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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603535
Report Date: 04/30/2026
Date Signed: 04/30/2026 05:22:51 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
04/27/2026 and conducted by Evaluator Noemi Galarza
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260427112401
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:
04/30/2026
UNANNOUNCEDTIME BEGAN:
12:28 PM
MET WITH:Alisa Dean, Assistant AdministratorTIME COMPLETED:
05:20 PM
ALLEGATION(S):
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Staff did not seek medical attention for resident in a timely manner.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Galarza conducted a subsequent complaint visit to investigate the above allegations. The purpose of the visit was discussed with Assistant Administrator Alisa Dean.


The investigation consisted of the following: On 4/28/26 and today a physical plant inspection of common areas and indoor/outdoor area was completed. Record review and copies of relevant documents were obtained. A total of 14 residents and 9 staff were interviewed.

*Pending: Sunday, April 26, 2026, timesheets were not provided due to corrections needed.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2026
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 5
Control Number 28-AS-20260427112401
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: SANTA ANITA ASSISTED LIVING
FACILITY NUMBER: 198603535
VISIT DATE: 04/30/2026
NARRATIVE
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Allegation: Staff did not seek medical attention for resident in a timely manner. The complaint alleges that residents (R1 & R2) engaged in a physical fight that resulted in injuries in both residents that required medical attention i.e. 1st Aid care and the residents did not receive any care because there were no AM med-techs on duty on Sunday April 26, 2026. The alleged incident occurred between 6:30 AM- 7:00 AM. NOC shift med-techs are off at 6:00 AM. A total of 14 residents were interviewed. Residents stated staff typically evaluate and provide care on site if there are minor injuries, and residents are sent out for medical attention if needed. Both residents (R1 & R2) confirmed they sustained injuries that resulted in bleeding. Resident (R1) was injured in the right eyebrow area and R2 had face injuries near the upper lip and right arm area. Staff interviews revealed that there were no med-techs working the morning shift on 4/26/2026. Therefore, residents (R1 & R2) did not receive 1st Aid medical attention at the facility. When residents have minor abrasions or minor open wounds med-techs apply saline solution, A & D ointment, and bandage the affected area(s). However, since all of the med-techs scheduled that day did not show up to work, and the facility currently does not have a Wellness Director that would have evaluated resident (R1 & R2's) injuries, neither resident receive 1st Aid care and/or medical attention in a timely manner. The Administrator and Assistant Administrator arrived at the facility several hours later because there were no med-techs working the morning shift. The residents did not receive timely 1st Aid care for their injuries.

Based on record review and interviews conducted the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Pursuant to Title 22, California Code of Regulations, a deficiency was cited.

An exit interview conducted with Assistant Administrator Alisa Dean. Due to printing issues the report was emailed.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 28-AS-20260427112401
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: SANTA ANITA ASSISTED LIVING
FACILITY NUMBER: 198603535
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/30/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/21/2026
Section Cited
CCR
87465(j)
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Incidental Medical and Dental Care. In all facilities licensed for sixteen (16) persons or more, one or more employees shall be designated as having primary responsibility for assuring that each resident receives needed first aid and needed emergency medical services and for assisting residents as needed with self-administration of medications......This requirement was not met evidenced by:
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Assistant Administrator agreed to submit:
1. A written plan of correction that addresses personnel shortages, staff schedules, and staff responsibilities.

2. In-service training
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Based on interviews, the findings indicate that on Sunday, April 26, 2026, residents (R1 & R2) had a physical fight that resulted in minor injuries with bleeding that required 1st Aid, but since there were no med-tech working the morning shift they did not receive care. This poses a potential health, safety, and personal rights risk.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
04/27/2026 and conducted by Evaluator Noemi Galarza
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260427112401

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:
04/30/2026
UNANNOUNCEDTIME BEGAN:
12:28 PM
MET WITH:Alisa Dean, Assistant AdministratorTIME COMPLETED:
05:20 PM
ALLEGATION(S):
1
2
3
4
5
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7
8
9
Staff do not provide a safe environment for residents in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Galarza conducted a subsequent complaint visit to investigate the above allegations. The purpose of the visit was discussed with Assistant Administrator Alisa Dean.


The investigation consisted of the following: On 4/28/26 and today a physical plant inspection of common areas and indoor/outdoor area was completed. Record review and copies of relevant documents were obtained. A total of 14 residents and 9 staff were interviewed.

*Pending: Sunday, April 26, 2026, timesheets were not provided due to corrections needed.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 28-AS-20260427112401
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: SANTA ANITA ASSISTED LIVING
FACILITY NUMBER: 198603535
VISIT DATE: 04/30/2026
NARRATIVE
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Allegation: Staff do not provide a safe environment for residents in care. It is alleged that on Sunday April 26, 2026, resident (R1) "slugged" resident (R2) causing a laceration in the eyebrow, lip, and arm. The complaint alleges staff are aware of resident behaviors that pose a risk to residents in care but the aggressive incidents are not addressed. According to information obtained, R1 has frequent aggressive behaviors towards other residents that lead to confrontations. It was also reported that there is a male resident that enters without consent the rooms of "vulnerable" females. A total 14 residents were interviewed. 11 out of 14 stated they feel safe, but acknowledged there are some residents that have aggressive behaviors due to mental disabilities. Residents confirmed the altercation/fight. Residents did not report knowledge of an alleged male entering female rooms. The alleged male was interviewed and stated they are invited into the rooms. A total of 9 staff were interviewed. The majority of staff stated the facility is safe. Interviews revealed that the resident altercation occurred between 6:30 AM- 7:00 AM, in the hallway outside the dining room. Resident (R1) hit R2's wheelchair and leg, and punched R2 in the face. Resident (R2) defended themselves and punched R1 back. Both residents sustained minor injuries that resulted in lacerations that bled. Kitchen staff notified staff via walkie-talkie of the incident. Resident (R2) called police later because staff did not notify law enforcement. Staff stated they did not call the police because R2 had already called the police. Due to insufficient information, the allegation cannot be supported.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is Unsubstantiated.

Exit interview conducted with Assistant Administrator Alisa Dean. Due to printing issues the report was emailed.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5