197608505-6-23-2026-31-AS-TAGD-DVHLZ5-20260629091123

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608505
Report Date: 06/23/2026
Date Signed: 06/23/2026 12:05:41 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
05/29/2025 and conducted by Evaluator Gina Saucedo

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20250529103419

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: 66	DATE:	06/23/2026
		UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Susan Parks, Administrator		TIME COMPLETED:	12:05 PM

ALLEGATION(S):

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Staff did not ensure resident was allowed to be readmitted to the facility
Staff do not ensure resident receives assistance with using the bathroom
Staff do not ensure resident receives adeqaute food portions
Staff do not ensure resident is spoken to in an appropriate manner

INVESTIGATION FINDINGS:

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On 06/23/26, at 8:15am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, subsequent complaint visit and was greeted by Susan Park, Administrator. LPA explained the purpose of this visit was to gather additional information and deliver findings for this complaint.

On 05/30/25, Licensing Program Analyst (LPA) Perchui Milena Khurshudyan conducted the initial complaint visit, conducted a physical tour and received documentation. On 06/23/26, at 8:50am, LPA Saucedo conducted another physical tour, interviewed additional staff and residents and received additional documentation.

LIC 9099C-continued

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2026

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-20250529103419

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: 06/23/2026

NARRATIVE

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Regarding the allegation: Staff did not ensure resident was allowed to be readmitted to the facility. It is alleged that resident #1 (R1) was not allowed back to the facility on 05/29/25. During LPA’s interview with staff #1 (S1), Responsible Party picked up R1 from hospital on 05/29/25 and brought R1 back to the facility without providing a discharge report from the hospital. S1 continued by saying R1 was sent to the hospital on 05/28/25 for a psychological evaluation. Furthermore, S1 confirmed that they had advised R1’s Responsible Party that R1 needed higher level of care and/or adjustment of medication because of all the behaviors R1 was exhibiting and R1 was also using a CPAP- Continuous Positive Airway Pressure machine nightly machine in the facility that required a skilled professional to provide to R1 and it was brought into the facility by R1’s daughter/responsible party without the facility’s knowledge. Although, R1’s daughter Responsible Party did not listen to S1 and their concern or R1’s higher level of care, R1 was still allowed back to the facility and R1 did not leave the facility again until 07/22/25 when R1’s daughter took R1 back to the hospital for having a fever and R1 never returned back to the facility. During LPA's interview with R1's daughter/responsible party, they confirmed that R1 was readmitted to the facility on 05/29/25 but they also brought R1 back from the hospital because they disagreed on R1 being at the hospital. LPA did obtain the Unusual/Incident/Injury report for 05/28/25 that was sent to Community Care Licensing Department. Therefore, based on the interviews conducted the allegation(s) is UNSUBSTANTIATED at this time.

Regarding the allegation: Staff do not ensure the resident receives assistance with using the bathroom. It is alleged that Resident #1 (R1) requires assistance with urinating every hour per doctor's orders. During LPA's file review, LPA obtained the doctor's order from 05/09/25, where it asks if R1's caregiver can assist with bladder training, visits to the restroom every hour. Let it be noted that R1's daughter/responsible party opted out of optional services, such as a one-to-one supervision program for R1, in the Admission Agreement. During LPA's interview with Staff #1 (S1) and S2, both staff stated that R1's daughter responsible party did not want R1 to wear any diapers or pull-ups and was demanding that facility staff attend to R1's bathroom needs by taking R1 to the restroom every hour, despite having the opportunity to pay for one-to-one supervision. S1 further stated that there are sixty (60) other residents in the facility who require care, some of whom receive one-to-one supervision, and that staff were doing their best to remind R1 to urinate as regularly as possible. During LPA's interview with R1's daughter/responsible party, did confirm that they did not want R1 to wear any diapers/pull-ups. Therefore, based on the interviews conducted the allegation is UNSUBSTANTIATED at this time.

LIC 9099C-continued

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2026

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20250529103419

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: 06/23/2026

NARRATIVE

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Regarding the allegation: Staff do not ensure resident receives adequate food portions. It is alleged that resident #1 (R1) did not get a larger portion size of food that was an order from the doctor. During LPA’s file review, LPA obtained the prescription of the doctor dated 05/09/25 that confirms that a daily additional meal with protein was supposed to be provided to R1. On 05/28/25, there was another doctor’s order for R1’s daughter/responsible behavior to provide protein shakes to R1. During LPA’s interview with staff #1 (S1) confirmed R1, R1 was provided extra snacks by the facility and by R1’s daughter/responsible party. Furthermore, S1 confirmed that they spoke to R1’s daughter/responsible party about the order from the doctor and told R1’s daughter/responsible party that the admission agreement under food services states: Three nutritious meals daily with snacks…which is part of their basic services and R1’s daughter/responsible party would have to pay for the any extra meals outside of that agreement instead they only brought snacks for R1. R1’s daughter/responsible party never bought the protein shakes for R1 only the doctor’s prescription. During LPA’s interview with R1’s daughter/responsible party, they confirmed they bought snacks for R1 but not protein shakes and did not pay the facility for extra meals. Although, R1’s medical assessment, preplacement appraisal resident appraisal and functional capability assessment did not indicate R1 was on a special diet and/or needed other portions of food S1 stated we tried our best to accommodate the eating habits of R1 we provided extra yogurt, sandwiches. Therefore, based on the interviews and file review of R1 conducted the allegation(s) is UNSUBSTANTIATED at this time.

Regarding the allegation: Staff do not ensure resident is spoken to in an appropriate manner. It is alleged that resident #1 (R1) was yelled at because they were trying to exit the front door. During LPA’s interview with staff #1 (S1) and S2, both confirmed that R1 would walk around the facility a lot and on multiple occasions R1 would try to exit the front door when they would see others exiting and/or entering the facility. S1 stated, “we were trying to redirect R1 not yell at them." S2 also stated, "R1 needed a lot of redirection." During LPA’s interview with R1’s daughter/responsible party, they confirmed that they were not at the facility when this happened, but they were on the phone and heard them redirecting R1. LPA obtained R1's Preplacement Appraisal and Resident Appraisal that confirms R1 needed constant redirection. Therefore, based on the interviews and file review of R1 conducted the allegation(s) is UNSUBSTANTIATED at this time.

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

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2026

LIC9099 (FAS) - (06/04)

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