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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603535
Report Date: 10/30/2025
Date Signed: 10/30/2025 05:23:24 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
10/21/2025 and conducted by Evaluator Mayra Cota
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251021162441
FACILITY NAME:SANTA ANITA ASSISTED LIVINGFACILITY NUMBER:
198603535
ADMINISTRATOR:JACQUELINE CORTEZFACILITY TYPE:
740
ADDRESS:5600 GRACEWOOD AVENUETELEPHONE:
(626) 442-8410
CITY:TEMPLE CITYSTATE: CAZIP CODE:
91780
CAPACITY:150CENSUS: 149DATE:
10/30/2025
UNANNOUNCEDTIME BEGAN:
08:43 AM
MET WITH:Jacqueline Cortez, Executive DirectorTIME COMPLETED:
05:30 PM
ALLEGATION(S):
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Staff did not respond to resident's call button in a timely manner.
Staff did not follow resident's care plan.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Mayra Cota, conducted a 10-day investigation visit today regarding the above mentioned allegations. LPA, met with Jacqueline Cortez, Executive Director and the reason for the visit was explained:

During today's visit:

LPA, obtained copies of staff and resident rosters, toured the facility, conducted interviews with Staff 1 - Staff 8 (S1-S8) and Resident 1 - Resident 15 (R1-R15) and obtained copies of caregiver floor assignments for resident care and care plan for (1) resident.

***Continues on LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Mayra Cota
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2025
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 2
Control Number 28-AS-20251021162441
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: SANTA ANITA ASSISTED LIVING
FACILITY NUMBER: 198603535
VISIT DATE: 10/30/2025
NARRATIVE
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Regarding: Staff did not respond to resident's call button in a timely manner.

It is alleged that resident pulled their call button but no one went to their room, even after pressing the button three more times. It is also alleged that staff finally went to resident’s room after three hours of the button being pulled.

Staff deny the allegation. Interviews with (8) out of (8) staff revealed that staff respond to residents who push their call button in a timely manner. Interviews with staff indicated that staff do not wait three hours to check in on a resident if their call button was pushed. Staff indicated that if a call button is pushed and the staff assigned to check in on a resident is attending to another resident’s needs, front desk staff will call on other staff who are available to check in on resident who called for help. Staff further indicated that although their resident assignments call for them to check on residents every two hours, checks on residents are ongoing during staff rounds. Interview with (14) out of (15) residents indicated that staff respond in a timely manner to their calls if they activate their call button. Residents further indicated that they have no concerns regarding staff not responding in a timely manner to calls made using their call button.

Staff did not follow resident's care plan.

It is alleged that resident’s care plan states that staff need to check on resident every two hours because they are a fall risk and they have a medical condition.

Staff deny the allegation. Interviews with (8) out of (8) staff revealed that staff check on all residents who live in the facility every two hours and during ongoing walks through the facility. Staff indicated that all residents get visits from staff whether they are independent, on hospice or require full care. Staff further indicated that residents’ care plans are followed to ensure residents’ needs are met appropriately. Interviews with (14) our of (15) residents indicated that staff check in on them every two hours or sooner. Residents further indicated that staff conduct visit to their rooms and also look for them in the common areas of the facility to check in on them. Residents stated that they have no concerns with staff not checking in on them every two hours or not following their care plan.

Based on interviews, the allegations could not be corroborated. Although the allegations may have happened or are valid, there is no preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted with Jacqueline Cortez, Executive Director and a copy of this report was provided.

SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Mayra Cota
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2