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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565850221
Report Date: 08/01/2023
Date Signed: 08/01/2023 03:46:08 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS NORTH, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/03/2023 and conducted by Evaluator Esther Cortez
COMPLAINT CONTROL NUMBER: 29-AS-20230403161332
FACILITY NAME:GLEN PARK AT OJAIFACILITY NUMBER:
565850221
ADMINISTRATOR:GARY Y LEEFACILITY TYPE:
740
ADDRESS:225 N LOMITA AVETELEPHONE:
(805) 646-2402
CITY:OJAISTATE: CAZIP CODE:
93023
CAPACITY:48CENSUS: 15DATE:
08/01/2023
UNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Gary LeeTIME COMPLETED:
03:50 PM
ALLEGATION(S):
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Facility staff exposing residents to hazardous chemicals.
Staff are unable to communicate/understand English.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Esther Cortez arrived unannounced to conduct a subsequent complaint visit. The LPA met with Executive Director Gary Lee and explained the reason for the visit.

On 4/10/2023 LPAs Cortez and Kelly Dulek along with facility ED toured the facility at 10:15AM, interviewed staff at the following times: 12:29PM, 01:14PM, 01:55PM, 02:42PM, 04:25PM, and 05:22PM, interviewed Administrator throughout the visit, and reviewed records at 04:15PM. During today’s visit, the LPA toured the facility from 9:40 a.m. - 9:50 a.m., reviewed documents with the ED and Assistant adminisrtator at 10:12 a.m. and interviewed residents at 11:14 a.m., 11:32 a.m., 11:40 a.m., 11:44 a.m. and staff at 2:32 p.m.

Report will continue on LIC9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Esther Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2023
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 3
Control Number 29-AS-20230403161332
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS NORTH, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: GLEN PARK AT OJAI
FACILITY NUMBER: 565850221
VISIT DATE: 08/01/2023
NARRATIVE
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Regarding the allegation Facility staff exposing residents to hazardous chemicals: It was further reported that Clorox wipes were being used on resident (R1) instead of regular wipes. The LPA interviewed Staff during both the initial and subsequent visits. Staff interviews revealed that cleaning supplies are stored inaccessible to residents in a locked cleaning storage closet or in locked offices. Furthermore, interviews with staff revealed that staff have not heard any resident voicing concerns about staff using Clorox wipes to clean them. The LPA conducted interviews with residents during today’s visit and no use of Clorox wipes being used on the residents was confirmed. In addition, all residents interviewed stated they feel safe at the facility and did not voice any immediate concerns to the LPA. Based on the information obtained in interviews there is insufficient evidence to support the above-mentioned allegation. The allegation ‘Facility staff exposing residents to hazardous chemicals is unsubstantiated at this time.

Regarding the allegation Staff are unable to communicate/understand English: The LPA interviewed Staff during both the initial and subsequent visits. Staff interviews revealed that even though there is staff that is not fluent in English, they know and understand enough English to be able to communicate with the residents and provide the necessary care. In addition, staff interviews revealed that there is always staff that are fluent in English at the facility, and that if any staff needs assistance in communicating with the residents, they can ask for help from other staff. Staff interviews also revealed that there’s residents that are non-verbal and staff uses different methods of communicating with the residents such as using hand signs, face expressions and pictures. Furthermore, residents interviewed during todays visit did not have any concerns about staff not being able to communicate with them. Based on the information obtained in interviews there is insufficient evidence to support the above-mentioned allegation. The allegation ‘Staff are unable to communicate/understand English’ is unsubstantiated at this time.

No deficiencies cited. Exit interview conducted. A copy of the report was issued.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Esther Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3