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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197602925
Report Date: 09/10/2026
Date Signed: 09/10/2026 06:53:46 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
09/10/2026 and conducted by Evaluator Mayra Cota
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260910112755
FACILITY NAME:ARBOR VISTAFACILITY NUMBER:
197602925
ADMINISTRATOR:COMMODORE, KIMFACILITY TYPE:
740
ADDRESS:811 E Washington BLVDTELEPHONE:
CITY:PasadenaSTATE: CAZIP CODE:
911045013
CAPACITY:69CENSUS: 42DATE:
09/10/2026
UNANNOUNCEDTIME BEGAN:
03:25 PM
MET WITH:Kim Commodore, AdministratorTIME COMPLETED:
07:00 PM
ALLEGATION(S):
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 Facility staff do not maintain a comfortable temperature for residents at all times.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Mayra Cota, conducted an unannounced 10-day complaint visit to investigate the above-mentioned allegation. LPA met with Kim Commodore, Administrator and the reason for the visit was explained.

The investigation consisted of the following:

LPA obtained copies of staff and resident rosters, toured the common areas of the facility and inspected and took temperatures for resident rooms, 40, 46, 47, 48, 49, 53, 54, and 55 and interviewed Staff 1 - Staff 2 (S1-S2) and Resident 1 – Resident 6 (R1-R6). LPA also obtained copies of AC repair estimate dated 8/26/2026.

The investigation revealed the following:
***Continues on LIC 9099-C***

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Mayra Cota
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026
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-20260910112755
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: ARBOR VISTA
FACILITY NUMBER: 197602925
VISIT DATE: 09/10/2026
NARRATIVE
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Regarding: Facility staff do not maintain a comfortable temperature for residents at all times.
It is alleged that the air conditioner has not been working for three weeks and that the thermostat in the hallway was observed at 91 degrees F.

Interviews with S1 and S2 revealed that the facility’s air conditioner is currently not working and malfunctioned as of Tuesday, September 8, 2026. Staff indicated that the area affected is the wing toward the back of the facility in which rooms 40-55 are located. Staff acknowledge that even with the individual AC units and fans running in resident rooms, the temperature has measured “in the 90s.” Staff indicated that a vendor has checked the AC unit and has ordered parts to proceed with repairs; however, staff could not indicate an estimated time for delivery of the parts and when repairs will begin and end. Per review of the vendor estimate, AC disrepair was assessed on 8/26/2026 which indicated that the facility has been without a working AC unit for a total of 15 days. No other records such as work and purchase orders or documents noting repairs were provided.
Maintenance staff (S2) facilitated temperature checks with LPA for (8) resident rooms using the facility’s infrared thermometer and temperature measured within 87 – 98.5 degrees F which is not within the compliance range of 78 – 85 degrees F. LPA observed that the hallway thermometer indicated a temperature of 89 degrees F. during tour of the back wing for the facility. Interviews with (5) out of (6) residents indicated that their rooms have been hotter than usual and have to stay within the range of their fan or individual AC unit to get relief from the heat in their room. Residents were unable to provide an exact date of when the AC stopped working; however, they stated that the AC has not been working for approximately a week. One (1) resident stated that they AC has not been working for three weeks. There is an extreme heat advisory warning in Los Angeles County which is an immediate health and safety risk for residents in care.
This week’s severe heat advisories, interviews and observations corroborate the allegation that facility does not maintain a comfortable temperature at all times. The preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations (Title 22), is being cited on the attached LIC 9099 D. An exit interview was conducted, and a copy of this report and Appeal Rights was provided.

SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Mayra Cota
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20260910112755
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: ARBOR VISTA
FACILITY NUMBER: 197602925
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/10/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/11/2026
Section Cited
CCR
87468.1(a)(2)
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87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement is not met as evidenced by:
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Licensee will proceed to offer residents once again, to be moved to the vacant rooms not affected by the AC malfunction and also offer additional indivudual AC units. Licensee will also provide a plan to find a vendor who can expedite repairs on the AC unit as soon as possible. Plan will be emailed to LPA by POC due date.
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The air conditioner in the facility is not working. Eight (8) resident rooms inspected measured within 87 – 98.5 degrees F which is not within the compliance range of 78 – 85 degrees F. Staff could not indicate an estimated time for delivery of the AC parts and when repairs will begin and end. Five (5) out of (6) residents indicated that their rooms have been hotter than usual and AC has not been working for about a week which poses an immediate health and safety risk for 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.
SUPERVISOR'S NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Mayra Cota
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026
LIC9099 (FAS) - (06/04)
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