197608505-5-28-2021-28-AS-MVAO-C3ZUCV-20210615152835

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608505
Report Date: 05/28/2021
Date Signed: 05/28/2021 03:12:03 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/17/2020 and conducted by Evaluator Cynthia D Chan

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20201217081755

FACILITY NAME:	GLEN PARK AT GLENDALE - BOYNTON ST		FACILITY NUMBER:	197608505
ADMINISTRATOR:	PINK, JR, TILLMAN		FACILITY TYPE:	740
ADDRESS:	1250 BOYNTON ST		TELEPHONE:	(818) 246-9000
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91205
CAPACITY:	98	CENSUS: 60	DATE:	05/28/2021
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Monica Lopez, Office Manager		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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1. Staff are abusing residents.
2. Staff are stealing from residents.
3. Facility is not maintained clean.
4. Residents are not allowed to attend day program.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Cynthia Chan initiated a subsequent complaint visit to deliver the findings for the allegations listed above. LPA met with Monica Lopez, Office Manager and explained the purpose of the visit.

The investigation consisted of the following:
On 12/24/20, LPA Chan conducted a telephone interview with the Assistant Administrator. The LPA also requested copies of the Staff and Resident rosters including contact numbers, Personal Rights In-Service Training log, and the Housekeeper's cleaning schedule. On 2/25/21, LPA held telephonic interviews with 7 residents and also toured the faciilty with the Office Manager and randomly selected seven rooms to inspect. LPA conducted additional interviews with 4 staff on 3/8/21. During today’s visit, LPA interviewed the Administrator Nirjara Acharya via telephone.

(Continue on LIC9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Cynthia D Chan	TELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:	DATE: 05/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2021

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 28-AS-20201217081755

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: GLEN PARK AT GLENDALE - BOYNTON ST	FACILITY NUMBER: 197608505
	VISIT DATE: 05/28/2021

NARRATIVE

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The investigation revealed the following:

Regarding allegation - Staff are abusing residents. Nirjara Acharya, has been the administrator of this facility since 6/22/2020 and denied physically or verbally abusing residents in care. Administrator also stated that her staff are mandated reporters and receive annual training on personal rights and reporting policy. LPA interviewed the alleged staff who denied abusing any residents. 4 out of the 5 Staff interviewed have not seen or heard of any staff physically or verbally abusing residents. In addition, 7 residents were interviewed and 6 of them stated they have not witnessed nor heard of any abuse coming from the staff. One resident indicated only hearing about a staff attacking another resident but no details were provided.

Regarding allegation - Staff are stealing from residents. Administrator Acharya denied stealing from residents. She stated that the facility manages some of the residents’ money while others are their own payees. The Assistant Administrator who is in charge of distributing money to residents, will hand out the money to residents in the office and is counted and signed off by the residents. There is another staff in the office who witnesses the money given to the residents. Staff interviewed do not have knowledge of any staff stealing from residents. LPA interviewed 7 residents regarding any money or belongings stolen from staff. 6 of the residents stated they have not had anything stolen by the staff, meanwhile, one reported that the staff would not give resident his/her money but not sure if they are stealing the money or not.

Regarding allegation - Facility is not maintained clean. The Administrator stated that the facility is well maintained and sanitized. The housekeeping staff clean daily and disinfect every 4 hours. Since the start of the pandemic, they have been disinfecting and sanitizing thoroughly to mitigate the spread of the virus. Staff interviewed said that the housekeepers clean daily to keep the facility clean. 6 of the 7 residents interviewed felt that the facility is well maintained and stated that their rooms are cleaned daily. During today’s visit, LPA Chan observed the housekeeper mopping the floors and throwing out the trash.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Cynthia D Chan	TELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:	DATE: 05/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2021

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20201217081755

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: GLEN PARK AT GLENDALE - BOYNTON ST	FACILITY NUMBER: 197608505
	VISIT DATE: 05/28/2021

NARRATIVE

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Regarding allegation - Residents are not allowed to attend day programs. The Administrative staff stated that the residents are not attending day programs due to the day programs being closed for in person services. Since the start of the Coronavirus pandemic in March 2020, the residents’ day programs were only providing remote services. LPA contacted and verified that 2 of the Adult Day Programs that some residents attend, have been closed for in-person services but are provided remote services. Staff interviewed stated that the day programs are closed and not because the facility is keeping them from attending. Residents interviewed are aware that the day programs are currently closed due to the pandemic.

Based on information gathered, LPA did not find sufficient evidence to support the allegations.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated.

Exit interview held and a copy of this report along with the appeal rights were provided to the Office Manager.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Cynthia D Chan	TELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:	DATE: 05/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2021

LIC9099 (FAS) - (06/04)

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