198603331-5-1-2025-28-AS-FFIS-DGTNJV-20250519103056

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603331
Report Date: 05/01/2025
Date Signed: 05/01/2025 03:58:59 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
03/03/2025 and conducted by Evaluator Luis DeLeon

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20250303111044

FACILITY NAME:	BRIGHT STAR ASSISTED LIVING		FACILITY NUMBER:	198603331
ADMINISTRATOR:	MARQUEZ, JOSE M		FACILITY TYPE:	740
ADDRESS:	9349 ROSE STREET		TELEPHONE:	(818) 642-3668
CITY:	BELLFLOWER	STATE: CA	ZIP CODE:	90706
CAPACITY:	70	CENSUS: 64	DATE:	05/01/2025
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Assistant Administrator Jennifer Serrano		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Facility illegally evicted a resident in care.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Luis De Leon, Blanca Gonzalez, and Licensing Program Manager (LPM) Fernando Fierros conducted a follow up complaint investigation for the allegations listed above. LPA arrived unannounced and met with the Administrator Jennifer Serrano. The purpose for the visit was discussed.

On 03/10/25, LPA DeLeon conducted the initial visit, during visit, LPA DeLeon owing on today’s visit: LPA along with Assistant Administrator and Operations Manager toured the kitchen and food pantry, including the common dining area. LPA toured kitchen and observed enough food, the meal being served during the lunch hour was also observed and appeared as a well-balanced meal: Baked Chicken, Rice, Mixed Green Salad, and mixed Vegetables. Serving portions were adequate for residents. LPA reviewed the food menu for January-February 2025. LPA obtained copies of the staff and resident roster, admission agreement, eviction letter, facility food menu and food supply orders.
Report continues on page LIC9099-C

Substantiated

Estimated Days of Completion: 0

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Luis DeLeon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/01/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2025

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

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
03/03/2025 and conducted by Evaluator Luis DeLeon

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20250303111044

FACILITY NAME:	BRIGHT STAR ASSISTED LIVING		FACILITY NUMBER:	198603331
ADMINISTRATOR:	MARQUEZ, JOSE M		FACILITY TYPE:	740
ADDRESS:	9349 ROSE STREET		TELEPHONE:	(818) 642-3668
CITY:	BELLFLOWER	STATE: CA	ZIP CODE:	90706
CAPACITY:	70	CENSUS: 64	DATE:	05/01/2025
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Assistant Administrator Jennifer Serrano		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Staff did not provide an adequate amount of food to a resident in care.
Staff retaliated against a resident in care.

INVESTIGATION FINDINGS:

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Unsubstantiated

Estimated Days of Completion: 0

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Luis DeLeon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/01/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 28-AS-20250303111044

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: BRIGHT STAR ASSISTED LIVING	FACILITY NUMBER: 198603331
	VISIT DATE: 05/01/2025

NARRATIVE

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On today’s visit, LPA's De Leon, and Gonzalez and LPM Fernando Fierros met with Administrator Jennifer Serrano and assisted with the visit. The investigation consisted of LPAs obtaining copies of the staff and resident rosters, admission agreement, facility weekly menu for April, weekly food invoices for April, and eviction notice. LPA's toured the facility dining room, food pantry, and kitchen areas and observed food service for lunch.

In regards to the allegation “Staff did not provide an adequate amount of food to a resident in care”. it is alleged that that facility serves sandwich and chip for dinner and residents are not provided with a sufficient amount of food. The investigation reveals the following: Seven (7) out of seven (7) staff denied that residents are not provided with an adequate portion of food during meals. Six (6) out of seven (7) residents denied receiving insufficient portions of food for each meals served at the facility, and, if seconds are requested or residents preferred not to have food from the menu, kitchen staff accommodated the residents by providing other food options. In addition, if residents were not able to have a meal at the schedule service time, the staff would store their meals for later. In addition, kitchen manager stated that if a resident prefers alternative meal other than the published meal on the food menu, the kitchen staff will prepare special meals per the resident's requests. The investigation revealed that residents are provided with adequate amount of food consisted of three meals a day and snack in between meals

