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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603648
Report Date: 09/04/2025
Date Signed: 09/04/2025 09:52:38 AM

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
07/08/2025 and conducted by Evaluator Sanjay Vaid
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250708121326
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:
09/04/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Jenifer Zhang-AdministratorTIME COMPLETED:
09:47 AM
ALLEGATION(S):
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Staff did not ensure resident had comfortable living accommodations
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Sanjay Vaid conducted an unannounced follow up visit and met with Administrator Jennifer Zhang. The purpose of the visit was to investigate the above-mentioned complaint and deliver compliant investigation findings and the purpose of the visit was discussed.

On 07/14/25, LPA Vaid conducted an initial complaint investigation visit. During the visit, LPA Vaid requested, obtained and reviewed five (5) residents’ file, including residents’ factsheets, medications list, admissions agreement, physicians’ reports, residents communications report, and staff and residents’ rosters. LPA Vaid interviewed five (5) staff and seven (7) residents.
On 07/25/25, LPA Vaid conducted a follow-up complaint investigation visit. During the visit, LPA Vaid requested and obtained the staff roster, resident roster and interviewed five (5) staff and seven (7) residents.
On today visit, Licensing Program Analyst (LPA) Sanjay Vaid conducted an unannounced visit with Administrator Jennifer Zhang. The purpose of the visit was to investigate the above-mentioned complaint. LPA Vaid and Administrator Zhang conducted a tour of the facility and did not observe any health and safety concerns. Continued on 9099C.........

Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Sanjay Vaid
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2025
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 6
Control Number 28-AS-20250708121326
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: OMEO ARCADIA LIVING
FACILITY NUMBER: 198603648
VISIT DATE: 09/04/2025
NARRATIVE
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The investigation consists of the following: LPA Vaid requested, obtained and reviewed five (5) residents’ fact sheets, medications list, residents’ admissions agreement, physicians’ reports, residents communications report, staff and residents’ rosters. Copy of unsigned ‘No Sue Agreement', which is not part of the admission agreement. ‘No Sue Agreement’ offered to resident by facility management for damages to personal property, in exchange for resident not to sue the facility for damages. Five staff and seven residents were interviewed.

Regarding the allegation: Staff did not ensure resident had comfortable living accommodations. It is alleged that the staff did not ensure a resident was provided with comfortable living accommodation after resident’ was moved to a new room #310 due to the flooding that occurred in the residents’ room #234 caused by a water pipe bursting in the ceiling. Three (3) out of five (5) staff interviewed denied this allegation, according to the staff all residents residing at the facility are provided comfortable. Two (2) out of five(5) staff interviewed, R1 was not provided comfortable living accommodations when R1 experienced a water leak in their room on 05/20/25 and reported the leak to S3. Staff placed a ladder and pail to capture the water from the leaking pipe. On the evening of 5/27/25 the water pipe burst and flooded R1’s room. According to two (2) out of five (5) staff interviews, on 05/27/25, R1 was not allowed to retrieve their electronics (two laptops, I-pad) and prized literature(old books) due to ankle high water in R1s room #234. The water leak caused R1s clothing and linen to become wet and R1s clothes were unwearable. In the early hours of 5/28/25, R1 was relocated to a new room with only the clothes and linens washed the previous night. S3, who was the acting manager did not provide R1 with comfortable living accommodation in the R1s new room, room #310. The following items were missing in R1’s new room#310; a blanket, a toilet seat on the toilet, (Toilet seat was not installed until 6/9/25), which was ten (10) days after R1 moved into new room#310. Staff provided R1 with an inadequate refrigerator on two instances, the first refrigerator had mold and second fridge was non operational. Five (5) out of seven (7) residents interviewed reported that S3 did not provide residents with services to meet the residents’ needs. Residents interviewed stated that S3 is not properly trained to meet the residents’ Wellness needs. LPA obtained photo evidence of ladder and pail to capture water pipe leaking from the large opening in the ceiling. The investigation revealed that staff placed the ladder and pail in R1’s room for six (6) days while R1 remained in the room with the leaking water pipe. S3 did not move R1 out of the room, until 05/28/25, after the water pipe completely burst on the evening of 05/27/25, which caused water to leak into multiple adjacent rooms. Based on the evidence obtained during the investigation, interviews conducted with staff and residents and LPAs observations, the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. Deficiencies are being cited according to California Cade of Regulations, Title 22. Exit interview conducted with Administrator Jennifer Zhang. Appeal rights were discussed and a copy the licensing report along with appeal rights were given during visit. .
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Sanjay Vaid
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 6
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
07/08/2025 and conducted by Evaluator Sanjay Vaid
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250708121326

