197608505-5-1-2024-31-AS-NMAN-D5RW5J-20240530165909

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608505
Report Date: 05/01/2024
Date Signed: 05/01/2024 04:28:14 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/27/2023 and conducted by Evaluator Abeye Duguma

COMPLAINT CONTROL NUMBER: 31-AS-20231027104543

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: 74	DATE:	05/01/2024
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Brenda Chacon		TIME COMPLETED:	04:35 PM

ALLEGATION(S):

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Staff do not assist residents with toileting
Staff do not answer residents' call buttons in a timely manner
Staff do not assist residents with bathing
Staff do not provide resident with drinking water

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced subsequent complaint visit to the facility to investigate the above allegation. LPA met with Office Manager, Brenda Chacon, and explained the reason for the visit.

--- Staff do not assist residents with toileting.

It was alleged that staff are telling residents to relieve themselves in their chairs and leaving them on toilets for an extended time. To investigate the allegation, LPA interviewed four (04) staff from around 11:30 AM to 12:15 PM and interviewed ten (10) residents from around 12:15 PM to 2:15 PM. During interviews with staff, all staff stated they have never told a resident to relieve themselves on their chair or refused toileting assistance. All staff added they do not leave residents on toilets for an extended time.

(CONT. on LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024

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 31-AS-20231027104543

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: GLEN PARK AT GLENDALE - BOYNTON ST	FACILITY NUMBER: 197608505
	VISIT DATE: 05/01/2024

NARRATIVE

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During interviews with residents, all residents stated they have never been told to relieve themselves in their chair and are not left on toilets for an extended time.

Based on interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

--- Staff do not answer residents' call buttons in a timely manner

It was alleged that multiple rooms are calling for help at once the caregivers are not able to get to them. To investigate the allegation, LPA conducted a physical plant tour at 10:30AM, interviewed four (04) staff from around 11:30 AM to 12:15 PM and interviewed ten (10) residents from around 12:15 PM to 2:15 PM. During the physical plant tour, LPA selected five (05) rooms at random, pressed the call button and observed an average response time of six (06) minutes. During interviews with staff, all staff stated they respond to call buttons with in five (05) to ten (10) minutes. During interviews with residents, four (04) out of ten (10) residents stated that staff take up to fifteen (15) minutes to respond to the call button while the remaining six (06) out of ten (10) residents stated that staff take no longer than ten (10) minutes to respond to the call button.

Based on interviews and observations, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

--- Staff do not assist residents with bathing.

It was alleged that residents go a week without getting a shower. To investigate the allegation, LPA interviewed four (04) staff from around 11:30 AM to 12:15 PM and interviewed ten (10) residents from around 12:15 PM to 2:15 PM. During interviews with staff, all staff stated they have a shower schedule for each resident, and they shower between two (02) to three (03) times a week. Staff added they have residents that sometimes refuse to shower but do not have residents that go a whole week without showering.

(CONT. LIC9099-C)

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20231027104543

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: GLEN PARK AT GLENDALE - BOYNTON ST	FACILITY NUMBER: 197608505
	VISIT DATE: 05/01/2024

NARRATIVE

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During interviews with residents, all residents stated they receive shower assistance between two (02) to three (03) times a week.

Based on interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

---Staff do not provide resident with drinking water.

It was alleged that residents are not getting enough drinking water. To investigate the allegation, LPA conducted a physical plant tour at 10:30AM, interviewed four (04) staff from around 11:30 AM to 12:15 PM and interviewed ten (10) residents from around 12:15 PM to 2:15 PM. During the physical plant tour, LPA observed two (02) drinking water fountains in the facility. During interviews with staff, all staff stated they offer residents water throughout the day and that the residents have free access to clean drinking water. During interviews with residents, all residents stated they are offered water throughout the day and that they have access to water whenever they want.

Based on interviews and observations, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

No health and safety hazards were noted during the visit.

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

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024

LIC9099 (FAS) - (06/04)

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