197608505-5-13-2026-31-AS-TAGD-DURTB2-20260605143424

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608505
Report Date: 05/13/2026
Date Signed: 05/13/2026 01:33:17 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
05/11/2026 and conducted by Evaluator Gina Saucedo

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20260511145120

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: 58	DATE:	05/13/2026
		UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Susan Parks, Executive Director		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff did not prevent a verbal altercation between residents
Staff did not prevent a phyiscal altercation between residents resulting in injury

INVESTIGATION FINDINGS:

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On 05/13/26, at 9:25am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, initial visit was greeted by Susan Parks, Executive Director. LPA explained the purpose of this visit was to gather information, interview staff and residents and deliver findings for this complaint.

On 05/13/26, LPA Saucedo asked for the census, staff, and resident rosters. On 05/13/26, at 9:45am, LPA Saucedo conducted a physical tour, interviewed both residents and staff.

LIC 9099C-continued

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 05/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2026

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-20260511145120

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: 05/13/2026

NARRATIVE

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Regarding the allegation: Staff did not prevent a verbal altercation between residents. It is being alleged that resident #1 (R1) and resident #2 (R2) began to argue at the front desk because both residents wanted to talk to the receptionist. During LPA's physical tour, LPA reviewed the facility cameras and R1 was seen arguing with the receptionist at the front desk, before R2 arrived at the front desk. R1 and R2 were then seen talking to each other for a bit. LPA conducted five (5) resident interviews. Out of the five (5) residents, three (3) resident interviews were attempted but to no avail were the residents understanding what the LPA was asking including R1 and R2. Furthermore, R1 and R2 did not remember the incident. Let it be noted R1 and R2 are diagnosed with dementia. In addition, LPA interviewed three (3) staff that confirmed R1 and R2 were not arguing it was R1 arguing with the staff member. LPA also received the Unusual Incident/Injury Report and SOC 341 which was reported to Community Care Licensing Department, the Police Department and the Ombudsman. Therefore, based on the LPA's observations, staff and resident interviews conducted, the allegation is UNSUBSTANTIATED at this time.

Regarding the allegation: Staff did not prevent a physical altercation between residents resulting in injury. It is being alleged that resident #1 (R1) stabbed resident #2 (R2) with a pen and staff did not prevent it. During LPA's physical tour, LPA reviewed the facility cameras and R2 was seen pushing their walker into R1 when R1 suddenly hit R2 with a pen which they already had in their hand. The cameras show that two (2) staff immediately responded to the incident. Let it be noted, R1 and R2 were not arguing before the incident. R2 was standing behind R1 when R1 got hit by R2 using their walker. LPA conducted five (5) resident interviews. Out of the five (5) residents, three (3) resident interviews were attempted but to no avail were the residents understanding what the LPA was asking including R1 and R2. Furthermore, R1 and R2 did not remember the incident. Let it be noted R1 and R2 are diagnosed with dementia. In addition, LPA interviewed three (3) staff that confirmed R1 and R2 are friends and are always together talking and walking around the facility. LPA also received the Unusual Incident/Injury Report and SOC 341 which was reported to Community Care Licensing Department, the Police Department and the Ombudsman. Therefore, based on the LPA's observations, staff and resident interviews conducted, the allegation 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: 05/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2026

LIC9099 (FAS) - (06/04)

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