Inspection Reports for Astoria Park Senior Living

An unannounced required 1-year annual inspection was conducted to evaluate compliance with licensing requirements for the Residential Care for Elderly facility serving residents aged 60 and over, including a Memory Care Unit for cognitively impaired residents.

The inspection found multiple deficiencies including failure to fill certain resident medications, maintenance and cleanliness issues in the Memory Care Unit, missing 'No Smoking-Oxygen In Use' signs in rooms with oxygen tanks, expired or missing staff first aid/CPR training, and lack of mattress pads on most resident beds. Plans of correction were requested with due dates ranging from 10/07/2025 to 11/03/2025.

An unannounced case management visit was conducted to follow up on observations made during a complaint investigation visit on 2025-09-02.

A deficiency was cited due to the licensee's failure to ensure that Resident #2 had routine and as needed medications available, posing an immediate risk to health, safety, and personal rights. Residents reported not needing to ask for the medications, and one resident refused to talk to the Licensing Program Analyst.

The visit was a follow-up to a complaint investigation conducted on 2025-09-02 regarding missing medications for residents.

An unannounced complaint investigation visit was conducted regarding the allegation that staff prohibit a resident from leaving the facility.

The investigation found that resident #1 may not leave the facility unassisted according to a physician's report. Interviews with staff and residents mostly denied the allegation, and the facility offers community outings residents can sign up for. There was insufficient evidence to substantiate the allegation, so it was deemed unsubstantiated. No deficiencies were cited.

The allegation was that staff prohibit resident #1 from leaving the facility. The allegation was unsubstantiated due to lack of preponderance of evidence.

The inspection was an unannounced complaint investigation visit triggered by allegations received on 2025-06-16 regarding staff retaining a resident requiring a higher level of care, failure to transport residents to medical appointments, unmet hygiene needs, lack of dignity in staff-resident relationships, and rough handling of residents.

Based on interviews with staff, residents, and review of records, there was insufficient evidence to substantiate the allegations. Most staff and residents reported that care needs, transportation, hygiene, dignity, and handling were appropriately managed. The allegations were therefore unsubstantiated.

The complaint investigation was unsubstantiated. Allegations included staff retaining a resident needing higher care, failure to transport residents, unmet hygiene needs, lack of dignity, and rough handling. Interviews with six staff and nine residents generally refuted these claims, and no disciplinary actions were noted.

The inspection was an unannounced complaint investigation visit triggered by an allegation received on 2025-04-14 regarding physical and mental abuse of a resident while in care.

The investigation included interviews with the administrator, staff, and residents, and a review of relevant documents. The allegation of abuse was not substantiated due to lack of preponderance of evidence, despite bruises observed on the resident during a shower transfer in March 2025.

The complaint alleged that Resident #1 was physically and mentally abused by two employees on 2025-03-20 at approximately 7 pm. Interviews and investigation did not find sufficient evidence to substantiate the allegation. Staff denied rough handling and reported no prior signs of abuse before police involvement on 2025-04-15.

An unannounced complaint investigation visit was conducted regarding an allegation that facility staff do not ensure a resident eats an adequate amount of food.

The investigation found that although one resident had decreased food intake and required nutritional shakes, staff assisted the resident with meals and physician follow-ups. Interviews with residents and staff supported that meals were provided adequately. Therefore, the allegation was unsubstantiated.

The complaint alleged that facility staff did not ensure a resident ate an adequate amount of food, resulting in malnourishment and muscle wasting. The allegation was found to be unsubstantiated due to lack of preponderance of evidence.

An unannounced case management visit was conducted to follow up on deficiencies observed on 2025-04-03 during a complaint investigation visit related to missing routine medications for three residents.

The facility was found to have deficiencies related to missing routine medications for residents R1, R2, and R3, which posed a potential risk to their health, safety, and personal rights. The deficiency was cited under LIC 809D per Title 22 Regulations.

The visit was a follow-up to a complaint investigation conducted on 2025-04-03, which found missing routine medications for three residents. The deficiency was substantiated and cited.

