197608505-12-11-2025-31-AS-TAGD-DPNQVQ-20251224113043

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608505
Report Date: 12/11/2025
Date Signed: 12/11/2025 11:41:17 AM

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
12/01/2025 and conducted by Evaluator Nadia Shahbazian

COMPLAINT CONTROL NUMBER: 31-AS-20251201113926

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: 65	DATE:	12/11/2025
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Christopher Redmond-Assistant Administrator		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Licensee changed resident's Insurance without the resident or their responsible party's authorization.
Staff did not assist resident with their medication.
Medication staff not properly trained.
Licensee retaliates against the resident.

INVESTIGATION FINDINGS:

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On 12/11/2025 at approximately 9:45 AM, Licensing Program Analyst (LPA) Nadia Shahbazian conducted an unannounced subsequent complaint visit to the facility to conclude the investigation regarding the above allegations. Upon arrival, LPA was greeted by Christopher Redmond-Assistant Administrator and Executive Director-Susan Park and advised of the complaint.

To investigate the above allegations, on 12/09/2025 at approximately 10:00 AM, Licensing Program Manager (LPM) Troy Agard and Licensing Program Analyst (LPA) Nadia Shahbazian had conducted an unannounced initial complaint visit to the facility and requested relevant documentation. From 10:30 AM to 1:30 PM, LPA/LPM conducted a record review and interviews with residents and staff. on 12/09/2025 at 1:20 PM, LPA/LPM conducted a physical plant tour.

Continued on 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Nadia Shahbazian
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2025

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-20251201113926

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: 12/11/2025

NARRATIVE

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Regarding the Allegation: Licensee changed a resident’s insurance without the resident’s or responsible party’s authorization. It was alleged that a facility staff member modified the resident’s health insurance without consent from the resident or their responsible party. LPA and LPM interviewed five staff members out of a total of 45. Interviews indicated that any changes to a resident’s health insurance must be initiated by the resident and/or their responsible party. During an interview with Staff 1 (S1) stated they were unaware of who made the changes to the medication portion of R1’s health insurance and explained that such modifications are typically handled between R1’s Power of Attorney (POA) and the pharmacy. Interviews with W1 and W2 did not confirm who made the changes to R1’s medical insurance; however, both stated that the facility was not responsible for the alteration. Interviews with the resident were not able to confirm this allegation.

Regarding the Allegation: Staff did not assist the resident with their medication.
It was alleged that staff failed to package a one-day supply of R1’s medications, resulting in a shortage, particularly at the end of the month. It was further alleged that the facility refused to transport medication to address the shortage. LPA and LPM interviewed five staff members and residents. Interviews confirmed that the pharmacy provides medications in blister packs covering an entire month, and refills are typically ordered one week in advance to prevent any interruption in the medication supply. It was determined that R1 went on a home visit during the middle of a medication cycle, and the POA had been informed that the medication for the upcoming month was not yet available due to the holiday week. During an interview with S1, S1 stated they did not transport the medication because no authorized individual was available to deliver it, that such transport is not standard practice unless the facility is at fault for a medication error, and that they were not comfortable with the request to send the medication via “Uber” while R1 was on a home visit. Interviews with the resident were not able to confirm this allegation.

Continued on 9099-C

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Nadia Shahbazian
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 31-AS-20251201113926

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: 12/11/2025

NARRATIVE

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Regarding the Allegation: Medication staff not properly trained. It was alleged that a Medication Technician (Med Tech) was not properly trained in preparing medications for residents who leave the facility for outings. Staff interviews indicated that Med Techs receive training from both a virtual Registered Nurse (RN) and an onsite Licensed Vocational Nurse (LVN). Training includes medication administration procedures and certification requirements. During an interview with S1, it was reported that the facility recently implemented a new system intended to reduce medication-related issues for residents who go on home visits. A review of training records confirmed that Med Techs receive three to six weeks of training, including shadowing. Interviews with the resident were not able to confirm this allegation.

Regarding the Allegation: Licensee retaliates against the resident. It was alleged that the facility retaliated against the resident. Interviews with R1, residents and staff unanimously denied this allegation.

Based on interviews, record review, and all information gathered, the above allegation(s) are determined to be UNSUBSTANTIATED.

Exit interview was conducted, and a copy of this report was provided to the Assistant Administrator.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Nadia Shahbazian
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2025

LIC9099 (FAS) - (06/04)

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