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:
09/04/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Jenifer Zhang-AdministratorTIME COMPLETED:
09:47 AM
ALLEGATION(S):
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Staff did not maintain a comfortable temperature for residents at all times
Staff do not ensure the facility is properly maintained
Staff did not safeguard resident's clothing
Staff do not ensure the facility is free of pest
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Sanjay Vaid conducted an unannounced follow up visit and met with Administrator Jennifer Zhang. The purpose of the visit was to investigate the above-mentioned complaint and deliver compliant investigation findings and the purpose of the visit was discussed.

On 07/14/25, LPA Vaid conducted an initial complaint investigation visit. During the visit, LPA Vaid requested, obtained and reviewed five (5) residents’ file, including residents’ factsheets, medications list, admissions agreement, physicians’ reports, residents communications report, and staff and residents’ rosters. LPA Vaid interviewed five (5) staff and seven (7) residents.
On 07/25/25, LPA Vaid conducted a follow-up complaint investigation visit. During the visit, LPA Vaid requested and obtained the staff roster, resident roster and interviewed five (5) staff and eight (8) residents.
On today visit, Licensing Program Analyst (LPA) Sanjay Vaid conducted an unannounced visit with Administrator Jennifer Zhang. The purpose of the visit was to investigate the above-mentioned complaint. LPA Vaid and Administrator Zhang conducted a tour of the facility and did not observe any health and safety concerns. Continued on 9099C...................
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Sanjay Vaid
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 28-AS-20250708121326
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: OMEO ARCADIA LIVING
FACILITY NUMBER: 198603648
VISIT DATE: 09/04/2025
NARRATIVE
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The investigation consists of the following: LPA Vaid requested, obtained and reviewed five (5) residents’ face sheets, medications list, residents’ admissions agreement, physicians’ reports, residents communications report, staff and residents’ rosters. Copy of unsigned ‘No Sue Agreement', which is not part of the admission agreement. ‘No Sue Agreement’ offered to resident by facility management for damages to personal property, in exchange for resident not to sue the facility for damages. Five staff and seven residents were interviewed.

Regarding the allegation: Staff did not maintain a comfortable temperature for residents at all times. It is alleged that the staff did not maintain comfortable temperature throughout the facility common areas at all times. (5) out of five (5) staff interviewed denied this allegation, the residents’ rooms all have a A/C -heater unit in their rooms, the residents can adjust the temperatures within the rooms. LPA observed the temperature on the thermostat at 80 deg F, in the hallways and commons areas to be within Title 22 regulations. LPA Vaid measured temperatures in common areas (hallways, activity areas, resident lounge) using Department issued thermometer. Staff interviewed stated the temperature is comfortable to work in. Seven (7) out of seven (7) residents interviewed stated they were comfortable with their room temperatures having control over the A/C -heating units in their rooms. Five (5) out of seven (7) stated they were comfortable with the temperatures throughout the facility and did not have any concerns about the temperatures being uncomfortable. LPA Vaid observed residents’ rooms with individual l A/C and heating units, residents stated they can keep their room at the temperature they desire. LPA Vaid observed the thermostat and AC/Heating units to be operational in all residents’ rooms that were interviewed. Based upon record review and interviews conducted the findings indicate that, although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

