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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603824
Report Date: 01/06/2026
Date Signed: 01/06/2026 06:37:42 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
12/29/2025 and conducted by Evaluator Cynthia D Chan
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251229131007
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: 66DATE:
01/06/2026
UNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Lisa Pham, Regional Director of OperationsTIME COMPLETED:
02:20 PM
ALLEGATION(S):
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Staff verbally threatened resident with eviction.
Staff provided an invalid admission agreement to resident in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cynthia Chan conducted a complaint investigation regarding the allegations listed above. LPA arrived unannounced and met with Lisa Pham, the Regional Director of Operations, to explain the purpose of the visit.

LPA obtained copies of the staff roster, resident roster, and documents for Resident #1. LPA interviewed Staff #1 - #5 and Residents #1 - #7.

Allegations - Staff verbally threatened resident with eviction. It is alleged that staff threatened to evict Resident #1 (R1) if R1 does not agree to sign the new admission agreement. LPA interviewed five (5) Staff. Staff stated they never told R1 that he/she will get evicted if the resident does not sign the new admission agreement. Staff stated that they respect the residents’ wishes and do not threaten any residents if they do not comply with things.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Cynthia D Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2026
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-20251229131007
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: 01/06/2026
NARRATIVE
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LPA interviewed seven (7) residents. One out of the seven felt threatened by staff for not wanting to sign the admission agreement. The rest of the residents interviewed have not been threatened by staff and feel that the staff are good and nice. There is insufficient evidence to corroborate this allegation.

Allegation - Staff provided an invalid admission agreement to resident in care. It is alleged that the resident was provided a new admission agreement and the fee amounts were left blank or incomplete. LPA interviewed Staff who communicated with all residents regarding the new admission agreement due to the change of ownership. Per staff, they met with each resident and/or their responsible parties to review and sign the new admission agreement. Staff stated that they attempted to meet with R1 to review the document. However, R1 did not allow the staff any opportunity to go over the new contract and told staff that R1 will not sign it. Staff also stated that R1 was provided another copy of the admission agreement upon request. LPA obtained a copy of the new admission agreement that was provided to R1. The contract appeared complete and indicated the resident’s name and charges. LPA interviewed R1 who stated that the staff only provided a copy of the blank admission agreement and told resident to sign. The other six (6) residents interviewed stated that the staff met with them to go over the new admission agreement and provided the rates.

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 with Lisa Pham. A copy of this report, along with the appeal rights, was provided.
SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Cynthia D Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2