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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603824
Report Date: 07/17/2026
Date Signed: 07/17/2026 02:49:46 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
06/08/2026 and conducted by Evaluator Christian Gutierrez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260608100925
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: 95DATE:
07/17/2026
UNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Paul GonzonTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff leave residents in soiled diapers for extended periods of time.
Staff did not adequately bathe resident in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Christian Gutierrez conducted a subsequent complaint visit in regard to the allegations listed above. LPA met with Executive Director Paul (Apolinario) Gonzon who assisted with today’s visit.

The investigation consisted of the following: During the initial visit conducted on 06/12/2026, LPA Daniel Konishi requested a copy of staff and resident rosters. LPA conducted a tour of facility and common areas with the Executive Director. During today’s visit LPA Gutierrez interviewed staff #1- staff #7 (S1-S7), residents #1- residents #7 (R1-R7), and delivered findings.

See LIC 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Christian Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2026
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-20260608100925
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: 07/17/2026
NARRATIVE
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In regard to the allegation” Staff leave residents in soiled diapers for extended periods of time.”, It is alleged that R1 was left in a soiled diaper for approximately two hours. During interview with staff seven (7) out of seven (7) staff stated that residents are never left in soiled diapers for extended periods of time. All seven staff stated that residents are changed every two hours or more if needed. S5 stated that in the morning R1 will complain and state it’s too early and staff has to continue to ask until he/she will comply. During interview with residents six (6) out of the seven (7) interviewed stated they are not left in soiled diapers for extended periods of time. R4 stated that staff comes every two hours and he/she will call the front desk if extra help is needed. R1 stated that he/she has been left for twelve hours. LPA obtained copies of R1’s service plan that states toileting every two hours. LPA also obtained a log, and no missed diaper changes were observed, only one refusal on 06/13/26.

In regard to the allegation” Staff did not adequately bathe resident in care”, It is alleged that during a bath R1 was told by caregivers that dried feces were still present from prior diaper change. During interview with staff seven (7) out of seven (7) staff stated that they have never witnessed or been told that staff has seen dried feces when bathing a resident. S2 stated that R1 will sometimes refuse to be bathed if a certain staff member does not do it. During interview with residents six (6) out of the seven (7) interviewed stated that staff does a pretty good job at assisting them with bathes. R1 stated that a caregiver changed him/her and by the next shift there was feces everywhere that was left over from last changing. R5 states it’s according to who gives them to you, but overall staff is good. LPA obtained documents that state R1 refused shower on 06/12/26.

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 Paul Gonzon.

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

DATE: 07/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2026
LIC9099 (FAS) - (06/04)
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