197609005-7-19-2022-28-AS-FFIS-CHE2JF-20220817172618

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609005
Report Date: 07/19/2022
Date Signed: 07/19/2022 12:37:54 PM

Unsubstantiated

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
01/25/2022 and conducted by Evaluator Mary G Flores

COMPLAINT CONTROL NUMBER: 28-AS-20220125164903

FACILITY NAME:	GLEN TERRA ASSISTED LIVING		FACILITY NUMBER:	197609005
ADMINISTRATOR:	RECORDS, TERRY		FACILITY TYPE:	740
ADDRESS:	917 N LOUISE STREET		TELEPHONE:	(818) 291-1918
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91207
CAPACITY:	155	CENSUS: 94	DATE:	07/19/2022
		UNANNOUNCED	TIME BEGAN:	08:42 AM
MET WITH:	Carlos Lara - Administrator		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Resident's apartment smells malodorous

INVESTIGATION FINDINGS:

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Licensing Program Analyst(s) (LPA) Mary Flores conducted an unannounced complaint investigation visit regarding the above allegation(s). LPA met with Carlos Lara Administrator and explained the reason for the visit.

The investigation consisted of the following: On 1/28/22 , LPA Chan toured the facility and gathered a copy of the staff roster, resident roster, and the housekeeping schedule for a week. On 7/19/22 LPA Flores conducted a tour of rooms #201,202,208,301,302,304, 401,402,404,406, alley/waste - trash containers/septic tank area, interview resident #1(R1),#2(R2),#3(R3),#4(R4),#5(R5),#6(R6),#7(R7),#8(R8),#9(R9),#10(R10), administrator (S1), staff #2(S2),#3(S3),#4(S4),#5(S5).

The investigation revealed the following: Regarding allegation: Resident's apartment smells malodorous. It is alleged apartment smells like sewage and that the smell is making resident sick. Interviews with residents revealed 6 out of 10 residents stated they have not experienced malodorous smells in their rooms or inside the facility. 2 out of 10 residents stated to have experienced sewer smell that comes into their rooms.
(CONTINUED ON LIC 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Stefanie Coronel	TELEPHONE: (323) 981-3961
LICENSING EVALUATOR NAME: Mary G Flores	TELEPHONE: (323) 981-3965
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2022

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-20220125164903

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 TERRA ASSISTED LIVING	FACILITY NUMBER: 197609005
	VISIT DATE: 07/19/2022

NARRATIVE

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1 out of the 2 residents stated that as long as the windows are closed the smell does not come inside the room. 1 out of 10 residents refused to be interview at the time of the visit, and 1 out of 10 residents was unable to be interview due to cognitive skills. Interviews with staff revealed 4 out of 5 staff stated to have noticed a smell produced by the cleaning of the septic tanks that lingers in the air outside for a couple of hours, however when the windows of the dining room and apartments in that area are closed the smell does not come inside the building and goes away within 30 minutes to 2 hours. Administrator stated that the smell is not a consequence of the septic tanks however a result of the sewage system in the alley and the smell does become stronger during the summer. The city has come to clean the sewage but workers have said that the heat will continue to create the smell in the area. Administrator stated that R9 has been offered to switch rooms at no additional cost but has refused to move from current room. During the tour of the facility conducted on 7/19/22, LPA Flores did not smell any malodorous smells in the residents rooms, dining room area, or facility hallways observed. LPA did noticed sewage smell while walking by the alley outside of the facility, and the smell was very faintly and did not rise above ground level. Documents reviewed revealed staff area assigned areas and rooms to clean on a daily basis and JR Grease Services provided septic pumping services on 1/13/22 and 5/12/22.

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

Exit interview was conducted with Anna Tupinyan - Wellness Director and a copy of this report was provided.

SUPERVISOR'S NAME: Stefanie Coronel	TELEPHONE: (323) 981-3961
LICENSING EVALUATOR NAME: Mary G Flores	TELEPHONE: (323) 981-3965
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2022

LIC9099 (FAS) - (06/04)

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