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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602134
Report Date: 05/29/2026
Date Signed: 05/29/2026 03:23:15 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
05/19/2026 and conducted by Evaluator Socorro Leandro
COMPLAINT CONTROL NUMBER: 11-AS-20260519135515
FACILITY NAME:GLEN PARK AT LONG BEACHFACILITY NUMBER:
198602134
ADMINISTRATOR:ACE HUYNHFACILITY TYPE:
740
ADDRESS:1046 E 4TH STTELEPHONE:
(562) 432-7468
CITY:LONG BEACHSTATE: CAZIP CODE:
90802
CAPACITY:208CENSUS: 108DATE:
05/29/2026
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH: Executive Director - Ace Huynh TIME COMPLETED:
03:40 PM
ALLEGATION(S):
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The facility did not ensure that resident was provided with comfortable, safe, and sanitary living accommodations.
INVESTIGATION FINDINGS:
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On 05/29/2026, Licensing Program Analyst (LPA) Socorro Leandro conducted an unannounced subsequent complaint investigation visit regarding the above allegation. LPA met with the Executive Director, Ace Huynh and the purpose of the visit was explained. LPA was granted entry to the facility.

Investigation consisted of the following:

On 05/20/2026, an interview was conducted. On 05/22/2026, interviews were conducted and records were reviewed. Interviews conducted consisted of Witness 1 (W1), Staff 1 (S1) to Staff 6 (S6) and Resident 2 (R2) to Resident 9 (R9). Facility records were reviewed which consisted of Personnel Report dated 05/01/2026 and Resident Roster. Resident 1’s (R1) records were reviewed which consisted of Admission Agreement, Physicians Report dated 4/24/2023, Appraisal/Needs And Services Plan (ANS) dated 01/30/2025, Friendly Reminder letter dated 02/20/2025, five (5) Internal Resident Incident Reports ranging from 01/27/2025 to 02/17/2026. On 05/29/2026, R1’s room was toured.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2026
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 6
Control Number 11-AS-20260519135515
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: 05/29/2026
NARRATIVE
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Investigation revealed the following:

Allegation: “The facility did not ensure that resident was provided with comfortable, safe, and sanitary living accommodations.” It is being alleged that staff allowed R1’s belongings and unsanitary items to accumulate in resident’s room.

On 05/22/2026 at around 9:30 AM, R1’s room was toured and the following was observed: the room floor was filled with miscellaneous items such as boxes, picture frames, bags of stuff, bags of food supplies, toys, art supplies, house hold supplies, there is a medical bed with a half bed rail, large black bags filled, wheelchair, microwave, toiletries, and other items. It was difficult to maneuver around the bedroom; there was a small narrow path that led to the bed; it was not possible to open the bedroom window because the floor was covered with miscellaneous items (as mentioned above). R1’s bathroom was toured and the following was observed: the bathroom bathtub/shower was filled with clothing items and other miscellaneous supplies. The shower curtain rod was used as a closet rod that holds about forty-seven (47) hangers with long sleeve t-shirts, sweaters, sweatpants, etc. The bathroom sink was filled with dirty dishes. Vermin droppings and dead vermin were observed in the bathroom. On 05/29/2026, R1’s room was toured and two (2) kitchen knives were observed out. (Several pictures of R1’s room were taken and video footage).
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 11-AS-20260519135515
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: 05/29/2026
NARRATIVE
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Interviews conducted with W1 revealed the following: W1 agreed with the allegation. W1 explained that the facility has not addressed R1’s hoarding; furthermore, W1 states that they have witnessed one (1) to four (4) portable urinal bottles filled with urine at one time on several occasions.

Interviews conducted with R2 to R9 revealed the following: Five (5) out of eight (8) residents agreed with the allegation. Residents indicated that R1 was a “pack rat,” “hoarder,” and they had observed cups filled with urine. Three (3) out of eight (8) residents could not corroborate towards the allegation (residents had not seen R1’s room).

