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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 05:19:59 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
10/23/2025 and conducted by Evaluator Mayra Cota
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251023134654
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 overcharged resident.
Staff do not provide residents with a notificatoin letter for the increase of rent.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Mayra Cota, conducted initial 10-day investigation visit 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), interviewed Resident 1 – Resident 15 (R1-R15) and conducted record review for resident’s rent ledger for October 1, 2024 – November 1, 2025 and Past Due notice from 10/10/25.

***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 3
Control Number 28-AS-20251023134654
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 overcharged resident.

It is alleged that resident owes the amount of $73.25 for rent that had been late and that resident has been trying to inquire about it but staff will not answer the phone in the office.

Interview with S1 denies the allegation. Interview with S1 indicated that the amount of $73.25 owed by the resident is not a late charge for resident’s rent. S1 indicated that the amount of $73.25 is a balance the resident had for the yearly rent increase that took effect on 1/1/2024. S1 indicated that the facility collected rent on 1/1/24 from the resident without the yearly increase and as a result, the resident had a balance of $75.25. S1 stated that resident’s admission date is 12/20/23 and a rent increase took effect the following month on 1/1/24. S1 indicated that the balance was paid by resident’s authorized representative and resident’s account is up to date and no other balances are owed because resident pays their rent on time every month. S1 indicated that they are the staff who handles the collection of rent and oversees notifying residents about the yearly increases. Per interviews with S2-S8, it was indicated that S1 handles the collection of rent and informes residents about the rent increase. Interviews conducted with (14) out of (15) residents indicated that facility does not overcharge them for rent and that increases happen once a year. Record review of resident’s ledger indicated, rent for 1/1/24 was paid on time however, the amount was short $73.25, which was the increase amount for the new year of 2024. Record review also indicated that resident’s rent has been paid in full and on time since resident’s initial admission till the present. Interview with (1) resident indicated that resident did receive a letter from the facility dated 10/10/25 informing of the $73.25 balance resident; however, they were confused and not sure why they owed the amount since resident’s rent for 10/1/25 was paid in full and on time. Interviews with staff, residents and record review, do not corroborate the allegation.

Regarding: Staff do not provide residents with a notification letter for the increase of rent.

It is alleged that every December, the facility raises the rent and that each time they raise the rent, they do not give any notice to the residents.

Staff deny the allegation. Interview with S1 revealed that residents receive notification in writing from the facility regarding upcoming increase in their rent. S1 indicated that all resident whether they pay from private funds or through the Assisted Living Waiver (ALW) program, receive notice of the yearly rent increase by letter ahead of time. ***Continues on LIC 9099-C page 2***

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: 3 of 3
Control Number 28-AS-20251023134654
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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The yearly increase takes effect on January of each year and therefore, residents receive notification starting September for residents paying through private funds and November for residents paying rent through the ALW program. S1 indicated that they are the staff who handles the collection of rent and notifying residents about the yearly increases. Per interviews with S2-S8, it was indicated that S1 handles the collection of rent and informs residents about the rent increases. Interviews with R2-R15 indicated that the facility informs them about the yearly rent increase via letter provided to them by S1 and have no concerns about not receiving prior notice about the yearly rent increase. Interview with (1) resident indicated that resident is aware that the facility increases rent every year around December or January; however, resident has not been provided with a letter to indicate the increase. Review of records by LPA indicated that residents who pay rent through private funds received a letter on 9/25/25. Rent increase notification letters have not been generated for residents who pay rent through the ALW program because those notifications are generated until November, according to S1. Interviews with staff, residents and record review do not corroborate the allegation.

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)
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