Unannounced complaint investigation visit conducted due to an allegation that staff administered another resident’s medication to a resident, resulting in the resident being admitted to the hospital.

The investigation substantiated the allegation that staff member S1 administered the wrong medication to resident R1, who was subsequently hospitalized. Interviews and record reviews confirmed medication errors, with corrective actions and in-service training provided to staff. Medication review also revealed that 3 out of 5 residents were missing at least one routine medication.

The complaint was substantiated. Staff administered another resident’s medication to resident R1, resulting in R1 being admitted to the hospital on 03/27/2025. Staff member S1 made the error and received corrective action and training. Medication errors were confirmed through interviews and documentation.

An unannounced complaint investigation visit was conducted in response to multiple allegations received on 2025-01-06 regarding staff response to resident calls, notification of falls and room changes, facility odors, safeguarding belongings, resident privacy, and staff negligence related to a resident fall.

The investigation found no preponderance of evidence to substantiate any of the allegations. Staff were observed and interviewed, and documentation reviewed showed appropriate responses to resident calls, notifications to responsible parties, maintenance of facility cleanliness, safeguarding of belongings, respect for resident privacy, and proper safety precautions related to wheelchair use. All allegations were determined to be unsubstantiated.

The complaint investigation was unsubstantiated. Allegations included failure to respond to resident calls, failure to notify responsible parties of falls and room changes, presence of bad odors, failure to safeguard belongings, lack of resident privacy, and staff negligence leading to a fall. Interviews, observations, and document reviews did not support these allegations.

An unannounced case management - health and safety check visit was conducted regarding the relocation of 2 residents from Foothill Heights Care Center due to mandatory evacuation orders from the Fire Advisory.

No immediate health and safety concerns were observed during the visit. The facility is fully staffed, medications for the relocated residents are centrally stored and inaccessible, and food and hygiene supplies are adequate. The administrator is working on proper placement for a resident with a prohibited health condition.

An unannounced complaint investigation visit was conducted in response to allegations that staff were not properly storing a resident's personal belongings and that staff did not ensure residents' hygiene needs were being met.

The investigation found no preponderance of evidence to substantiate the allegations. Residents' belongings were observed to be properly stored, and residents were assisted with showers at least twice a week with clean bedding observed. Both allegations were determined to be unsubstantiated.

The complaint investigation was unsubstantiated. Allegations included improper storage of resident belongings and failure to meet residents' hygiene needs. Interviews with residents and staff, facility tour, and review of service plans showed compliance with care standards.

An unannounced complaint investigation visit was conducted in response to allegations that staff were not preventing the spread of a communicable disease and were not following infection control requirements.

The investigation found that staff did not consistently follow infection control procedures such as hand hygiene and proper use of PPE, substantiating the allegations. However, the allegation that staff did not report an outbreak to required agencies was found to be unsubstantiated.

The complaint investigation was substantiated for failure to prevent the spread of communicable disease and failure to follow infection control requirements. The allegation that staff did not report the outbreak to required agencies was unsubstantiated.

The visit was an unannounced complaint investigation triggered by an allegation that staff did not prevent inappropriate interactions between residents, including assault and stalking.

The investigation found no evidence of physical abuse or stalking. Staff were aware of the residents' interactions and took steps to supervise and separate them as needed. The allegation was determined to be unsubstantiated due to lack of evidence.

The complaint alleged that staff failed to prevent inappropriate interactions between residents, including assault and stalking. The investigation included interviews with staff, residents, and family representatives, and review of medical and care documents. The allegation was unsubstantiated.

An unannounced complaint investigation was conducted regarding allegations that staff were not preventing the spread of a communicable disease, not following infection control requirements, and did not report an outbreak to required agencies.

The investigation substantiated that staff failed to follow proper infection control procedures including hand hygiene and PPE use, posing risks to residents. However, the allegation that staff did not report the outbreak to required agencies was unsubstantiated as the facility reported the outbreak to Community Care Licensing and the Department of Public Health within required timeframes.

The complaint investigation was substantiated for allegations related to failure to prevent the spread of communicable disease and failure to follow infection control requirements. The allegation that staff did not report the outbreak to required agencies was unsubstantiated.

