197608505-1-21-2026-31-AS-TAGD-DT7P9V-20260416110745

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608505
Report Date: 01/21/2026
Date Signed: 01/21/2026 02:14:01 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
01/14/2026 and conducted by Evaluator Abeye Duguma

COMPLAINT CONTROL NUMBER: 31-AS-20260114125531

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:	01/21/2026
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Christopher Redmond, Assistant Administrator		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff did not ensure that resident was provided a safe environment.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced initial complaint visit to investigate the above allegation. LPA met with Assistant Administrator, Christopher Redmond, and explained the reason for the visit.

--- Staff did not ensure that resident was provided a safe environment.

It was alleged that Resident #1 (R1) was pushed and pulled to the ground on multiple occasions by two former roommates approximately one month ago. To investigate the allegation, on January 21, 2026, LPA requested documents at 9:30am and interviewed three staff and six residents from 10:00a.m. – 1:00p.m. A review of facility schedule shows there are five caregivers and one MedTech during the morning and afternoon shifts and three caregivers for the overnight shift. A review of the Department’s records shows that R1 had two fall incidents during the period in question.
(CONT. on LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026

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-20260114125531

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: 01/21/2026

NARRATIVE

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During interviews with residents, R1 stated on two separate occasions, Resident #2 (R2) pushed them to the floor and Resident #3 (R3) pulled them to the bed. R1 could not recall when. R1 added there were no witnesses during both alleged incidents. During the interview, R1 stated, “I think that happened, I may have imagined it.” LPA was unable to interview R2 and R3 due to current health conditions. During interviews, all staff stated they did not witness the alleged incident or know of any witnesses. Staff added residents are checked on at least every hour or more frequently if needed. Staff #1 (S1) stated R1 was evaluated, did not have visible injuries but was sent to the hospital as a precaution. On both alleged incidents, the hospital returned R1 with no injury. S1 stated as an additional precautionary measure, R1 was moved to another room on both alleged occurrences.

Based on interviews and record review, 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 and a copy of the report was issued.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026

LIC9099 (FAS) - (06/04)

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