197608506-2-9-2026-31-AS-TAGD-DRUSU7-20260304131041

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608506
Report Date: 02/09/2026
Date Signed: 02/09/2026 04:15:52 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 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
10/21/2025 and conducted by Evaluator Nadia Shahbazian

COMPLAINT CONTROL NUMBER: 31-AS-20251021115416

FACILITY NAME:	GLEN PARK AT GLENDALE - MARIPOSA ST		FACILITY NUMBER:	197608506
ADMINISTRATOR:	SUSAN PARK		FACILITY TYPE:	740
ADDRESS:	1220 S MARIPOSA ST		TELEPHONE:	(818) 242-9000
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91205
CAPACITY:	120	CENSUS: 88	DATE:	02/09/2026
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Susan Park-Executive Director		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Facility staff are insufficient to meet resident needs.
Licensee does not ensure that staff are adequately trained.
Licensee does not ensure that the facility has sufficient hygiene supplies.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Nadia Shahbazian conducted an unannounced subsequent complaint visit to investigate the above allegations. LPA met with the Administrator Susan Park and explained the reason for the visit. Initial complaint investigation was conducted by LPA Shahbazian on 10/28/2025.

LPA obtained copies of pertinent information, such as LIC 500, Resident Roster, care staff job descriptions. From 1:10pm to 2:00pm LPA interviewed residents. Today's visit concentrated maily on interviewing residents.

Facility staff are insufficient to meet resident needs. It was alleged that the caregivers are being assigned to care for up to 25 residents per shift. To investigate the allegation, LPA Shahbazian interviewed nine (9) residents in random. Interviews with all nine (9) residents revealed that all residents were happy with the services and staff. Two (2) residents stated that staff assist them with Activities of Daily Living (ADL)s, assist with showering two times weekly and to assist with using the restroom. All nine (9) residents stated that staff check of them on regular basis, sometimes every 2-3 hours and that caregivers assist them in

Continued on 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Nadia Shahbazian
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2026

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-20251021115416

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: GLEN PARK AT GLENDALE - MARIPOSA ST	FACILITY NUMBER: 197608506
	VISIT DATE: 02/09/2026

NARRATIVE

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their rooms and in the dining room; in addition Med Techs provide medications timely. During interviews with residents, six (06) out of nine (09) residents stated they have not called for assistance but three (3) residents stated that when pulling the cord, staff respond with five (05) to ten (10) minutes or sooner.
LPA Shahbazian pulled the cord for the signal system in two rooms and one bathroom and in each incident, caregivers attended to residents within 2 minutes. LPA Shahbazian interviewed nine (9) care staff members, working in various shifts. All care staff members stated that they are assigned to assist 16-20 residents during their daily shift but approximately 5-8 residents needs total care and others require assistance every 2-3 hours. Care staff stated they shower residents two times or more weekly, assist with ADLs, cleaning the rooms, taking out the trash and assisting residents in the dining room. All staff interviewed stated they feel they are short staffed, they all help each other to ensure residents are care for. Several staff members informed LPA that due to shortness of staff, facility is using caregivers from agencies, also Med Techs and LVN do assist caregiver when needed.
Interview with Executive Director revealed that usually there are five (5) caregivers in the morning shift, four (4) assigned to pm shift and three (3) to graveyard shift and each caregiver is assigned to approximately sixteen (16) residents daily. Executive Director stated that currently one (1) caregiver is out on medical leave and residents for the caregiver are divided amongst the other caregivers, but there is enough coverage per shift. In addition Executive Director mentioned that caregivers, housekeepers and med techs all assist each other and communicate with each, to ensure residents are assisted as soon as possible or within seven (7) minutes. Executive Director stated that facility uses services from two (2) separate staffing agencies to complete any caregiver staff shortages. Records obtained by LPA from September 2025 through current, revealed that facility has been using caregivers from the staffing agencies, on regular basis, to cover staff during various shifts. During the initial complaint visit on 10/28/2025 LPA had observed a banner hanging outside regarding hiring but during today's visit LPA did not see the banner. Executive Director stated that they have hired a Human Resources Manager at the facility, in order to concentrate on interviewing and hiring staff, including caregivers and housekeepers. Facility has hired five (5) caregivers and one (1) housekeeper in January 2026 and are still recruiting for more caregivers.

During facility visits, residents were observed to be appropriately supervised, and staff were present and engaged in resident care activities. Based on staff interviews and records review, if was reveled that facility is using staffing agencies and has hired multiple caregivers to address staff shortages. Therefore, the allegation is UNSUBSTANTIATED at this time.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Nadia Shahbazian
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2026

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20251021115416

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: GLEN PARK AT GLENDALE - MARIPOSA ST	FACILITY NUMBER: 197608506
	VISIT DATE: 02/09/2026

NARRATIVE

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Licensee does not ensure that staff are adequately trained. It was alleged that the caregivers do not have proper training to provide care to residents. To investigate the allegation, LPA Shahbazian interviewed nine (9) caregivers. All caregivers stated that they feel the training was sufficient in the beginning and there is always trainings and meetings to cover various topics. Caregivers stated that initial training is learning facility policies and online training specific for their duties. In addition, they stated for 2-3 weeks caregivers shadow other senior caregivers and med techs to learn their tasks. Based on interviews with staff, it was revealed that staff are satisfied with their training and facility provides continued training to all staff. Therefore, the allegation is UNSUBSTANTIATED at this time.

Licensee does not ensure that the facility has sufficient hygiene supplies. It was alleged that facility does not have enough gloves or hygiene supplies such as shampoo or personal care items. To investigate the allegation, LPA Shahbazian interviewed staff who revealed that there is no shortage of personal or hygiene supplies. Staff informed LPA that they are always provided a supply of masks, gloves and any required items at the front desk but several caregivers stated the quality of the gloves are not good. Interview with Office Manager revealed that it is their responsibility to purchase supplies, including office and personal care items. Supplies are ordered every 2 weeks and there is available funds for any immediate purchases. LPA toured the facility with Office Manager and observed three storage areas filled with boxes of masks, alcohol pads, shampoos, gloves, incontinence supplies, office supplies and medical supplies. LPA also observed supplies in med room and front reception area. Based on interviews and observations, the allegation is UNSUBSTANTIATED at this time.

Exit interview conducted and copy of the report was signed and given to the Administrator.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Nadia Shahbazian
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2026

LIC9099 (FAS) - (06/04)

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