197608505-10-27-2023-31-AS-RORN-D66PFD-20240612111635

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608505
Report Date: 10/27/2023
Date Signed: 10/27/2023 02:21:58 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
05/09/2023 and conducted by Evaluator Michael Cava

COMPLAINT CONTROL NUMBER: 31-AS-20230509133727

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: 64	DATE:	10/27/2023
		UNANNOUNCED	TIME BEGAN:	11:23 AM
MET WITH:	Peter Bonilla		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff does not ensure resident's hygiene needs are being met.
Staff does not ensure resident's showering needs are being met.
Staff does not provide adequate meal service.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Angela Panushkina and Michael Cava conducted an unannounced subsequent complaint visit to conclude the investigation regarding the above allegations. This initial visit to this complaint was made by LPA Cava on 05/26/23. LPAs met with the Executive Director, Peter Bonilla, and explained the reason for the visit. At approximately 11:30am to 1:00pm, LPAs conducted a physical plant inspection of the facility and conducted interviews with five (5) residents. A record review was also made.

Staff does not ensure resident's hygiene needs are being met:
In regards to the allegation, it was reported that Resident 1's (R1) hasn't had their nails clipped or cleaned in over two weeks. Also, it was alleged that R1 wasn't getting assistance with their teeth brushed. During the initial visit on 05/26/23, LPA Cava attempted to interview R1, but R1 was non-verbal to the LPA's questions. LPA did assess and observe R1 to be maintained and in good hygiene, and R1's nails to be manicured and kept. During visit on 10/27/23, LPAs were advised R1 is no loger at the

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Michael Cava	TELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2023

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-20230509133727

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: 10/27/2023

NARRATIVE

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facility. LPAs conducted interviews with five (5) of five residents, and all five denied the allegation of not getting their hygiene needs met. Therefore, based on the information obtained, the allegation of staff not insuring R1's hygiene needs not being met is deemed Unsubstantiated at this time.

Staff does not ensure resident's showering needs are being met:
In regards to the allegation, it was alleged that R1 has not been showered or bathed for weeks. During the initial visit on 05/26/23, LPAs reviewed R1's records, and confirmed R1 requires assistance with bathing. Record review also reveal that the facility maintained bathing schedule for R1 and other residents, showing that R1 was provided assistance with bathing two to four times per week. LPA Cava attempted to interview R1 on 05/26/23, but R1 was non-verbal to the LPA's questions. On 10/27/23, LPAs interviewed five of five residents, who all denied the allegation of not getting their bathing/showering needs met. Based on the information obtained, it could not be proven that staff does not ensure R1's showering needs are being met. Therefore, the allegation is deemed Unsubstantiated at this time.

Staff does not provide adequate meal service:
In regards to the allegation, it was reported that staff had forgotten to provide R1 their meals. No dates were specified on when R1 could have missed their meals. During the initial 10 day visit to investigate this allegation, LPA Cava attempted to interview R1 on 05/26/23, but R1 was non-verbal to the LPA's questions. On 05/27/23, LPAs conducted interviews with five (5) of five residents, and all five denied the allegation of not being provided an adequate meal service. In addition, LPAs conducted a walk through of the dining room area, and observed meals provided to all the residents that were there. Based on the information obtained, it could not be proven that staff does not provide adequate meal service. Therefore, the allegation is deemed Unsubstantiated at this time.

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Michael Cava	TELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2023

LIC9099 (FAS) - (06/04)

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