The inspection was an unannounced complaint investigation visit regarding allegations that staff did not seek medical attention for a resident in a timely manner and that the facility van was not accessible for residents to get in.

The investigation substantiated that staff delayed obtaining emergency medical attention for resident #1 by about an hour after an injury sustained while entering the facility van, posing an immediate personal right, health, or safety risk. The allegation that the facility van was not accessible for residents to get in was unsubstantiated, as the van and its equipment were found to be in good repair and appropriate steps were used.

The complaint alleged that staff did not seek medical attention for resident #1 in a timely manner after the resident injured their knee while entering the facility van on 8/1/2024. The investigation found a delay of about an hour in obtaining emergency services, substantiating the allegation.

The visit was an unannounced complaint investigation conducted in response to allegations including questionable deaths, inadequate food service, and staff not meeting residents' needs at Astoria Park Senior Living Facility.

The investigation found no preponderance of evidence to substantiate the allegations. Two resident deaths were reviewed and determined to be sudden but not preventable by staff care. The facility was found to provide meals according to residents' dietary needs, including vegan meals, and residents reported satisfaction with care and assistance, including wheelchair and dining support.

The complaint investigation addressed allegations of questionable deaths, inadequate food service, and staff not meeting residents' needs. The investigation included interviews with residents, staff, and family members, review of incident and physician reports, and facility observations. All allegations were found to be unsubstantiated.

The visit was an unannounced case management inspection regarding an incident report submitted on 2024-09-11 about a resident who eloped from the memory care unit on 2024-08-31.

The licensee failed to ensure that resident #1 did not elope from the facility, posing an immediate risk to the health, safety, and personal rights of the persons in care. Staff were unaware that the resident had left the memory care unit, and corrective actions including staff training and warnings were implemented.

The visit was triggered by a complaint/incident report regarding resident #1 eloping from the memory care unit on 2024-08-31. The complaint was substantiated as deficiencies were cited.

An unannounced complaint investigation visit was conducted in response to multiple allegations including failure to prevent a resident's fracture, hazardous conditions causing injuries, facility disrepair, failure to follow physician's orders, and interference with resident's sleep.

The investigation found no preponderance of evidence to substantiate any of the allegations. The facility was found to be safe with no hazardous conditions, the showers and A/C were in working condition, physician's orders were followed appropriately, and staff responded to resident concerns about sleep disturbances.

The complaint investigation was unsubstantiated for all allegations including failure to prevent resident injury, hazardous conditions, facility disrepair, failure to follow physician's orders, and interference with resident's sleep.

An unannounced annual continuation inspection visit was conducted to evaluate compliance with various regulatory domains including infection control, staffing, medical care, and resident rights.

The inspection found a deficiency related to medication labeling where prescribed medication for resident #3 did not have labels, posing a potential health and safety risk. Other domains such as infection control, staffing, and disaster preparedness were reviewed without noted deficiencies.

An unannounced complaint investigation visit was conducted regarding allegations that staff were not preventing the spread of COVID-19.

The investigation included interviews with staff and residents, review of documents, and a facility tour. Although some staff and residents were observed without masks, the recent rescission of the mask order in Pasadena was noted. The allegation was found to be unsubstantiated due to insufficient evidence.

The complaint alleged that staff were not preventing the spread of COVID-19. The allegation was unsubstantiated after investigation, with 10 of 12 residents and 5 of 5 staff denying the allegation. The COVID outbreak was not reported per the 24-hour reporting requirement, which will be addressed in a separate case management report.

The visit was conducted as a case management investigation related to complaint control #28-AS-20240905092935 concerning the facility's failure to report a Covid-19 outbreak within the required 24-hour timeframe.

The facility failed to notify the Department of the Covid-19 outbreak within the 24-hour reporting requirement, as multiple residents tested positive several days before the report was sent. This deficiency was documented and cited under regulation LIC809-D.

Complaint control #28-AS-20240905092935 was investigated and substantiated based on the facility's failure to report the Covid-19 outbreak within the required timeframe.

