198603723-1-28-2026-28-AS-FFIS-DRG3AN-20260219170502

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603723
Report Date: 01/28/2026
Date Signed: 01/28/2026 04:55:29 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
01/23/2026 and conducted by Evaluator Sanjay Vaid

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20260123154107

FACILITY NAME:	BEVERLY HILLS SENIOR CARE		FACILITY NUMBER:	198603723
ADMINISTRATOR:	ORDONEZ, DANA		FACILITY TYPE:	740
ADDRESS:	1015 S ORANGE GROVE AVE		TELEPHONE:	(323) 933-8271
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90019
CAPACITY:	45	CENSUS: 44	DATE:	01/28/2026
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Administrator Dana Ordonez		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff did not ensure that facility was kept free of cockroaches

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Vaid conducted initial 10-day complaint investigation visit and met with Administrator Dana Ordonez and explained the reason of the visit. LPA Vaid and Administrator Ordonez toured the physical plant and did not observe any health and safety issues.

LPA Vaid requested, obtained and reviewed the following documents: Staff roster LIC 500, resident roster, monthly pest control invoices from June 2025-January 2026. Interviewed staff and residents. Requested and obtained five residents face sheets and physicians report.

Regarding the allegation: Staff did not ensure that facility was kept free of cockroaches. It is alleged that the staff is not ensuring the facility is free of cockroaches in R1’s room, bathroom, and around the water dispensers and microwaves in the dining area. Five of five staff interviewed deny the allegation.

CONTINUED ON 9099C................

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Sanjay Vaid
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2026

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-20260123154107

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: BEVERLY HILLS SENIOR CARE	FACILITY NUMBER: 198603723
	VISIT DATE: 01/28/2026

NARRATIVE

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According to staff the pest control company performs monthly pest control service visits to prevent and keep the facility pest free. Staff are performing their housekeeping and janitorial duties daily to ensure the facility is kept clean and pest free. Staff stated housekeeping in all rooms is done daily. Records review observed pest control company services are performed monthly for pest control spraying and prevention. Pest control technician stated they have not observed cockroaches within the interior and exterior of the facility. Administrator Ordonez explained that the facility has a service agreement with a pest control company for monthly treatment. In addition, Administrator Ordonez may call pest control as per need basis. Administrator Ordonez stated that on each monthly visit, Administrator Ordonez provides various rooms to be fumigated. The service agreement includes service control for roaches. Six out of seven residents interviewed could not corroborate this allegation. Five of seven residents interviewed stated they have not observed cockroaches in the facility. Four of seven resident stated they have seen the pest control company performing pest control services on a monthly basis. Visual observations by LPA Vaid were made in seven residents’ rooms: around and under the beds and in the bathrooms-under the sink and shower areas, dining areas- water fountains and the microwave areas. LPA Vaid did not observe any cockroaches in the above-mentioned areas. Based on interviews, observations and records reviewed, 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.

Exit interview was conducted and copy of this report was given to Administrator Dana Ordonez.

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Sanjay Vaid
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2026

LIC9099 (FAS) - (06/04)

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