197608505-3-26-2025-31-AS-NMAN-DKHRXX-20250813132525

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608505
Report Date: 03/26/2025
Date Signed: 03/26/2025 03:25:37 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/25/2025 and conducted by Evaluator Abeye Duguma

COMPLAINT CONTROL NUMBER: 31-AS-20250325084258

FACILITY NAME:	GLEN PARK AT GLENDALE - BOYNTON ST		FACILITY NUMBER:	197608505
ADMINISTRATOR:	SUSAN PARK		FACILITY TYPE:	740
ADDRESS:	1250 BOYNTON ST		TELEPHONE:	(818) 246-9000
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91205
CAPACITY:	98	CENSUS: 67	DATE:	03/26/2025
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Susan Park		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Staff does not ensure Med Tech is properly trained.
Staff does not ensure resident's medical needs are being met.
Staff does not safeguard resident's personal belongings.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced initial complaint visit to this facility to investigate the above allegations. LPA met with Susan Park and explained the reason for the visit.

--- Staff does not ensure Med Tech is properly trained.

It was alleged that Staff #2 (S2) is not a trained MedTech. To investigate the allegation, LPA requested documents at 11:45a.m., interviewed three (03) staff from 12:00p.m. to 1:00p.m. and seven (07) residents from around 1:00p.m. to 2:30p.m. A review of S2’s records shows that S2 successfully completed the medication training courses. During interviews with staff, all staff stated they are all properly trained.

(CONT. LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:	DATE: 03/26/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20250325084258

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: GLEN PARK AT GLENDALE - BOYNTON ST	FACILITY NUMBER: 197608505
	VISIT DATE: 03/26/2025

NARRATIVE

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During interviews with residents, all interviewed residents stated they felt staff were competent. LPA was unable to interview R1.

Based on interviews and record review, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

---Staff does not ensure resident's medical needs are being met.

It was alleged that R1's blood pressure is not taken by facility staff. To investigate the allegation, LPA interviewed three (03) staff from 12:00p.m. to 1:00p.m. and seven (07) residents from around 1:00p.m. to 2:30p.m. During interviews with staff, all staff stated facility staff are not skilled trained medical professionals and are not expected to take residents’ blood pressure. During interviews with resident, all interviewed residents stated they feel all their medical needs are being met.

Based on interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

---Staff does not safeguard resident's personal belongings.

It was alleged that facility dryer is damaging residents’ bedsheets. To investigate the allegation, on 03/26/2025 LPA conducted a physical plant tour at around 10:30a.m., interviewed three (03) staff from 12:00p.m. to 1:00p.m. and seven (07) residents from around 1:00p.m. to 2:30p.m. During the physical plant tour, LPA inspected seven (07) rooms at random and did not observe damaged bedsheets. During interviews with staff, all staff stated there is no issue with the dryer and that R1 only has a few bedsheets to rotate that they have had for an extended time and any signs of it being worn is normal wear and tear from usage and repeated wash cycles. During interviews with resident, all interviewed residents stated they don’t feel the dryer damages their property.

Based on interviews and observations, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.
No health and safety hazards noted during the visit.
Exit interview conducted. Copy of this report issued.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:	DATE: 03/26/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2025

LIC9099 (FAS) - (06/04)

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