Interviews conducted with Staff 1 (S1) to Staff 6 (S6) revealed the following: Six (6) out of six (6) staff agreed that R1 has a hoarding problem which makes it difficult for R1 to remove items from their room. Staff indicated that R1 uses a wheelchair, is a large person, and were unsure how R1 maneuvered in their room. Furthermore, staff indicated that it was difficult to work inside R1’s room due to it being difficult to ambulate in the room. Moreover, staff indicated that they had observed portable urinals filled with urine. Additionally, staff indicated that R1 was unable to shower in their bathroom because it was filled with clothing items. Staff indicated since the date they began working in the facility R1’s room has been like this (filled with boxes, art supplies, etc.). Staff were unaware if Unusual Incident Reports and Adult Protective Services (APS SOC341) reports were submitted to the department. Staff were unaware if there was a specific detailed plan in place to decrease the number of items R1 had.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 11-AS-20260519135515
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: 05/29/2026
NARRATIVE
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R1’s records reviewed revealed the following: Admission Agreement was not signed nor dated by R1 nor facility staff but stated that date of Admission was 04/25/17; on page 11 under “9. Clutter No hoarding or clutter is allowed in the units. Blocking the walkways, exit areas, and air/heat unit is a safety hazard.”; R1 is “Self-Responsible.” Physicians Report dated 04/24/2023 (report not signed by R1), stated that R1 needs assistance with bathing, grooming, toileting needs, and is non-ambulatory due to both mental and physical condition. Internal Resident Incident Report dated 01/27/2025, stated that the facility contacted R1’s family about R1 being a fall risk and room being a fire hazard; family indicated they are aware of R1’s “hoarding in the past.” Appraisal/Needs And Services Plan (ANS) dated 01/30/2025 was not signed by R1 nor facility staff; document stated that R1 required assistance with Activities of Daily Living (ADLs); it stated that on 01/08/2025, “staff reported that the resident’s room had become excessively cluttered, making it difficult to move around safely. The resident also reported seeing roaches in the room.”; under “Physical/Health” it stated “Environmental/Safety Needs” “Provide a constant supervision and assistance maintaining a clean, safe, and uncluttered living space” and “all staff” will be involved daily. Internal Resident Incident Report dated 02/06/2025, indicated that R1 was hospitalized and not in the facility. Friendly Reminder letter dated 02/20/2025, stated that R1 was not complying with the facilities House Rules and/or policies, referenced House Rule 9, and stated that R1 had until 03/20/2025 to clear out the room; the letter went on to explain that “The room is extremely cluttered. This poses a fire risk and makes it difficult for our staff to assist R1”; furthermore, it indicated failure to resolve will lead to the beginning of eviction proceedings. Internal Resident Incident Report dated 03/11/2025, described R1’s room as a fire hazard. Internal Resident Incident Report dated 03/22/2025, indicated that R1’s room still needs to be de-cluttered. Internal Resident Incident Report dated 02/17/2026, indicated that R1 went to the hospital.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 11-AS-20260519135515
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: 05/29/2026
NARRATIVE
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Substantiated: Based on observations, interviews and record reviewed, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, Title 22, Division 6 and Chapter 8 are being cited on the attached LIC 9099D.

An exit interview was conducted, Plans of Corrections were reviewed and developed. A copy of this report and appeal rights were discussed and left with the Executive Director, Ace Huynh.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 11-AS-20260519135515
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: 05/29/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/30/2026
Section Cited
CCR
87468.1(a)(2)
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Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment.
This requirement is not met as evidence by:
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The Executive Director has agreed to create a plan with R1 to maintain R1’s room free of clutter, human waste, and vermin. A plan to maintain R1’s room and bathroom free of clutter, human waste, and vermin will be emailed to Socorro.Leandro@dss.ca.gov.
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Based on observations, interviews, and record review, the licensee did not comply with the section cited above, in not ensuring that R1's room was free of excessive items, vermin, and vermin droppings. This poses a potential health, safety and personal rights risk to residents in care.
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Progress of R1's room will be submitted to the Department on a weekly basis up until 07/03/2026. Pictures of R1's room/bathroom along with an Unusual Incident/Injury Report (UIR) will be faxed to the Departments at 424-544-1016.
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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: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2026
LIC9099 (FAS) - (06/04)
Page: 6 of 6