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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602134
Report Date: 01/15/2026
Date Signed: 01/15/2026 01:05:11 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/13/2025 and conducted by Evaluator Wendy Gibbs
COMPLAINT CONTROL NUMBER: 11-AS-20251013125552
FACILITY NAME:GLEN PARK AT LONG BEACHFACILITY NUMBER:
198602134
ADMINISTRATOR:MICHAEL MENDOZAFACILITY TYPE:
740
ADDRESS:1046 E 4TH STTELEPHONE:
(562) 432-7468
CITY:LONG BEACHSTATE: CAZIP CODE:
90802
CAPACITY:208CENSUS: 111DATE:
01/15/2026
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Catherine DacaraTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Staff are mishandling the residents medications
INVESTIGATION FINDINGS:
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On 01/15/2026, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced subsequent complaint visit to the facility listed above. LPA met with Assistant Administrator, Catherine Dacara, and the purpose of today’s visit was explained. LPA was granted entry into the facility.
The investigation consisted of the following:
During today’s visit, LPA interviewed a Resident and delivered findings for the complaint.
During a subsequent visit conducted on 12/04/2025, LPA conducted a medication review for eight (8) residents, observed lunch service, and received and reviewed the following documents Medication Administration Records (MAR) for December 2025, Weekly Menus for four (4) weeks, Sanitation and Food Safety Checklist for Assisted Living by RDs for Healthcare INC (dated 11/072025, 10/03/2025, and 09/05/2025), and invoices from Sysco for November and December 2025.
During the initial visit on 10/21/2025, LPA inspected the facility, interviewed Staff S1-S8, interviewed Residents R1-R10, conducted a narcotic medication count, and received and reviewed the Staff Roster, Resident Roster, Resident Diabetic List, Physician’s Report for R1-R10, In-Service Training Log,
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026
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 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/13/2025 and conducted by Evaluator Wendy Gibbs
COMPLAINT CONTROL NUMBER: 11-AS-20251013125552

FACILITY NAME:GLEN PARK AT LONG BEACHFACILITY NUMBER:
198602134
ADMINISTRATOR:MICHAEL MENDOZAFACILITY TYPE:
740
ADDRESS:1046 E 4TH STTELEPHONE:
(562) 432-7468
CITY:LONG BEACHSTATE: CAZIP CODE:
90802
CAPACITY:208CENSUS: 111DATE:
01/15/2026
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Catherine DacaraTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Staff are not following the residents diabetic needs
Staff are not providing adequate food service
Staff are eating the food for the residents
INVESTIGATION FINDINGS:
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On 01/15/2026, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced subsequent complaint visit to the facility listed above. LPA met with Assistant Administrator, Catherine Dacara, and the purpose of today’s visit was explained. LPA was granted entry into the facility.
The investigation consisted of the following:
During today’s visit, LPA interviewed a Resident and delivered findings for the complaint.
During a subsequent visit conducted on 12/04/2025, LPA conducted a medication review for eight (8) residents, observed lunch service, and received and reviewed the following documents Medication Administration Records (MAR) for December 2025, Weekly Menus for four (4) weeks, Sanitation and Food Safety Checklist for Assisted Living by RDs for Healthcare INC (dated 11/072025, 10/03/2025, and 09/05/2025), and invoices from Sysco for November and December 2025.
During the initial visit on 10/21/2025, LPA inspected the facility, interviewed Staff S1-S8, interviewed Residents R1-R10, conducted a narcotic medication count, and received and reviewed the Staff Roster, Resident Roster, Resident Diabetic List, Physician’s Report for R1-R10, In-Service Training Log,
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 7
Control Number 11-AS-20251013125552
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: GLEN PARK AT LONG BEACH
FACILITY NUMBER: 198602134
VISIT DATE: 01/15/2026
NARRATIVE
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Medication Management Program verification, med tech Certification of Completion in Basic Medication Training, and med tech Basic Medication Shadow Training Logs. The following additional documents were requested and are to be emailed to LPA Unusual Incident Reports (URI), Physician’s Orders, Needs and Service Plan, and Medication Administration Records (MAR).

The investigation revealed the following:

Allegation: Staff are not following resident’s diabetic needs


The allegation alleges that med techs are giving residents their insulin.

During the facility visit, LPA observed residents going to the Medication Room to see the trained LVN, to have their blood sugar level checked, and to receive their insulin injections. During the visit, LPA observed insulin secured in a locked refrigerator, in the medication room.


During record review, LPA reviewed the training and in-service logs for the LVN and medication technicians and observed they have received training regarding medication administration. LPA reviewed the Plan of Operation that indicates a licensed skilled professional can assist with self-administration of injections. LPA received and reviewed Resident R2-R 11’s Medication Administration Record (MAR) and observed glucose testing and insulin injections signed off by the LVN.
During interviews with Staff S1-S8, were asked who checks residents’ sugar and provides insulin injections, eight (8) out of eight (8) stated the LVN is who tests residents’ sugar and gives insulin injections.
During interviews with Residents R1-R11, were asked who provides them with their insulin shots and tests their sugar, eight (8) out of eleven (11) stated the nurse gives them their shots and tests their sugar. One resident stated they do their own sugar testing, and the nurse is there to document the numbers, and they do their own injections with the nurse watching. Two residents stated they do not require glucose testing or insulin injections.

During the course of the investigation, LPA was unable to find evidence to support the allegation. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 7
Control Number 11-AS-20251013125552
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: GLEN PARK AT LONG BEACH
FACILITY NUMBER: 198602134
VISIT DATE: 01/15/2026
NARRATIVE
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Allegation: Staff are not providing adequate food service
The allegation alleges that residents are unable to get a second serving of food during mealtimes due to the kitchen running out of food.

