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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603885
Report Date: 09/04/2026
Date Signed: 09/04/2026 04:17:52 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
09/02/2026 and conducted by Evaluator Gabriela Castro
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260902151909
FACILITY NAME:DIGNITY FIRST ASSISTED LIVING FACILITYFACILITY NUMBER:
198603885
ADMINISTRATOR:HALLADJIAN,PAULINEFACILITY TYPE:
740
ADDRESS:1016 EAST LEADORA AVETELEPHONE:
(626) 376-6144
CITY:GLENDORASTATE: CAZIP CODE:
91741
CAPACITY:6CENSUS: 3DATE:
09/04/2026
UNANNOUNCEDTIME BEGAN:
08:53 AM
MET WITH:Pauline Halladjian, Admin & Kevork Halladjian, Licensee TIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Staff do not safeguard residents personal belongings.
Staff are not providing an authorized representative access to a resident's records.
Staff does not ensure resident's personal finances are safeguarded.
Staff did not provide authorized representative with an admissions agreement.
Resident was over medicated by facility staff.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Gabriela Castro conducted an unannounced complaint visit on 09/04//2026 to deliver findings related to the above allegations. LPA met with Pauline Halladjian, Admin & Kevork Halladjian,Licensee explained the purpose of the visit, and was granted entry to the facility.

The investigation included a review of the resident roster, staff roster, R1’s Face Sheet, Physician’s Report, hospice agreement, unsigned Admission Agreement dated 08/21, Medication Administration Record (MAR), personal belongings pickup/receipt, and Special Incident Report (SIR) regarding R1’s hospitalization. LPA conducted interviews with four (4) staff members (S1–S4) and one (1) witness (W1).LPA attempted to interview three (3) residents; however, due to medical conditions, cognitive limitations, and language barriers, LPA was unable to obtain meaningful statements from the residents.Additionally, LPA toured the facility and observed resident bedrooms, bathrooms, common areas, kitchen, medication storage area, exterior grounds, swimming pool area, and general facility conditions.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Gabriela Castro
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2026
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-20260902151909
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: DIGNITY FIRST ASSISTED LIVING FACILITY
FACILITY NUMBER: 198603885
VISIT DATE: 09/04/2026
NARRATIVE
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Allegation: Staff do not safeguard residents’ personal belongings.
It is alleged that facility staff failed to safeguard R1’s personal belongings. Specifically, concerns were raised that an individual may have had access to R1’s personal belongings and/or personal documents without verified authorization. It was further alleged that the individual may have obtained permission from R1 to access R1’s private residence for the purpose of retrieving personal documents and manuscripts. Review of the facility’s visitation logs did not identify any record indicating that the individual in question visited R1 while R1 resided at the facility. During interviews, staff reported they were unaware of R1 providing the individual authorization to access R1’s private residence and/or personal documents. Staff further reported no knowledge of the individual accessing or removing R1’s belongings from the facility. Records reviewed indicated that R1 was admitted to the facility on 08/21/2026 and was hospitalized on 08/23/2026. R1 did not return to the facility following the hospitalization. S1 reported visiting R1 at the hospital on 08/24/2026 at approximately 5:04 p.m. S1 stated that R1’s relative was present during the visit and that R1 provided S1 with verbal authorization to allow the relative to retrieve R1’s belongings from the facility. S1 reported that R1’s belongings were released to the relative based on R1’s authorization. The facility’s Personal Belongings Pick-Up Receipt documented that on 08/26/2026, R1’s relative retrieved R1’s belongings, which included a cellular phone, keys, clothing provided by the facility, and paperwork/documents.

Allegation: Staff are not providing an authorized representative access to a resident’s records.
It is alleged that facility staff failed to provide R1’s authorized representative access to R1’s records. Specifically, concerns were raised that R1’s authorized representative requested access to R1’s facility records and was not provided the requested documentation. During the interview, S1 reported that since becoming acquainted with R1, S1 was not aware of R1 having a Power of Attorney (POA). S1 stated that R1 coordinated R1’s own placement at the facility based on a recommendation from a friend. During record review, LPA did not observe documentation identifying a POA or other legally authorized representative for R1. Additionally, W1 reported that records available to W1 identified R1’s relative as a designee and/or emergency contact only and did not identify the relative as R1’s POA.

