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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603749
Report Date: 08/03/2026
Date Signed: 08/04/2026 02:23:30 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
05/15/2026 and conducted by Evaluator Sanjay Vaid
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260515084922
FACILITY NAME:ST MATTHEW'S HOME FOR THE ELDERLY IIIFACILITY NUMBER:
198603749
ADMINISTRATOR:BOISTON, BARBARAFACILITY TYPE:
740
ADDRESS:1654 E RUDDOCK ST.TELEPHONE:
(626) 253-5806
CITY:COVINASTATE: CAZIP CODE:
91724
CAPACITY:6CENSUS: 6DATE:
08/03/2026
UNANNOUNCEDTIME BEGAN:
01:15 AM
MET WITH:ADMINISTRATOR, BARB BOISTONTIME COMPLETED:
02:45 PM
ALLEGATION(S):
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Resident sustained bruises due to neglect or physical abuse
INVESTIGATION FINDINGS:
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***This licensing report supersedes the previous licensing report dated 05/21/26 in order to clarify information obtained during the complaint investigation. The investigation findings will remain the same***

On 05/21/26, Licensing Program Analyst (LPA ) Vaid conducted an unannounced visit for the above-mentioned complaint, met with Administrator Barbara Boiston and explained the reason for the visit. LPA Vaid and Administrator toured the facility and did not observe any health and safety concerns. During the 05/21/26 visit, LPA Vaid conducted interviews with three (3) staff and six (6) residents and three (3) witnesses. LPA Vaid requested and reviewed the following document: Resident 1 (R1) face sheet/ID, physicians report, medications list. Staff and resident rosters. R1’s Home Health Agency contact information.

On today’s visit, LPA Vaid met with Administrator Bioston, toured the facility and observed no health concerns.
Regarding the allegation: Resident sustained bruises due to neglect or physical abuse. It is alleged that a resident sustained bruising to lower leg and left side of resident’s body, due to staff neglect or physical abuse.
CONTINUED ON 9099C.......

Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Sanjay Vaid
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2026
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 2
Control Number 28-AS-20260515084922
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: ST MATTHEW'S HOME FOR THE ELDERLY III
FACILITY NUMBER: 198603749
VISIT DATE: 08/03/2026
NARRATIVE
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***This licensing report supersedes the previous licensing report dated 05/21/26 in order to clarify information obtained during the complaint investigation. The investigation findings will remain the same***

Three (3) of three (3) staff interviewed deny this allegation. Staff stated that staff do not physically abuse or neglect the residents in care. Staff stated they are proactive with the resident’s care and tend to residents’ needs and services daily. Staff stated some residents have unsteady gaits and often bump into furniture and sustained bruises on their person.

Staff stated reporting to R1’s physicians and family of the incidents of severe dizziness and muscle cramps causing R1 to involuntarily cause injury to themselves. Staff stated they escort each resident to the family /activity areas in the morning and assist residents with using their walker and provide walking assistance to residents when needed. Interviews with five (5) of six (6) residents could not corroborate the allegation. Residents stated they are unaware of residents being abused or neglected in the facility. One (1) of six (6) residents stated they are not being neglected or abused by the staff and that the resident is experiencing weakness using the walker and when transferring from bed to wheelchair. The resident stated feeling too weak to walk unassisted and has experienced bruising due to fragility of the skin. Interviews with R1 revealed that R1 is not being neglected or abused by staff. LPA observed R1 had no bruises on R1’s lower leg and left side of R1’s body. Review of R1s medical records show that R1 is prescribed medications that make R1 dizzy and experience muscle fatigue. The majority of R1’s prescribed medications are known to cause dizziness, muscle cramping, and light-headedness, which may contribute to R1 injuring themselves. Review of R1’s physician report dated 03/06/2026, indicates that R1 has history of skin breakdown, and pressure induced deep tissue damage causing bruising to R1. R1’s Primary Physician is aware of R1’s physical condition and R1’s susceptibility to weakness and dizziness caused by the interactions of R1’s prescribed medications, which have led to R1 striking a surface and bruising to R1. R1 is not receiving Home Health services, due to R1’s family stopping R1’s Home Health services as of 04/09/2026. The investigation did not reveal that staff are neglecting and/or physically abusing residents in care.

Based on records review and interviews conducted, 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 held and copy of this report was provided to the Administrator, Barbara Bioston.
SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Sanjay Vaid
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2