During the facility inspection, LPA observed lunch being prepared and served. LPA observed staff preparing residents plates using scoopers measuring half (1/2) a cup for mixed vegetables, fruit, and stuffing. Soup was measured using an 8 fluid ounce ladle. Residents were provided with one to two pieces of chicken with gravy. LPA observed a resident who wanted an alternative meal, and they were provided with either a turkey or ham sandwich, fruit, vegetables, soup, and stuffing. LPA observed multiple residents served a second serving of lunch. After all residents were provided with their meals, LPA observed an ample supply of prepared food still in the kitchen. Additionally, LPA inspected the food supply in the kitchen and observed a two (2) day supply of perishable foods and a seven (7) day supply of nonperishable foods.


During record review, LPA received and reviewed invoices from Sysco listing food deliveries on the following dates 12/03/2025, 11/28/2025, 11/25/2025, 11/21/2025, 11/18/2025, 11/14/2025, 11/11/2025, 11/07/2025, 11/05/2025, and 11/04/2025. The food delivered consisted of dairy, meats, poultry, canned goods, frozen goods, dry goods, and condiments. Additionally, LPA received and reviewed the Sanitation and Food Safety Checklist for Assisted Living dated 09/25/2025 and 11/07/2025. On both forms, indicates the facility has a “one week of nonperishable food and 2 days perishable are available.”
During interviews with Staff S1-S8, were asked if residents are able to have a second serving during mealtimes, eight (8) out of eight (8) stated residents are able to have a second serving of food during mealtimes.
During interviews with Residents R1-R11, were asked if they are provided with enough food throughout the day, eleven (11) out of eleven (11) stated yes, they are provided with enough food throughout the day.

During the course of the investigation, LPA was unable to find evidence to support the allegation. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.


Allegation: Staff are eating the food for the residents
The allegation alleges that staff are eating all the food resulting in there not being enough food for residents.

During the facility inspection, LPA observed lunch being prepared and served. LPA observed staff preparing residents plates using scoopers measuring half (1/2) a cup for mixed vegetables, fruit, and stuffing. Soup

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 7
Control Number 11-AS-20251013125552
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: GLEN PARK AT LONG BEACH
FACILITY NUMBER: 198602134
VISIT DATE: 01/15/2026
NARRATIVE
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was measured using an 8 fluid ounce ladle. Residents were provided with one to two pieces of chicken with gravy. LPA observed a resident who wanted an alternative meal, and they were provided with either a turkey or ham sandwich, fruit, vegetables, soup, and stuffing. LPA observed multiple residents served a second serving of lunch. After all residents were provided with their meals, LPA observed an ample supply of food prepared in the kitchen. LPA did not observe any staff eating the food that was served from the kitchen.
During review of an Admission Agreement, LPA observed a resident’s guest may purchase a meal and eat with the resident they are visiting.
During interviews with Staff S1-S8, were asked if staff eat the food served to the residents, six (6) out of eight (8) stated they have eaten or seen staff eating the food served to the residents. Additionally, four (4) out of eight (8) stated meals are available for purchase and some staff eat the food for quality testing.
During interviews with Residents R1-R11, were asked if there has been a time they wanted a second serving and it was not available due to the kitchen running out of food, eleven (11) out of eleven (11) stated no, the kitchen has not run out of food.

During the course of the investigation, LPA was unable to find evidence to support the allegation. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.



An exit interview was conducted with Catherine Dacara, and a copy of this report was provided.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 7
Control Number 11-AS-20251013125552
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: GLEN PARK AT LONG BEACH
FACILITY NUMBER: 198602134
VISIT DATE: 01/15/2026
NARRATIVE
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Medication Management Program verification, med tech Certification of Completion in Basic Medication Training, and med tech Basic Medication Shadow Training Logs. The following additional documents were requested and are to be emailed to LPA Unusual Incident Reports (URI), Physician’s Orders, Needs and Service Plan, and Medication Administration Records (MAR).

The investigation revealed the following:

Staff are mishandling the residents medications


The allegation alleges residents are not getting their medication because the medication is missing.

During the facility inspection, LPA conducted a medication review for eight (8) residents. LPA observed three (3) out of eight (8) residents had medications that were unable to be located in the medication cart and medication room. Additionally, LPA observed two (2) out of eight (8) resident’s medications were not consistent with documented records.


During interviews with Staff S1-S8, were asked if there have been any medication errors or missing medications in the past, five (5) out of eight (8) staff stated yes, there was recently a medication error that was documented and reported.
During interviews with Residents R1-R11, were asked if there have been any medication errors or missing medications in the past, four (4) out of eleven (11) stated yes, they have had missing medications that the staff did not know what happened to them.

During the course of the investigation, LPA was able to find evidence to support the allegation. Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California code of Regulation, (Tittle 22, Division 6 & Chapter number 8), are being cited on the attached LIC 9099D.

An exit interview was conducted with Assistant Administrator, Catherine Dacara, and a copy of this report and Appeal Rights were provided.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026
LIC9099 (FAS) - (06/04)
Page: 6 of 7
Control Number 11-AS-20251013125552
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: GLEN PARK AT LONG BEACH
FACILITY NUMBER: 198602134
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/15/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/25/2026
Section Cited
CCR
87465(h)(2)
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87465 Incidental Medical and Dental Care (h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of centrally stored
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The Licensee agrees to retrain staff on properly storing centrally stored medications and ensuring they are secured and will work with TSP to implement new procedures they feel is needed. Training Logs will be emailed to LPA by POC.
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medications.
This requirement was not met as evidence during record review, observation, and interviews, during medication audit staff were unable to locate 3 of R4’s PRN medications, 4 of R6’s medications, and 1 of R9’s medications.
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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.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026
LIC9099 (FAS) - (06/04)
Page: 7 of 7