Allegation: Staff does not ensure resident’s personal finances are safeguarded.


It was alleged that facility staff failed to safeguard R1’s personal finances. Specifically, concerns were raised that an individual may have been involved in R1’s financial affairs and may have had access to R1’s finances and/or financial information without verified authorization. During interviews, staff reported they were not aware of any concerns regarding R1’s personal finances, as R1 had not expressed any financial concerns to staff. Staff also reported they were unaware of any concerns or suspicions involving a specific individual having access to or involvement with R1’s finances. S1 reported that R1 had agreed with the facility to pay for R1’s stay and services provided by the facility. However, R1 resided at the facility from 08/21/2026 through 08/23/2026, when R1 was hospitalized and did not return to the facility. S1 reported that the facility did not receive any payment from R1 for the stay or services provided..
(continued on 9099C)
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Gabriela Castro
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20260902151909
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: DIGNITY FIRST ASSISTED LIVING FACILITY
FACILITY NUMBER: 198603885
VISIT DATE: 09/04/2026
NARRATIVE
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Allegation: Staff did not provide authorized representative with an Admission Agreement.

It is alleged that facility staff failed to provide R1’s authorized representative with a copy of R1’s Admission Agreement. Specifically, concerns were raised that R1’s representative was not provided a copy of the Admission Agreement following R1’s admission to the facility. During interviews, S1 and S2 reported that R1 signed R1’s own hospice agreement with Kaiser prior to placement at the facility. S1 and S2 further reported that R1 did not provide documentation or indicate that R1 had a Power of Attorney (POA). Staff reported that R1 arranged R1’s own admission to the facility and was expected to review and sign the Admission Agreement. S1 and S2 reported that they were never asked by R1’s relative, representative, or any other individual to provide R1’s Admission Agreement, resident records, or any other documentation pertaining to R1. S1 reported that R1 arrived at the facility late on 08/21/2026. On 08/22/2026, R1 was resting and indicated the Admission Agreement would be signed at a later time. On 08/23/2026, R1 experienced a change in condition and was hospitalized before the Admission Agreement was signed. R1 did not return to the facility following the hospitalization. S1 provided LPA with R1’s Admission Agreement. LPA observed that the agreement was unsigned. During record review, LPA did not observe documentation identifying a POA or other authorized representative for R1. Additionally, W1 reported that the records available to W1 did not identify or contain documentation of a POA for R1. LPA also obtained and reviewed a copy of the hospice agreement, which contained R1’s signature.


Allegation: Resident was overmedicated by facility staff.

It is alleged that R1 was overmedicated by facility staff. Specifically, concerns were raised that R1 may have received excessive medication while residing at the facility, resulting in a change in R1’s condition, including becoming nonverbal and unresponsive, which subsequently resulted in R1 being transported to the hospital for further medical evaluation. S2 reported that when R1 was admitted to the facility on 08/21/2026, R1 arrived without medications. S1 and S2 reported that R1 was upset and requesting R1’s medications. S1 reported that on Saturday, 08/22/2026, S1 went to Kaiser in Baldwin Park to obtain R1’s prescribed medications. Staff reported that the facility did not obtain R1’s medications until later in the day on 08/22/2026, at which time the facility updated R1’s MAR and documented the medications provided to R1. During record review, LPA reviewed R1’s Medication Administration Record (MAR) for 08/22/2026, as R1 arrived at the facility late on 08/21/2026. LPA observed that medications documented on the MAR were administered in accordance with the orders available for review. During interviews, staff reported assisting R1 with medications as prescribed. A copy of R1’s MAR and corresponding physician’s medication orders were provided to LPA for review. S2 reported that on 08/23/2026, after R1 was transported to the hospital, an attending emergency room physician contacted S2 because the hospital did not have R1’s medication orders and needed information regarding R1’s prescribed medications. S2 stated that the facility provided the physician with the available medication orders and medication log documenting the medications administered to R1. According to S2, during the conversation, the emergency room physician stated that Kaiser had been overmedicating R1.


Based on the investigation conducted, which included interviews with staff and witness, as well as a review of relevant records, there was insufficient evidence to support the reported allegation. 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 was held, and a copy of this report was provided.
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Gabriela Castro
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3