197608505-6-18-2021-28-AS-LHIS-C6VKD3-20210915074802

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608505
Report Date: 06/18/2021
Date Signed: 06/18/2021 12:25:38 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/22/2021 and conducted by Evaluator Cynthia D Chan

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20210222112225

FACILITY NAME:	GLEN PARK AT GLENDALE - BOYNTON ST		FACILITY NUMBER:	197608505
ADMINISTRATOR:	PINK, JR, TILLMAN		FACILITY TYPE:	740
ADDRESS:	1250 BOYNTON ST		TELEPHONE:	(818) 246-9000
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91205
CAPACITY:	98	CENSUS: 62	DATE:	06/18/2021
		UNANNOUNCED	TIME BEGAN:	11:05 AM
MET WITH:	Brenda Chacon, Assistant Administrator		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Facility staff are withholding resident's money.
Facility staff tampered with resident's mail.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Cynthia Chan conducted a subsequent complaint visit to deliver the findings on the allegations listed above. LPA met with Brenda Chacon and explained the purpose of the visit.

During the initial visit on 2/25/21, LPA Chan conducted telephone interviews with the Administrator, Office Manager, 7 residents, and a video call which consisted of a review of the facility lobby, kitchen, and rooms #17, #19, #33, #47, #51, #54, and #65. The LPA also requested copy of the staff and resident rosters, Physician's Report and Regional Center report if applicable for 7 residents. On 3/8/21, LPA Chan conducted additional interviews with 5 Staff telephonically.

The investigation revealed the following:
Regarding allegation – Facility staff are withholding resident’s money. It is alleged that when Resident #1 (R1) asked for the birthday money, the staff stated “you can’t have it right now”.
(Continue on LIC9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Cynthia D Chan	TELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021

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 28-AS-20210222112225

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: GLEN PARK AT GLENDALE - BOYNTON ST	FACILITY NUMBER: 197608505
	VISIT DATE: 06/18/2021

NARRATIVE

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The Assistant Administrator who manages the distribution of resident’s money, acknowledged that Resident #1 received a $500 check from the mother. R1 signed the check, returned it to her, and requested for the money at that moment. R1 is unable to cash own check and the facility manages R1’s money. The Assistant Administrator explained to R1 that the check needed to be cashed first before receiving the money. In addition, R1 is a Regional Center client and is given a limit to the amount of money that resident can handle at one time. LPA Chan verified with R1’s Service Coordinator and confirmed that resident is able to manage between $150 - $200. LPA interviewed 6 other residents who either stated the staff does not withhold their money or they manage their own money.

Regarding allegation #2– Facility staff tampered with resident’s mail. It is alleged that the staff opened R1’s mail, took out the $500 check and kept it. LPA Chan interviewed Administrator Archarya who stated that the staff do not open residents’ mail since they know it is not right. The Assistant Administrator stated that she did not open R1’s mail. R1 was given the mail at the front office and R1 opened it in front of her. R1 had anticipated the check and after opening the mail, R1 signed the check and handed it to the staff. Based on interviews with the other 5 staff, they do not open nor tamper with any resident’s mail. They are aware of the resident’s rights and opening mail without consent would be a violation of their rights. Staff explained that the mailman delivers mail to the front desk and the office staff will sort out the mail. Residents’ mails are either deliver them directly or residents pick up themselves at the front desk. If assistance is needed, the staff will help the resident open the package while the resident is present. 5 out of 7 residents interviewed stated that staff have not tampered with their mail.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

An exit interview was conducted with the Assistant Administrator. A copy of this report along with the appeal rights were provided.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Cynthia D Chan	TELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021

LIC9099 (FAS) - (06/04)

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