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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 12:09:55 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
02/24/2026 and conducted by Evaluator Christian Gutierrez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260224120551
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:
11:40 AM
MET WITH:Martha GonzalezTIME COMPLETED:
12:20 PM
ALLEGATION(S):
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Staff do not ensure residents are served food of good quality, resulting in residents getting ill.
Staff are not ensuring residents’ needs are being met.
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 Activity Assistant Martha Gonzalez who assisted with today’s visit. Administrator Paul Gonzon was notified via telephone.
The investigation consisted of the following: During the initial visit conducted on 03/03/2026, LPA Sanjay Vaid conducted an unannounced visit and obtained copies of the resident and staff rosters, documents for Resident #1, and six (6) random residents, resident shower schedules, resident shower refusal logs for February to present, monthly menus, and Interviewed Staff #1-#3 and Resident #1-#4. During today’s visit, LPA Gutierrez checked kitchen food supply, toured six (6) random resident bedrooms, obtained staff roster, resident roster, reviewed R1’s file and obtained copies of R1’s service plan, family meeting notes, and shower schedule. LPA also obtained facility food menu, resident council meeting notes, and requests from Administrator to email a copy of Aprils housekeeping schedule for all employees worked. LPA interviewed Administrator, staff #1-staff #8 (S1-S8), and residents# 1-residents #7 (R1-R7). During today’s visit LPA delivered findings.
Substantiated
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 5
Control Number 28-AS-20260224120551
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” Staff do not ensure residents are served food of good quality, resulting in residents getting ill.”, It is alleged that facility is serving inedible meals that are not fresh and making residents sick. During interviews with Administrator and staff four (4) out of seven (7) stated that food is fresh and has not caused any resident to become ill. Three (3) staff indicated that several residents complain of diarrhea and upset stomach after eating food. During interviews with residents four (4) out of seven (7) stated that food is not good and has either made them sick or other residents, Two (2) residents stated that they were served uncooked chicken that resulted in them being sick. Three (3) residents stated food was good. LPA did a check of food, and it observed silk almond milk with an expiration date of 04/22/26, chicken tuna best if used by 02/07/26, and Alta Dena heavy cream expiration 05/05/26.

In regard to the allegation” Staff are not ensuring residents’ needs are being met”, It is alleged that staff did not follow R1’s care plan for showering. During interviews with Administrator and staff two (2) staff stated that residents are getting showered according to their shower schedule .Two (2) staff indicated there are times that they miss scheduled showers because they are either short staffed or they don’t have clean towels During interviews with residents four (4) out of seven (7) stated that they do not need assistance with showers. One (1) R7 stated that he/she gets showered every day because that is there rights and they had assistance from CCLD to enforce that right. One (1) resident R1 stated they need to ask for showers and one (1) resident stated they ask for help occasionally and need to wait. During record review it was reviled that occurring to R1’s care plan they are to be showered twice a week, LPA obtained shower logs for the month of February and R1 should have been showered a total of eight times long indicated four showers, one refusal shower, and three missed showers from staff. LPA also collected notes from a meeting with facility staff and family dated 02/06/2026 indicating showers were to be given twice a week and two showers were missed after that meeting.

Based on record review and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. Deficiencies are being cited according to California Code of Regulations, Title 22 and Health and Safety Code. An exit interview was conducted, and a copy of this report and appeal rights were 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 5
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
02/24/2026 and conducted by Evaluator Christian Gutierrez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260224120551

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:
11:40 AM
MET WITH:Martha GonzalezTIME COMPLETED:
12:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
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9
Staff do not ensure residents’ rooms are cleaned.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Christian Gutierrez conducted a subsequent complain visit in regard to the allegations listed above. LPA met with Activity Assistant Martha Gonzalez who assisted with today’s visit. Administrator Paul Gonzon was notified via telephone.
The investigation consisted of the following: During the initial visit conducted on 03/03/2026, LPA Sanjay Vaid conducted an unannounced visit and obtained copies of the resident and staff rosters, documents for Resident #1, and six (6) random residents, resident shower schedules, resident shower refusal logs for February to present, monthly menus, and Interviewed Staff #1-#3 and Resident #1-#4. During today’s visit, LPA Gutierrez checked kitchen food supply, toured six (6) random resident bedrooms, obtained staff roster, resident roster, reviewed R1’s file and obtained copies of R1’s service plan, family meeting notes, and shower schedule. LPA also obtained facility food menu, resident council meeting notes, and requests from Administrator to email a copy of Aprils housekeeping schedule for all employees worked. LPA interviewed Administrator, staff #1-staff #8 (S1-S8), and residents# 1-residents #7 (R1-R7). During today’s visit LPA 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: 3 of 5
Control Number 28-AS-20260224120551
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” Staff do not ensure residents’ rooms are cleaned.”, It is alleged that R1’s room had not been cleansed in months. During interview with Administrator, and staff four (4) out of six (6) staff stated rooms are cleaned every day with deep cleaning done once a month. Administrator stated that they were not fully staffed but have since hired more housekeepers and had utilized agencies for housekeepers during the time when they were short staffed. LPA confirmed that an outside agency was used to hire housekeepers and all three were fingerprinted and associated to facility with Guardian. During interview with residents Four (4) out of seven (7) felt staff does a good job at cleaning there rooms. Three (3) residents felt they are understaffed and don’t do a good job LPA conducted a tour of six (6) random bedrooms and did not find any rooms to be dirty and found no concerns

“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 and appeal rights 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: 4 of 5
Control Number 28-AS-20260224120551
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: 05/09/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
05/10/2026
Section Cited
CCR
87555(a)(8)
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87555 General Food Service Requirements (a) The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents and shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. All food shall be selected, stored, prepared and served in a safe and healthful manner.(8) All food shall be of good quality. Commercial foods shall be approved by appropriate federal, state and local authorities. Food in damaged containers shall not be accepted, used or retained.

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Administrator will come up with a plan with the kitchen staff to insure all food is checked for experation dates and send plan to LPA by POC due date.
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Based on interviews and obsevation, the facility had expired food that caused residents to become ill which posed a which posed an immediately health, safety, and personal rights risk to residents in care.
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Deficiency Dismissed
Type B
05/16/2026
Section Cited
HSC
1569.2(c)(4)
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Health and Safety Code section 1569.2(c) "Care and supervision" means the facility assumes responsibility for, or provides or promises to provide in the future, ongoing assistance with activities of daily living without which the resident’s physical health, mental health, safety, or welfare would be endangered. Assistance includes assistance with taking medications, money management, or personal care.(4)Personal assistance and care as needed by the resident and as indicated in the pre-admission appraisal, with those activities of daily living such as dressing, eating, bathing and assistance with taking prescribed medications, as specified in Section 87608, Postural Supports.

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Administrator will develop a plan with all care staff to insure that shower schedule is followed and send plan to LPA by POC due date.
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Based on interviews and record review, the facility failed to follow R1's care plan for showers that resulted in 3 missed showers for the month of february which posed a potential personal rights risk to residents in care.
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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.
SUPERVISOR'S NAME: David Sicairos
LICENSING EVALUATOR NAME: Christian Gutierrez
LICENSING EVALUATOR SIGNATURE:

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

DATE: 05/09/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5