An unannounced complaint investigation visit was conducted regarding an allegation that staff handled a resident in a rough manner.

The investigation substantiated that staff member S1 assisted resident R2 aggressively, causing R2 to scream in pain due to rough handling while placing the resident's leg in the wheelchair footrest. S1 was suspended and subsequently terminated for suspected abuse. No physical injuries were caused to the resident.

The complaint was substantiated. The allegation was that staff handled a resident in a rough manner. Evidence included incident reports, staff and resident interviews, and internal investigation. Staff member S1 was suspended and terminated following the investigation. No physical injuries were found. The Pasadena Police Department conducted a visit and filed a report.

An unannounced annual inspection visit was conducted using the CARE inspection tool to evaluate compliance with licensing regulations at the facility.

The facility was found to be in good repair with sufficient food supplies and proper safety measures in place. However, a deficiency was noted regarding the storage of a cleaning solution accessible to residents in a memory care unit room, posing a safety risk.

The visit was an unannounced case management inspection triggered by incident reports submitted on 08/06/2024 and 08/08/2024 regarding allegations of physical abuse by staff towards residents and a choking incident requiring Heimlich maneuver assistance.

The investigation substantiated physical abuse by staff member S1 towards two residents in the memory care unit, resulting in a deficiency citation. No injuries were caused, but the staff member was suspended and terminated. A separate choking incident was handled promptly with no deficiencies noted.

The complaint investigation was substantiated regarding physical abuse by staff member S1 towards two residents (R1 and R2) in the memory care unit. The facility conducted an internal investigation, suspended, and terminated the staff member. Police department conducted a visit and filed report #PA24-61517.

The inspection was an unannounced case management visit triggered by an incident report submitted on 2024-03-07 regarding a resident who eloped the facility on 2024-03-04.

The facility failed to prevent resident #1 from eloping through an emergency exit door despite the delay egress system working. The resident sustained a minor head laceration and was hospitalized briefly. Deficiencies were cited related to insufficient staffing to meet resident needs and failure to prevent elopement, posing immediate risk to resident safety.

The visit was complaint-related due to an incident where resident #1 eloped the facility by exiting through an emergency exit door and climbing over a parking gate. The incident was substantiated by video footage and staff interviews.

The visit was an unannounced case management inspection conducted in response to an incident report submitted on 2024-02-21 regarding a resident elopement from the memory care unit.

The inspection found that a resident with dementia eloped from the memory care unit by climbing over a fenced door. The facility had a plan of care for the resident and was in the process of hiring additional staff. However, an obstruction was noted in the passageway leading to the exit door from the courtyard, resulting in a cited deficiency.

The visit was triggered by a complaint incident report of a resident elopement from the memory care unit on 2024-02-21. The complaint was substantiated by observation and review of video surveillance.

The inspection visit was conducted as an unannounced complaint investigation in response to an allegation that staff unlawfully evicted a resident.

The investigation found that resident #1 was not given the required 30 days written eviction notice before leaving the facility. It was determined that resident #1 required a higher level of care not initially identified at admission, and the facility did not feel the resident should return after hospital discharge. The allegation was substantiated and deficiencies were cited.

The complaint alleged that staff unlawfully evicted resident #1. The allegation was substantiated based on record review and interviews. Resident #1 moved in on 11/21/2023 and left on 12/4/2023 without receiving a 30-day eviction notice. The facility determined resident #1 required a higher level of care and should not return after hospital discharge.

The visit was an unannounced case management follow-up to an incident report submitted on 2023-12-07 regarding a resident who left the facility unattended.

The Licensing Program Analyst found that the resident had left the facility unattended twice as allowed by a physician's report, but due to concerns about the resident's dementia diagnosis and decision-making capacity, the facility will obtain a reassessment and submit updated documentation by 2023-12-18. No deficiencies were noted during the visit.

The inspection was an unannounced complaint investigation visit triggered by an allegation that staff did not prevent a resident from being sexually abused while in care.

The investigation found that a male resident allegedly inappropriately touched a female resident in an elevator. Surveillance video and interviews were reviewed, but due to cognitive impairments and lack of sufficient evidence, the allegation was determined to be unsubstantiated.

