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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603535
Report Date: 02/05/2026
Date Signed: 02/05/2026 01:56:47 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
02/03/2026 and conducted by Evaluator Christian Gutierrez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260203102212
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: 146DATE:
02/05/2026
UNANNOUNCEDTIME BEGAN:
08:33 AM
MET WITH:Jacqueline CortezTIME COMPLETED:
02:13 PM
ALLEGATION(S):
1
2
3
4
5
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7
8
9
Staff yell at residents
INVESTIGATION FINDINGS:
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5
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13
Licensing Program Analyst (LPA) Christian Gutierrez conducted an unannounced complaint investigation visit regarding above allegations. LPA met with Administrator Jackie Cortez and explained the reason for the visit.

The investigation consisted of the following: LPA requested a copy of resident roster and staff roster. LPA obtained staff #4 (S4) file and completed a record review. LPA Gutierrez interviewed Administrator, staff 1-9 (S1-S9), residents 1-11 (R1-R11), and delivered findings.


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

DATE: 02/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2026
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-20260203102212
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: 02/05/2026
NARRATIVE
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In regard to the allegation “Staff yell at residents “, It is alleged that S4 yelled at R1 for telling him/her how to do their job about taking care of their roommate R5 and R1 felt threatened when being told that. During interviews with Administrator and staff ten (10) out of ten (10) staff stated that they have never yelled at residents. Administrator stated R1 did voice their concerns to the front desk about that particular staff and that S4 was spoken to about the alleged incident and denied allegation. S4 stated that he/she never yells at the residents and on that particular day S4 was explaining to R1 that he/she knows how to take care of R5 and that R1 did not like that. S4 believes that R1 wants the room to his/herself therefore complains when staff doesn’t take R5 out of the room right away. During interviews with residents one (1) resident was confused and could not answer any questions, and six (6) out of (11) residents stated that staff has not yelled at them and they have never witnessed staff yelling at other residents. R7 stated that they do hear residents yelling and being aggressive toward staff and that if a resident is cussing at S4 he/she will throw up their hands and say, “I’m done and walk away”. R4 stated that staff is good and has no problems with them. Review of S4’s staff records indicated that S4 does not have any write-ups or disciplinary actions on file for not speaking to residents in a respectful manner or any other misconduct.

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 provided.

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

DATE: 02/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2