197609005-11-27-2023-31-AS-NMAN-D8EU6D-20240823151811

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609005
Report Date: 11/27/2023
Date Signed: 11/27/2023 04:04:07 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
11/20/2023 and conducted by Evaluator Rosaura Valenzuela

COMPLAINT CONTROL NUMBER: 31-AS-20231120120707

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: 98	DATE:	11/27/2023
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Carlos Lara, Executive Director		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Staff do not ensure infection control plans are followed for residents in care

Staff do not ensure residents personal property is adequately disinfected

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Rosaura Valenzuela conducted an unannounced complaint investigation for the above noted allegations. LPA met with Exexcutive Director Carlos Lara and explained the reason for vist.

It was alleged that staff do not ensure infection control plans are followed for residents in care. It was reported that two residents have scabies. To investigate this allegation on 11/27/2023, between 1:00pm and 2:00pm, staff interviews were initiated. Interviews revealed that Resident #1 (R1) and Resident #2 (R2) have been itchy and scratching their skin, but that neither of the two residents have been diagnosed by a medical doctor for scabies. They have both been given medicated creams to help alleviate the itchy skin. Both residents are doing better and scratching less often. Between 2:00pm and 2:30pm, LPA reviewed facility records. Records did not reveal that either R1 or R2 have scabies or have been diagnosed with scabies.
Continue on 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Rosaura Valenzuela	TELEPHONE: 818-596-4334
LICENSING EVALUATOR SIGNATURE:	DATE: 11/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023

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-20231120120707

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 TERRA ASSISTED LIVING	FACILITY NUMBER: 197609005
	VISIT DATE: 11/27/2023

NARRATIVE

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Based on interviews and record review there is not sufficient information to verify this allegation. Therefore, this allegation is UNSUBSTANTIATED at this time.

It was alleged that staff do not ensure residents personal property is adequately disinfected. It was reported that the all the residents clothes are washed together and not separated from those that have scabies. To investigate this allegation between 1:00pm and 2:00pm, staff interviews were initiated. Interviews revealed that residents clothes are washed separately, but the linens and towels are not. The washing machines and dryers are pre-set to hot temperatures to make sure everything gets disinfected. In addition, if the towels or linens are white, bleach is also added to the wash. There are six washing machines and there is a schedule that each resident has as to when their clothes gets washed. Currently, the facility does not have any residents with an active case of scabies. Between 3:15pm and 3:30pm, LPA went to inspect one of the laundry rooms. LPA observed more that one washing machine and staff washing residents clothes separately.

Based on interviews and observation, there is not sufficient information to support this allegation. Thus, this allegation is UNSUBSTANTIATED at this time.

Exit interview conducted and a copy of the report was issued.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Rosaura Valenzuela	TELEPHONE: 818-596-4334
LICENSING EVALUATOR SIGNATURE:	DATE: 11/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023

LIC9099 (FAS) - (06/04)

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