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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603535
Report Date: 05/14/2026
Date Signed: 05/14/2026 05:34:31 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
04/27/2026 and conducted by Evaluator Gabriela Castro
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260427120552
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:
05/14/2026
UNANNOUNCEDTIME BEGAN:
09:28 AM
MET WITH:Alisa Dean, Administrator TIME COMPLETED:
10:20 AM
ALLEGATION(S):
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Facility staff did not dispense medications as prescribed.
INVESTIGATION FINDINGS:
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***This report supersedes the report dated 05/05/26 and was updated to correct the regulation cited on the deficiency page. No other changes were made, and the report findings remain unchanged.***

Licensing Program Analyst (LPA) Gabriela Castro conducted an unannounced complaint visit on 05/05/2026 to deliver findings related to the above allegation. LPA met with Administrator Jacky Cortez and explained the purpose of the visit.

The investigation included a review of the client roster, staff roster, medication technician and caregiver schedules, Medication Administration Record (eMAR) for the specified date, including medication review. LPA conducted interviews with nine (9) staff members and ten (10) residents.
A facility walkthrough was conducted, including observation of resident bedrooms, common areas, medication storage areas, and other areas accessible to residents.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Gabriela Castro
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2026
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 3
Control Number 28-AS-20260427120552
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: 05/14/2026
NARRATIVE
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Allegation: Facility staff did not dispense medications as prescribed

It is alleged that there were no personnel on-site to administer the daily morning medications to residents. During staff interviews, multiple staff reported that scheduled medication technicians (med techs) were not present at the start of the morning shift due to no-call/no-shows. Staff stated that residents inquired about their medications and that medication administration was delayed until additional staff arrived to provide coverage, resulting in a delay in the morning medication administration window. During resident interviews, residents reported that medication technicians (med techs) were not available and that the Administrator and Assistant Administrator provided coverage and administered medications. Residents stated that medications were administered late. A review of the Medication Administration Records (eMARs) indicated that medications were administered outside of the morning medication window of 7:00 a.m. to 9:00 a.m. Documentation reflected that medications were administered between approximately 9:30 a.m. and 12:30 p.m. A medication review was conducted, and medications were observed to be on hand at the facility.


Based on LPA's observations and interviews which were conducted and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6 and Chapter 1 are being cited on the attached LIC 9099D.
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Gabriela Castro
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20260427120552
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/14/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/19/2026
Section Cited
CCR
87465(a)(4)
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(a) A plan for incidental medical ... care shall be developed by each facility. The plan shall encourage routine medical care and provide assistance in obtaining such care, by compliance with the following:
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Administrator shall submit a written plan by the POC due date outlining how medication administration training will be provided to staff to ensure compliance. Administrator shall provide proof of completed training, including sign-in sheets and training curriculum, to the Department by 05/19/2026.
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(4) The licensee shall assist residents with self-administered medications as needed.

This requirement is not met as evidenced by: Based on observation, interviews, and record review, the licensee did not comply with the cited section, as the facility failed to ensure timely administration of morning medications as prescribed on 4/26/26. This deficiency poses an immediate risk to the health, safety, and personal rights of residents in care.
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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: David Sicairos
LICENSING EVALUATOR NAME: Gabriela Castro
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3