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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608505
Report Date: 06/06/2025
Date Signed: 06/06/2025 03:13:30 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
03/25/2025 and conducted by Evaluator Abeye Duguma
COMPLAINT CONTROL NUMBER: 31-AS-20250325084258
FACILITY NAME:GLEN PARK AT GLENDALE - BOYNTON STFACILITY NUMBER:
197608505
ADMINISTRATOR:SUSAN PARKFACILITY TYPE:
740
ADDRESS:1250 BOYNTON STTELEPHONE:
(818) 246-9000
CITY:GLENDALESTATE: CAZIP CODE:
91205
CAPACITY:98CENSUS: 64DATE:
06/06/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Susan ParkTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Staff mismanages resident's medications.
Staff cannot communicate due to language barrier.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced subsequent complaint visit to this facility to investigate the above allegations. LPA met with Susan Park and explained the reason for the visit.

---Staff mismanages resident's medications.

It was alleged that staff did not provide medications for 02/28/2025 and are not giving medications as prescribed. To investigate the allegation, LPA requested documents at 11:45a.m., interviewed three (03) staff from 12:00p.m. to 1:00p.m. and seven (07) residents from around 1:00p.m. to 2:30p.m. A review of Resident #1’s (R1) Medication Administration Records shows that R1 was given their medications as prescribed.

(CONT. on LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:

DATE: 06/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 31-AS-20250325084258
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: 06/06/2025
NARRATIVE
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It also shows that on 02/28/2025 morning medications were given in the facility and R1 was sent with the evening medications for an overnight stay. During interviews with staff, all staff stated all medications are given as prescribed. During interviews with resident, all interviewed residents stated they are given their medications as prescribed.

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

---Staff cannot communicate due to language barrier.

It was alleged that staff do not follow orders because they do not speak English. To investigate the allegation, LPA requested documents at 11:45a.m., interviewed three (03) staff from 12:00p.m. to 1:00p.m. and seven (07) residents from around 1:00p.m. to 2:30p.m. A review of staff records revealed that all housekeepers have completed all necessary training. During interviews with staff, all staff stated although the English language is a second language for most staff, they are able to communicate effectively with residents and get the job done. If by any chance there is a miscommunication or barrier, we have plenty of other staff that speak all the languages that our residents speak. During interviews with resident, all interviewed residents stated they are able to communicate effectively with staff and they are able to meet all of their needs.

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

No health and safety hazards noted during the visit.
Exit interview conducted. Copy of this report issued.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:

DATE: 06/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2025
LIC9099 (FAS) - (06/04)
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