eight residents indicated they do not have issues with the phone calls because they have their own cell phone, and so, people can reach them easily. However, two of them stated when they contact the front desk, the receptionist does not pick up.

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 with Administrator Zhang. A copy of this report with the appeal rights were provided.
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5