The complaint alleged that staff failed to prevent sexual abuse of a resident. The investigation included interviews with residents and staff, review of surveillance footage, and contact with the police department. The allegation was unsubstantiated due to insufficient evidence.

The inspection was an unannounced complaint investigation visit triggered by allegations received on 03/28/2023 regarding inadequate care and supervision, staff blocking doorways to prevent residents from leaving, and other resident care concerns at Astoria Park Senior Living Facility.

The investigation substantiated that staff did not provide adequate care and supervision, including residents exiting the memory care unit unattended and a blocked exit door with a non-functioning egress system. Other allegations such as staff leaving residents soiled, use of inappropriate language, and staff behavior posing risk were found unsubstantiated based on interviews and observations.

The complaint investigation was substantiated for allegations that staff did not provide adequate care and supervision, including residents exiting the memory care unit unattended and blocked exit doors. Other allegations regarding staff leaving residents soiled, inappropriate language, and risky staff behavior were unsubstantiated.

An unannounced case management visit was conducted during a complaint investigation related to complaint #28-AS-20230328095738.

Two deficiencies were noted: failure to report an incident involving a resident leaving the facility unattended within 7 days, and failure to provide an annual medical assessment and care plan for a dementia resident who eloped.

Complaint #28-AS-20230328095738 was investigated, with findings delivered on 10/19/23. The complaint involved a resident leaving the facility unattended and lack of proper reporting and care planning.

The visit was an unannounced case management inspection triggered by an incident report submitted on 2023-10-02 regarding a resident who reportedly jumped from a bedroom window.

The investigation found that Resident #1 jumped from a window but had no documented history or recent indications of suicidal tendencies. Staff responded promptly, and the resident was hospitalized. No deficiencies were noted during the visit.

The visit was conducted due to an incident report alleging Resident #1 jumped from a window. The complaint was investigated through staff interviews, file review, and observation. No substantiated deficiencies or violations were found.

Licensing Program Analyst Mary Flores conducted an unannounced annual visit at the facility using the CARE tool to evaluate compliance with regulations and licensing requirements.

The inspection identified multiple deficiencies including unsecured disinfectant sprays in the dementia unit, lack of TB clearance and health screenings for some staff, expired CPR/First Aid training, maintenance issues such as a clogged toilet and water damage, obstructed passageways, and an outdated emergency disaster plan. Plans of correction were required for all deficiencies.

The inspection was an unannounced complaint investigation visit triggered by an allegation that a resident was hit with an object by an unknown perpetrator resulting in a fracture.

The investigation found that although the resident did sustain a sternal fracture and initially identified a perpetrator, there was no preponderance of evidence to support that anyone inflicted the injury. The allegations were therefore unsubstantiated.

The complaint alleged that a resident was assaulted by another resident resulting in a fracture. The investigation included interviews with staff and review of video footage, hospital and police reports. The evidence did not substantiate the allegation.

The visit was a case management follow-up to verify corrections needed from a pre-licensing visit conducted on 2022-09-12.

The facility corrected previously noted issues including fixing a loose outlet cover plate, repairing a hole in a wall, maintaining water temperatures within required ranges, and ensuring skid strips were present in bathrooms. Medication storage issues were resolved with updated physician documentation.

An announced pre-licensing visit was conducted to evaluate the facility for licensing purposes and ensure compliance with regulations.

The facility was generally observed to be in good repair with clean and sanitized areas, sufficient food supplies, and proper infection control protocols. However, several deficiencies were noted including loose outlet cover plates, holes in walls, water temperatures not maintained within required range, missing skid strips/mats in some bathrooms, and medication stored in resident rooms.

The visit was conducted as part of a Change of Ownership (CHOW) application process involving a telephone call with the Community Care Licensing analyst to verify applicant and administrator identity and confirm understanding of licensing requirements.

The applicant and administrator successfully completed Component II of the licensing process, demonstrating understanding of facility operation, staff qualifications, program policies, grievance procedures, and physical plant requirements. Technical assistance was provided regarding application documents and certifications.