197609005-3-18-2026-31-AS-NMAN-DVXRYM-20260713132635

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609005
Report Date: 03/18/2026
Date Signed: 03/18/2026 01:12:27 PM

Substantiated

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
01/02/2026 and conducted by Evaluator Antonia Alvizar-Ettima

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20260102091923

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: 99	DATE:	03/18/2026
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Executive Director, Carlos Lara		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff do not provide snacks to residents in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Antonia Alvizar- Ettima conducted an unannounced subsequent visit to deliver finding of the above noted allegation. LPA met with ED and explained the reason for this visit. During this visit at approximately 10:00a.m., LPA and ED conducted a physical plan tour and observed no health and safety issues.

It was alleged that facility does not provide any free snacks to residents in between meals or at bedtime. Resident #1 (R1’s) caregiver phoned the daytime receptionist to request snacks because R1 was hungry.
To investigate the allegation, during initial visit on 01/09/26 at approximately 10:00a.m., LPA requests and received copies of the facility resident and staff rosters. Between 10:45a.m. – 2:30p.m., LPA interviewed ED, Chef, Staff #1- 2 (S1-S2) and nine (9) out of ninety-three (93) residents.

Interviews with residents revealed that snacks are not routinely provided between meals. If they feel hungry
Cont. on LIC 9099-C

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2026

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-20260102091923

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: 03/18/2026

NARRATIVE

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Cont. from LIC9099

outside of scheduled mealtimes, they must buy a snack from the vending machine or go to the market. Staff interviews reveal that snacks are not consistently offered to residents and are not part of the facility’s regular daily meal schedule. Administrator indicated that in the past there was a resident that would take all the snacks and since then snacks have not been readily available or accessible to residents.

During the visit on 01/09/26, LPA conducted a tour of the facility kitchen and Coffee Room and did not observe any snacks readily available or accessible to residents between scheduled meals times in the Coffee Room. At the time of the visit the Coffee Room only had a vending machine selling snacks, there was no designated snack area or other common areas where residents could get snacks. There was no written documentation/notification posted in prominent areas indicating that snacks are regularly offered or available to residents. During inspection, LPA observed a schedule of mealtimes as follows; Breakfast time- 7:45am - 10:00am, Lunch time 11:30am – 1:00pm, Dinner time 4:30pm - 6:00pm. Snacks and refreshments (no time frame) are provided in Coffee Room. A review of the facility’s posted menu did not reflect the provision of snacks between meals.

Based on observation, interviews, and records reviewed, the facility failed to ensure that snacks are available and offered to residents between meals. Therefore, the allegation is SUBSTANTIATED at this time.

Exit interview conducted/Citations issued on 9099-D/Appeal rights/Copy of report given.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2026

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20260102091923

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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/18/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 04/08/2026 Section Cited CCR 87555(b)(3)	1 2 3 4 5 6 7	87555(b)(3) General Food Service Requirements(b) The following food service requirements shall apply: (3) Between meals nourishment or snacks shall be made available for all residents unless limited by dietary restrictions prescribed by a physician.	1 2 3 4 5 6 7	By POC due date, the licensee wil submit a written plan describing how snacks will be consistently available between meals. The facility menu will be updated to include snacks times and options, and a current weekly menu with snack information will be submitted to CCLD.
	8 9 10 11 12 13 14	This requirement is not met as evidenced by. On 01/09/26 and before licensee failed to ensure that snacks are available or accessible to residents between meals.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2026

LIC9099 (FAS) - (06/04)

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