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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603748
Report Date: 02/05/2026
Date Signed: 02/05/2026 01:45:09 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
01/30/2026 and conducted by Evaluator Blanca Gonzalez
COMPLAINT CONTROL NUMBER: 28-AS-20260130151913
FACILITY NAME:ST MATTHEW'S HOME FOR THE ELDERLY VFACILITY NUMBER:
198603748
ADMINISTRATOR:MCGEE, TERRYFACILITY TYPE:
740
ADDRESS:1044 CLARADAY STTELEPHONE:
(626) 222-2664
CITY:GLENDORASTATE: CAZIP CODE:
91740
CAPACITY:6CENSUS: 4DATE:
02/05/2026
UNANNOUNCEDTIME BEGAN:
09:01 AM
MET WITH:House Manager Barbara BoistonTIME COMPLETED:
01:55 PM
ALLEGATION(S):
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Staff do not allow resident to go outside of facility
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Blanca Gonzalez conducted an unannounced initial 10-day complaint investigation visit regarding the above allegation. LPA Gonzalez was greeted by staff, and the purpose of the visit was explained. House Manager Barbara Boiston arrived shortly after.

The investigation consisted of the following: LPA Gonzalez requested copies of Personnel Roster, Resident Roster, and the following documents for R1: Admission Agreement, physician’s report, Resident Pre-Appraisal, Functional needs and service plan. LPA toured the facility physical plant tour, interviewed staff #1-3 (S1- S3) and interviewed residents #1-3 (R1-R3).
continued on LIC9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Blanca Gonzalez
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-20260130151913
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: ST MATTHEW'S HOME FOR THE ELDERLY V
FACILITY NUMBER: 198603748
VISIT DATE: 02/05/2026
NARRATIVE
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Regarding allegation “Staff do not allow resident to go outside of facility.”
It was reported that R1 asked to go outside the last few days and staff did not allow R1 to go outside. The investigation revealed 3 out of 3 staff deny the allegation. S3 stated R1 was asked by staff to wait, as staff had been assisting other residents, before S3 walked outside with R1. S1 and S2 stated they will walk outside with R1 a couple of times a day. Interviews with residents revealed 2 out of 3 residents interviewed stated staff do not deny residents requests to go outside, staff are great and staff are helpful. Residents are not denied stepping outside if they want. R1 stated S1 did not let R1 go outside but could not confirm when nor number of times R1 was not allowed outside by S1.

Based on interviews, record review and observations, although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

An exit interview was conducted, and a copy of this report was provided.
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Blanca Gonzalez
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