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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603824
Report Date: 05/09/2026
Date Signed: 05/09/2026 12:11:49 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
03/26/2026 and conducted by Evaluator Christian Gutierrez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260326150127
FACILITY NAME:ARCADIA RETIREMENT VILLAGEFACILITY NUMBER:
198603824
ADMINISTRATOR:ACHARYA, NIRJARAFACILITY TYPE:
740
ADDRESS:607 WEST DUARTE RDTELEPHONE:
(626) 447-6070
CITY:ARCADIASTATE: CAZIP CODE:
91007
CAPACITY:200CENSUS: DATE:
05/09/2026
UNANNOUNCEDTIME BEGAN:
12:01 PM
MET WITH:Martha GonzalezTIME COMPLETED:
12:15 PM
ALLEGATION(S):
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Facility is shutting off the water without notice.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Christian Gutierrez conducted a subsequent complain visit in regard to the allegations listed above. LPA met with Administrator Paul Gonzon who assisted with today’s visit.

The investigation consisted of the following: During the initial visit conducted on 04/02/2026, LPA Sanjay Vaid conducted an unannounced visit and obtained copies of Staff roster, residents roster. LPA Vaid, Administrator Sievert and Operations Director Pham and Maintenance Director Lara toured the facility and did not observe any health and safety concerns. On 05/09/2026 LPA Gutierrez toured six (6) random resident bedrooms, obtained staff roster, and resident roster. LPA interviewed Administrator, staff #1-staff #8 (S1-S8), and residents# 2-residents #8 (R2-R8). LPA conducted a telephone interview with R1 During today’s visit, LPA Gutierrez delivered findings.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Christian Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2026
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-20260326150127
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: 05/09/2026
NARRATIVE
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In regard to the allegation” Facility is shutting off the water without notice”, It is alleged that R1 was using restroom and water was shut off without notice. During interview with Administrator, and staff nine (9) out of nine (9) staff stated that water has not been shut off. Administrator stated that if for any reason water needed to be shut off staff would inform residents 24 hrs. in advance and post signs. LPA asked if there was any maintenance logs that identified any plumbing issues or water interruptions and was told there was no logs because water has never been shut. During interview with residents five (5) out of the nine (9) interviewed stated water has not been shut off. R5 stated water was shut off but that was years ago for maintenance and that residents were notified. R1 stated that it was a long time ago.

“Based on interviews conducted and records reviewed, there is insufficient evidence to support the allegations. 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, and a copy of this report was given to Martha Gonzalez.

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Christian Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2