198603824-4-3-2026-28-AS-FFIS-DT5PAR-20260414110907

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603824
Report Date: 04/03/2026
Date Signed: 04/03/2026 05:16:42 PM

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
02/03/2026 and conducted by Evaluator Cynthia D Chan

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20260203153254

FACILITY NAME:	ARCADIA RETIREMENT VILLAGE		FACILITY NUMBER:	198603824
ADMINISTRATOR:	ACHARYA, NIRJARA		FACILITY TYPE:	740
ADDRESS:	607 WEST DUARTE RD		TELEPHONE:	(626) 447-6070
CITY:	ARCADIA	STATE: CA	ZIP CODE:	91007
CAPACITY:	200	CENSUS: 76	DATE:	04/03/2026
		UNANNOUNCED	TIME BEGAN:	02:45 PM
MET WITH:	Silvia Valdez, Administrator		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Staff refused to accept resident back into the facility upon hospital discharge.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Cynthia Chan conducted a subsequent visit to deliver findings. LPA met with Administrator Silvia Valdez and explained the reason for the visit.

The investigation consisted of the following:
On 2/10/26, LPA Chan conducted the initial visit. LPA obtained copies of the resident and staff rosters, documents for Resident #1, and interviewed five (5) Staff and seven (7) Residents. LPA also interviewed a Mental Health Therapist on 3/9/26.

The investigation revealed the following:
Allegation - Staff refused to accept the resident back into the facility upon hospital discharge. It is alleged that Resident #1 (R1) was ready for discharge on 1/30/26, but staff stated that the resident could no longer return to the facility.

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Cynthia D Chan
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2026

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-20260203153254

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: ARCADIA RETIREMENT VILLAGE	FACILITY NUMBER: 198603824
	VISIT DATE: 04/03/2026

NARRATIVE

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LPA interviewed the hospital staff, facility staff, and residents regarding this allegation. LPA interviewed a personnel member from Olive View – UCLA Psychiatric, who confirmed that R1 was ready for discharge on 1/30/26 and did not have a change of condition or require additional care services. The hospital staff reported that they have been in contact with the facility to arrange for discharge and were informed that R1 cannot return to the facility. LPA also interviewed a mental health professional who stated that R1 appeared stable and was ready for hospital discharge.
LPA interviewed the facility staff. Staff indicated that they received a call from the hospital to discharge R1 back to the facility. However, staff stated they were unable to reassess the resident and determined that it may not be safe for R1 to return to the facility due to suicidal ideation. Staff voiced that R1 is actively trying to hurt self, and that the facility does not have the staffing to provide adequate supervision for R1’s psychiatric needs.
Upon review of the R1’s medical notes, the resident was hospitalized from 1/14/26 and was placed on a 5250 (14-day) hold to expire on 1/30/26. The records indicated that on 1/29/26, R1 was not currently endorsing Suicidal Ideation and had actively engaged in safety planning. Therefore, R1 was ready for discharge back to the facility.

Based on interviews conducted and record review, 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.

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Cynthia D Chan
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2026

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20260203153254

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: ARCADIA RETIREMENT VILLAGE	FACILITY NUMBER: 198603824
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/03/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Request Denied Type B 04/10/2026 Section Cited CCR 87468.2(a)(20)	1 2 3 4 5 6 7	87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (a) In addition to the rights listed in Section 87468.1, (20) To be protected from involuntary transfers, discharges, and evictions. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Licensee shall review the regulation and adhere to it. A statement acknowledging this regulation by POC due date 4/10/26.
	8 9 10 11 12 13 14	Based on interviews and record reviews, the facility did not accept R1 back to the facility which posed a potential personal rights risk to residents in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Cynthia D Chan
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2026

LIC9099 (FAS) - (06/04)

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