197608505-5-15-2024-31-AS-NMAN-D5RW5H-20240530165909

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608505
Report Date: 05/15/2024
Date Signed: 05/15/2024 04:30:21 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:	05/15/2024
		UNANNOUNCED	TIME BEGAN:	10:35 AM
MET WITH:	Brenda Chacon		TIME COMPLETED:	04:45 PM

ALLEGATION(S):

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Staff handled resident in a rough manner
Staff yelled at resident
Staff do not have appropriate training
Staff did not ensure resident was provided a bed

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 handled resident in a rough manner.

It was alleged that staff are rough with residents. To investigate the allegation, on 05/01/2024, 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, including Staff #2 (S2), stated they are always handling residents gently and are never rough with residents.

(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: 05/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024

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: 05/15/2024

NARRATIVE

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During interviews with residents, all residents stated staff are never handling them in a rough manner.

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

--- Staff yelled at resident.

It was alleged that staff are yelling at residents. To investigate the allegation, on 05/01/2024, 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, including Staff #2 (S2), stated they never yell at residents and treat all residents with dignity and respect. During interviews with residents, all residents stated staff do not yell at them.

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

--- Staff do not have appropriate training.

It was alleged that staff receive no training before they begin working as caregivers. To investigate the allegation, LPA requested staff files at 10:30 AM and, on 05/01/2024, interviewed four (04) staff from around 11:30 AM to 12:15 PM. A review of staff files revealed that all staff have completed all necessary training to provide care and supervision. During interviews with staff, all staff stated that they completed all training prior to starting their work as caregivers.

--- Staff did not ensure resident was provided a bed

It was alleged that residents are left in their wheelchairs all night because their beds are not ready. To investigate the allegation, on 05/01/2024, 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.

(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: 05/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024

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: 05/15/2024

NARRATIVE

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During interviews with staff, all staff stated they have never left a resident in their wheelchair all night due to residents’ beds not being ready. During interviews with residents, all residents stated they have never been without a bed all night due to bed not being ready.

Based on interviews, 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: 05/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024

LIC9099 (FAS) - (06/04)

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