197609005-2-10-2026-31-AS-NMAN-DY6MXM-20260922100011

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609005
Report Date: 02/10/2026
Date Signed: 02/10/2026 05:11:25 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
02/06/2026 and conducted by Evaluator Antonia Alvizar-Ettima

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20260206091821

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: 95	DATE:	02/10/2026
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Executive Director, Carlos Lara & Director Community Relations (DCR), Tony Rios		TIME COMPLETED:	05:15 PM

ALLEGATION(S):

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Staff do not ensure resident's room is a safe and healthy environment
Staff do not ensure residents hygiene needs are met

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Antonia Alvizar- Ettima conducted an unannounced initial visit to investigate the above noted allegations. LPA met with the Executive Director (ED), Director Community Relations (DCR) and explained the reason for the visit.

At approximately 10:30a.m., LPA requested and received resident and staff roster, facility file of the resident #1 (R1), Physician Report, Identification Information, Appraisal/Needs and Services Pla and Unusual Incident Report. Between 11:05a.m. – 12:05p.m. LPA conducted interviews with ED, DCR, Witness #1 (W1) and resident #1 (R1). LPA also interviewed nine (09) out of ninety-five (95) residents. At approximately 12:10p.m., LPA, R1 and W1 conducted a tour of R1’s room. At approximately 12:40p.m., LPA reviewed copies of records relevant to the investigation.

Staff do not ensure resident's room is a safe and healthy environment
Cont. on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima
LICENSING EVALUATOR SIGNATURE:	DATE: 02/10/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2026

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-20260206091821

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: 02/10/2026

NARRATIVE

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Cont. from LIC 9099
It was alleged that R1 has been hoarding and does not allow staff inside their room to assist with cleaning. R1’s room was filled with boxes and trash all over it. R1 interview during investigation indicated that they needed more time to separate the boxes they just moved in from their storage unit. R1 indicated that they allow the housekeeper staff in their room when they needed assistance. R1 stated that there is nothing hazards in their room because they do not smoke nor do they light candles. Interviews with residents did not indicate any concerns. Interview with W1 indicated that there is a clear walkway in R1’s room. ED and DCR indicated that R1’s behavior of bringing stuff from outside into their room has been an off and on thing for several years. Interviews with the ED and DCR were consistent and corroborated by records reviewed. Documentation demonstrated ED made repeated attempts to address this issue with R1’s Social Worker via-Email to provide weekly housekeeping services and R1 refused. Records reflected ongoing communication with R1 regarding safety concerns. Observations during the visit LPA confirmed that R1’s does have boxes in their room however there was no obstructed walkways or exits.

Due to information provided by R1, observation and based on interviews, this allegation is deemed UNSUBSTANTIATED at this time.

Staff do not ensure residents hygiene needs are met

It was alleged that R1’s bathroom floor was filled with items to the top leaving it unusable to shower. R1 interview during investigation indicated that they were going to move the boxes from the bathroom just needed a little more time to do it. R1 indicated that they would ask maintenance staff for assistance if needed. R1 did not indicate any concerns regarding not being able to bathe or maintain their hygiene. Resident’s interviews did not indicate that they have any concerns about resident’s hygiene needs not met. Staff interviews indicated that they have not received any complaints regarding R1’s hygiene or any other resident in care. Documentation revealed that R1 is capable for self-care independently without facility staff assistance. R1’s bathroom was observed to be filled with items, however R1 indicated that they were going to clear it.

Due to information provided by R1 and based on interviews, record review this allegation is deemed UNSUBSTANTIATED at this time.

No health and safety hazards were noted during the visit. Exit interview was conducted and a copy of the report was issued.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima
LICENSING EVALUATOR SIGNATURE:	DATE: 02/10/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2026

LIC9099 (FAS) - (06/04)

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