In regards to the allegation “Staff retaliated against a resident in care”. It is alleged that a resident is being evicted for filing a complaint. The investigation reveals the following: Seven (7) out of seven (7) staff denied knowledge of staff retaliating against residents for any reason. Six (6) out of seven (7) residents expressed being comfortable submitting a complaint to administration without fear of retaliation, none of the residents have heard of any residents being retaliated against for filing a complaint and expressed that staff treat residents with respect. Staff acts professionally even when residents do not follow facility rules, but none of the residents recall an incident where staff were disrespectful. The investigation revealed that residents are not retaliated against by staff and staff treat residents with respect,

Based on statements and interviews conducted with staff/residents, review of R1's file and observations made during facility tour, there was not enough supportive evidence to concur with the reported 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.

Exit interview held, and a copy of this report and appeal rights were provided.

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Luis DeLeon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/01/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2025

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20250303111044

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: BRIGHT STAR ASSISTED LIVING	FACILITY NUMBER: 198603331
	VISIT DATE: 05/01/2025

NARRATIVE

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On today’s visit, LPA's De Leon, and Gonzalez and LPM Fernando Fierros met with Administrator Jennifer Serrano who assisted with the visit. The investigation consisted of LPAs obtaining copies of the staff and resident rosters, Resident #1(R1's) admission agreement, facility weekly food menu for April, weekly food invoices, and R1's eviction notice. LPAs toured the facility dining room and kitchen.

In regard to the allegation “Facility illegally evicted a resident in care”. It is alleged that a resident is being evicted for nonpayment for rent for basic services and for filing a complaint against the facility. The investigation reveals the following: One out of Seven staff were aware of a resident being evicted for non- payment of rent. Six (6) out of Seven (7) staff members were not aware of any resident being evicted from facility. Six (6) out of (7) residents are not aware of any evictions being issued to residents. Per Administrator the facility issued an eviction notice to a R1 on February 17, 2025 due to non payment of rent. Further review of eviction notice reveals that, although the reason of eviction is valid, the facility did not include information regarding resources available to assist with alternative housing or a referral for alternative housing. In addition, the facility did not include the resident's right to file a complaint with the State Long Term Care Ombudsman office and a message informing tenant that the facility must file an unlawful detainer action in superior court and receive a written judgment signed by a judge. Therefore, the investigation revealed that the facility issued an illegal eviction notice to R1 on 02/17/25 and did not meet the required eviction guideline set forth by the California Code of Regulations, Title 22.

Based on interviews conducted, observation and documents reviewed, the preponderance of evidence standard has been met, therefore the allegation is found SUBSTANTIATED. California Code of Regulations Title 22, Division 6, and Chapter 8 are being cited on the attached LIC 9099-D.

Exit interview held, and a copy of this report and appeal rights were provided.

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Luis DeLeon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/01/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2025

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 28-AS-20250303111044

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: BRIGHT STAR ASSISTED LIVING	FACILITY NUMBER: 198603331
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/01/2025

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 05/08/2025 Section Cited CCR 87224(d)(1)(B)(C)(D)	1 2 3 4 5 6 7	87224 Eviction Procedures (d) The licensee shall set forth in the notice to quit the reasons relied upon for the eviction with specific facts to permit determination of the date, place, witnesses, and circumstances concerning those reasons. (1) The notice to quit shall include the following information: This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Licensee will rescind the eviction notice issued to R1and copy licensing. Licensee will send a letter to licensing indicating the licensee has read and will comply with Section 87224 by POC due date.
	8 9 10 11 12 13 14	During todays visit, LPA observed the Eviction Notice to R1 dated 02/17/25 was missing the following: Resources available, Referral Services, Right to file a complaint, unlawful detainer process and cross report to LTC0 Ombudsman is	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.

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Luis DeLeon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/01/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2025

LIC9099 (FAS) - (06/04)

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