197608505-8-25-2025-31-AS-TAGD-DLCM39-20250909091447

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608505
Report Date: 08/25/2025
Date Signed: 08/25/2025 01:00:34 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 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
08/21/2025 and conducted by Evaluator Gina Saucedo

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20250821130800

FACILITY NAME:	GLEN PARK AT GLENDALE - BOYNTON ST		FACILITY NUMBER:	197608505
ADMINISTRATOR:	SUSAN PARK		FACILITY TYPE:	740
ADDRESS:	1250 BOYNTON ST		TELEPHONE:	(818) 246-9000
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91205
CAPACITY:	98	CENSUS: 67	DATE:	08/25/2025
		UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Susan Park, Administrator		TIME COMPLETED:	01:05 PM

ALLEGATION(S):

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Staff did not provide adequate supervision resulting in resident sexually abusing another resident.

INVESTIGATION FINDINGS:

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On 08/25/25, at 9:20am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, initial complaint visit and was greeted by Administrator, Susan Park. LPA explained the purpose of this visit was to gather information, interview staff and residents and deliver findings for this complaint.

On 08/25/25, at 9:45am, LPA Saucedo asked for the census, staff, and resident rosters. At 10:15am, LPA Saucedo conducted a physical tour, interviewed staff and residents.

LIC 9099C-continued

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2025

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-20250821130800

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: GLEN PARK AT GLENDALE - BOYNTON ST	FACILITY NUMBER: 197608505
	VISIT DATE: 08/25/2025

NARRATIVE

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Regarding the allegation: Staff did not provide adequate supervision resulting in resident sexually abusing another resident. It is being alleged that resident #1 (R1) has dementia with wandering behavior and can be confused/disoriented and might not have the capacity to consent to potential sexual interactions. During LPA's physical tour, LPA reviewed the facility cameras on 08/16/25, where it shows that R1 entered resident #2 (R2)'s room with their walker willingly. R2 was behind R1 walking normally. Let it be noted, R1 in non-ambulatory and R2 is ambulatory. About twenty-five to thirty minutes later, R1 was seen exiting R2's room. Both R1 and R2 continued to look outside of the room on their left and right side to check if anyone was coming in both directions. R1 proceeded to step out of R2's room and R2 came out right behind R1. LPA spoke to R1's daughter via telephone to check if the facility had contacted them and the daughter stated, "yes, they contacted me and stated R1 has the right to do what they want, I cannot stop them and R1 is happy and has not reported anything inappropriate them." LPA also spoke to four (4) staff that confirmed that R1 is always talking to R2 and two (2) staff confirmed that R1 has been seen with R2 on multiple occasions. Two (2) staff also confirmed that they saw R1 on the day of the incident where R1 came into the dining hall with messy hair and R1 seemed happy and did not report anything to them. LPA also interviewed R1 and R2 and they both stated that they are friends and they are both happy. Both also confirmed that they have not been sexually and/or physically abused by anyone. Let it be noted, both R1 and R2 are diagnosed with dementia. Both R1 and R2's Physician Report was obtained. LPA attempted to interview four (4) other residents but they did not understand what the LPA was asking. LPA also obtained the Unusual Incident/Injury Report regarding R1 and R2. Therefore, based on the LPA's observations, staff and resident interviews, the above allegation(s) above is UNSUBSTANTIATED at this time.

An exit interview was conducted, no citation(s) were issued, and a copy of this report was given to the Administrator.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2025

LIC9099 (FAS) - (06/04)

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