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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608505
Report Date: 11/13/2025
Date Signed: 11/13/2025 04:05:54 PM

Substantiated


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
06/06/2025 and conducted by Evaluator Abeye Duguma
COMPLAINT CONTROL NUMBER: 31-AS-20250606101944
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: 66DATE:
11/13/2025
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Chris RedmondTIME COMPLETED:
03:27 PM
ALLEGATION(S):
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Facility staff did not follow reporting requirements
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced initial complaint visit to this facility to investigate the above allegations. LPA met with Chris Redmond and explained the reason for the visit.

---Facility staff did not follow reporting requirements

It was alleged that facility has multiple unreported incidents involving Resident #1 (R1). To investigate the allegation, on 06/12/2025 LPA Melissa Spaeth interviewed three (03) staff from around 11:20a.m. to 1:15p.m. On 06/16/2025, LPA Spaeth interviewed other parties. To further investigate the allegation, on 11/13/2025, LPA contacted Local Ombudsman office and reviewed the Community Care Licensing Department’s records.

(CONT. on LIC9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2025
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 6
Control Number 31-AS-20250606101944
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: 11/13/2025
NARRATIVE
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During interviews with staff, all staff stated they follow all reporting requirements. During interviews with Staff #1 (S1), they stated facility has had multiple incidents involving staff and other residents. S1 also stated that R1 had an incident on 05/28/2025 involving a physical altercation between R1 and another resident. During interviews with other parties, they stated facility did not notify the Responsible Party until the following day that an incident had occurred. The Local Ombudsman stated they were not given authorization to release the information to the LPA. Although facility notified the Responsible Party within 24 hours, a review of the Department’s records revealed that facility did not notify the department of the alleged incidents between R1 and staff, and R1 and resident(s).

Based on interviews and record reviews, there is enough information to verify the allegation. Therefore, the allegation is SUBSTANTIATED at this time.

Pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 9099-D):

No health and safety hazards noted during the visit.

Exit interview conducted. Copy of this report issued.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 6
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
06/06/2025 and conducted by Evaluator Abeye Duguma
COMPLAINT CONTROL NUMBER: 31-AS-20250606101944

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: 66DATE:
11/13/2025
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Chris RedmondTIME COMPLETED:
03:27 PM
ALLEGATION(S):
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Facility staff is retaliating against resident.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced initial complaint visit to this facility to investigate the above allegations. LPA met with Chris Redmond and explained the reason for the visit.

--- Facility staff is retaliating against resident.

It was alleged that S1 is retaliating against R1. To investigate the allegation, on 06/12/2025 LPA Melissa Spaeth interviewed three (03) staff and seven (07) residents from around 11:20a.m. to 1:15p.m. LPA was unable to interview R1. To further investigate the allegation, on 11/13/2025, LPA contacted Local Ombudsman office.

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

DATE: 11/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 31-AS-20250606101944
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: 11/13/2025
NARRATIVE
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During interviews with staff, all staff stated they do not retaliate against residents and have never witnessed S1 retaliating against R1. During interviews with residents, all residents stated they have never experienced any retaliation from S1. S1 stated R1 has had multiple altercations between staff and residents and that a 30-day eviction was issued for the health and safety of other residents, staff and R1. The Local Ombudsman stated they were not given authorization to release the information to the LPA.

Based on interviews, 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: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 31-AS-20250606101944
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/13/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/17/2025
Section Cited
CCR
87211(a)(1)(D)
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Reporting Requirements(a)(1)A written report shall be submitted to the... agency.. within seven days…(D)Any incident which threatens the welfare, safety or health of any resident,... by staff or other residents,...This requirement is not met as evidenced by;
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Licensee will review the CCR Title 22 87211 and submit a written letter stating they have reviewed the regulation and going forward will ensure to adhere to the regulation by the POC due date.
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Based on interviews & record review, Licensee did not submit to the licensing agency...within 7 days an incident that threatened the welfare, safety or health of a residents which poses a potential health, safety and personal rights risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 6