197603165-4-10-2024-29-AS-KLOZ-D9GPBK-20240926111025

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197603165
Report Date: 04/09/2024
Date Signed: 04/10/2024 08:07:37 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 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
05/08/2023 and conducted by Evaluator Sandra Urena

COMPLAINT CONTROL NUMBER: 29-AS-20230508154924

FACILITY NAME:	GLEN PARK AT VALLEY VILLAGE		FACILITY NUMBER:	197603165
ADMINISTRATOR:	TILLMAN PINK		FACILITY TYPE:	740
ADDRESS:	5527 LAUREL CANYON BLVD		TELEPHONE:	(818) 769-6626
CITY:	VALLEY VILLAGE	STATE: CA	ZIP CODE:	91607
CAPACITY:	100	CENSUS: 37	DATE:	04/09/2024
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Marylou V. Mendoza		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff do not meet the minimum qualifications required.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sandra Urena conducted a subsequent complaint unannounced visit to investigate the allegation(s) listed above. LPA Urena met with Executive Director (ED) Marylou V. Mendoza and Assistant Administrator (AA) Virginia Sumulong, and explained the reason for the visit.

On 05/09/2023, Licensing Program Analyst (LPA) Angel Ascencio conducted an initial 10-day complaint. LPA Ascencio met with Interim Administrator Rafael Silva at 10:08 a.m. Entrance interview conducted. During the visit, LPA Ascencio reviewed staff files at 11:00 a.m. and obtained pertinent documents. LPA Ascencio advised Interim Administrator Silva that the allegation of Personal Rights has been referred to the Department's Investigation Branch (IB) for further review.
On 04/09/2024, LPA Urena requested additional pertinent documents at 11:30 a.m. and interviewed the ED at 11:55 a.m.
Continues on LIC9099C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kasandra Lopez	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Sandra Urena	TELEPHONE: 747-230-3919
LICENSING EVALUATOR SIGNATURE:	DATE: 04/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024

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 29-AS-20230508154924

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: GLEN PARK AT VALLEY VILLAGE	FACILITY NUMBER: 197603165
	VISIT DATE: 04/09/2024

NARRATIVE

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Staff do not meet the minimum qualifications required.
On the allegation that staff do not meet the minimum qualifications required, the reporting parties concern is that staff#1 (S1) has no education and is not qualified to run a facility. To investigate the allegation, the LPA reviewed documents collected during the initial 10-day visit. The records indicate that S1 meets the minimum requirements by the department. The records include State Certification, background check and training required.

Based on the documents review, the allegation that staff do not meet the minimum qualifications required, is deemed Unsubstantiated at this time.

Exit interview was conducted, and a copy of the report was issued.

SUPERVISOR'S NAME: Kasandra Lopez	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Sandra Urena	TELEPHONE: 747-230-3919
LICENSING EVALUATOR SIGNATURE:	DATE: 04/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024

LIC9099 (FAS) - (06/04)

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