Regarding the allegation: Staff do not ensure the facility is properly maintained. It is alleged that the facility did not properly maintain the water pipes from bursting inside a residents’ room. Five (5) out of five (5) staff interviewed stated that the staff ensures the facility is clean and in good working order. Staff stated they clean and sanitize common areas and alert manager when breakdown occurs affecting the residents. Staff stated they have no control over the malfunctioning of the water pipes bursting. Staff notifies the managers and the issues are fixed. Staff acknowledged the pipes bursting on the evening of 05/27/25. Staff stated the three (3) residents that were affected by the water leak were provided with adequate accommodation, such as being relocated to another rooms and provided with any salvageable personal items that staff moved to the residents’ new rooms. Continued on 9099C.......
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Sanjay Vaid
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 28-AS-20250708121326
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: OMEO ARCADIA LIVING
FACILITY NUMBER: 198603648
VISIT DATE: 09/04/2025
NARRATIVE
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Six (6) out of seven (7) residents interviewed could not corroborate this allegation, the residents acknowledged that the facility is kept clean and issues with broken or malfunctioning items are addressed by staff in a prompt manner. The shower leak in new room #310 was repaired the same day reported, the leak was contained to the tub. The shower floor has permanent non-skid strips in the tub. Based upon record review and interviews conducted the findings indicate that, although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Regarding the allegation: Staff did not safeguard resident's clothing. It is alleged that the staff did not safeguard residents clothing during the water leak causing the clothes to become wet and unwearable. Making residents to sleep in dirty clothes. Five out of five (5) staff interviewed denied this allegation, according to staff interviews, R1s wet clothes and linens were taken and washed and dried by staff in the late evening of 05/27/25 the same night the water leak occurred, and in the early morning of 5/28/25. Staff washed and dried all R1’s clothing and linens during late evening and early morning hours. Staff stated they returned all clothing and linens to R1 in new room #310. Six (6) out of seven (7) residents interviewed could not corroborate this allegation. Residents interviewed stated that the staff does their laundry and have never experienced losing or misplacing of resident’s clothes by the staff who does residents’ laundry. According to residents interviewed, the laundry staff person, who does the residents laundry is safeguarding their clothes from being lost or misplaced. Based upon interviews conducted the findings indicate that, although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Regarding the allegation: Staff did not ensure the facility is free from pest. It is alleged that a resident was bitten by insect in the resident’s room. Five (5) out of five (5) staff interviewed denied this allegation. According to the staff, pest control company services the facility each month, invoices from Jan 25-May 25 were reviewed, the invoices did not reveal any issues with the interior of the facility and no mention of pest were noted in the pest control reports. LPA Vaid conducted site visits on 07/14/25 and 07/25/25 and LPA Vaid did not observe any pests or ants in the facility while touring the interior of the facility. Six (6) out of seven (7) residents interviewed stated they have not seen nor encountered any pest like ants in their rooms or in the facility. Based upon records reviewed and interviews conducted the findings indicate that, although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Exit interview conducted with Administrator Jennifer Zhang. Copy of licensing report was given to the Administrator.
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Sanjay Vaid
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 28-AS-20250708121326
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: OMEO ARCADIA LIVING
FACILITY NUMBER: 198603648
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/08/2025
Section Cited
CCR
87307(d)(1)
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87307-Personal Accommodations and Services(d)The following space and safety provisions shall apply to all facilities:(1)Sufficient room shall be available to accommodate persons served in comfort and safety. This requirement was not met by evidence:
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 Licensee/administrator to ensure that residents are afforded safe and comfortable accommodations. Staff In-service training of Residents Rights. Administrator to submit All-Staff in service training to CCL/LPA by 9/12/25.
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Based on interviews, records reviews and photo evidence the facility did not provide safe and comfortable accommodation to R1 in the new room 310 after flooding occurred in room 234.
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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: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Sanjay Vaid
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 6