197608506-11-12-2024-31-AS-EMIR-DBWSXA-20241213131531

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608506
Report Date: 11/12/2024
Date Signed: 11/12/2024 03:23:23 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 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
05/23/2023 and conducted by Evaluator Evelin Rios

COMPLAINT CONTROL NUMBER: 31-AS-20230523084151

FACILITY NAME:	GLEN PARK AT GLENDALE - MARIPOSA ST		FACILITY NUMBER:	197608506
ADMINISTRATOR:	SUSAN PARK		FACILITY TYPE:	740
ADDRESS:	1220 S MARIPOSA ST		TELEPHONE:	(818) 242-9000
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91205
CAPACITY:	120	CENSUS: 94	DATE:	11/12/2024
		UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Susan Park and Assistant Administrator, Bryanna Luke		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Staff are sexually abusing residents and staff.
Facility staff are not qualified.

INVESTIGATION FINDINGS:

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On 11/12/24 Licensing Program Analyst (LPA) Evelin Rios arrived at the facility to conduct an unannounced subsequent visit to continue the investigation and provide determinations on the above allegations. LPA was greeted by the Executive Director (ED), Susan Park. LPA explained the reason for the visit.

To investigate the allegations, an initial visit was conducted on 05/30/23, by LPAs Michael Cava and Mariana Agban. During the initial visit LPAs interviewed the ED, Susan Park and conducted a record review. On 10/10/24 LPA Rios interviewed ten (10) randomly selected residents, the ED and one (1) staff. LPA reviewed five (5) resident records and obtained copies of pertinent documents. On todays visit 11/12/24, at approximately 10:10 a.m. LPA Rios conducted four (4) staff interviews. Residents interviewed were living in the facility during the initial visit on 05/30/23. At 12:00 p.m. LPA reviewed three (3) resident records. LPA reviewed 9 residents' medication and medication records for correctness. To assist with the investigation LPA Rios referenced the investigation conducted by LPAs Esther Cortez, Ashley Smith, and Kelly Dulek at Glen Park at Ojai, Complaint Control 29-AS-20230406155619. (Cont. to LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Evelin Rios	TELEPHONE: 424-299-6104
LICENSING EVALUATOR SIGNATURE:	DATE: 11/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2024

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-20230523084151

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: GLEN PARK AT GLENDALE - MARIPOSA ST	FACILITY NUMBER: 197608506
	VISIT DATE: 11/12/2024

NARRATIVE

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(Continued from LIC9099)
Allegation #1: Staff are sexually abusing residents and staff. Regarding the allegation, it was reported that Staff#1 (S1) has been sexually abusing residents. Interviews conducted by LPA Rios on 10/15/24, and 11/12/24 revealed eight (8) residents and five (5) staff that lived and worked in the facility since the initial visit all denied either being sexually abused or witnessing any staff sexually abuse residents. Interview obtained from Complaint Control 29-AS-20230406155619 with S1 revealed they deny ever abusing any residents in any form. Staff interviews revealed S1 has minimal to no contact with residents at this facility and they have never witnessed S1 alone with a resident. Furthermore seven (7) out of the ten (10) residents interviewed revealed all staff in general treat residents well, and residents did not voice any concerns of sexual abuse. Interview with one (1) resident had concerns regarding staff, but it did not involve sexual abuse and two (2) residents were asleep during visit. LPAs tours of the facility on 05/30/23, 10/15/24 and 11/12/24 did not observe and health or safety concerns or issues. Based on interviews, there is insufficient evidence to support the claim that, staff are sexually abusing residents and staff, therefore the allegation is deemed Unsubstantiated at this time.

Allegation #2: Facility staff are not qualified. Regarding the allegation, it was reported that Staff#1 (S1) is not qualified to run and manage the facility. To investigate the allegation LPA conducted interviews with the ED and staff. According to the ED, S1 is part of the cooperation and has no contact with residents directly. When S1 visits the facility they meet with the administration to discuss and conduct building safety checks. S1 reports any concerns to the Administrator. According to the ED, S1 does not work in the capacity to "run and manage" the facility. The ED is responsible for the day to day operations of the facility. Furthermore, the there is also an administrator assistant at this facility. Review of the Administrator Certification for Susan Park is active and she has been the administrator since the initial visit. According to staff, S1 conducts quality assurance visits, for example issues with the physical building in regards to issues like workers compensation. Based on interviews and record review the allegation is deemed Unsubstantiated at this time.

Exit interview conducted. A copy of the report was issued to Assistant Administrator, Bryanna Luke.

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Evelin Rios	TELEPHONE: 424-299-6104
LICENSING EVALUATOR SIGNATURE:	DATE: 11/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2024

LIC9099 (FAS) - (06/04)

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