197609007-2-7-2024-31-AS-NMAN-D2NRFZ-20240221115954

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609007
Report Date: 02/07/2024
Date Signed: 02/07/2024 03:47:11 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
01/30/2024 and conducted by Evaluator Rosaura Valenzuela

COMPLAINT CONTROL NUMBER: 31-AS-20240130170529

FACILITY NAME:	GLENDALE GARDEN CARE HOME		FACILITY NUMBER:	197609007
ADMINISTRATOR:	DEANON, IRENE		FACILITY TYPE:	740
ADDRESS:	405 CHESTER STREET		TELEPHONE:	(818) 640-2912
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91203
CAPACITY:	6	CENSUS: 5	DATE:	02/07/2024
		UNANNOUNCED	TIME BEGAN:	11:46 AM
MET WITH:	Irene Deanon,		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Staff is holding resident against resident's will.
Staff is financially abusing resident in care.
Staff does not allow resident access to resident's personal records.
Staff confiscated resident's cell phone.
Staff does not accord resident private phone calls and visitations.
Staff does not allow Ombudsman access to resident's personal records.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Rosaura Valenzuela conducted an unannounced visit for the above noted allegations. LPA met with Administrator Irene Deanon and explained the reason for the visit.

It was reported tha staff is holding resident against resident's will. To investigate this allegation, on 2/07/2024, between 12:00pm and 12:45pm, staff interviews were initiated. Interviews revealed that staff is not retaining Resident #1 (R1) against their will. R1 wants to go home , but their responsible party can not look after them due to their many underlying medical diagnoses. Between 1:00pm and 1:30pm, LPA reviewed facility records. Records revealed that R1 has several co-morbidities that require constant care and supervision.

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

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: 02/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024

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-20240130170529

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: GLENDALE GARDEN CARE HOME	FACILITY NUMBER: 197609007
	VISIT DATE: 02/07/2024

NARRATIVE

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It was alleged that staff is financially abusing resident in care. To investigate this allegation, LPA interviewed the Administrator. Interviews revealed that staff is not financially abusing the resident in care. R1 does not have any money on them. R1 has a designated power of attorney and they handle all their finances. Between 1:00pm and 1:30pm, LPA reviewed facility records. Records confirmed what facility told LPA.

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

It was reported that staff does not allow resident access to resident's personal records. To investigate this allegation, LPA spoke to the Administrator. Interviews revealed that R1 was provided copies of documents requested. R1 has requested documentation a total of three times since they have lived at the facility, Between 2:00pm and 2:30pm, LPA spoke to R1's responsible party and they verified what facility had told LPA.

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

It was alleged that staff confiscated resident's cell phone. To investigate this allegation, between 12:00pm and 12:45pm, staff interviews were initiated. Interviews revealed that R1 had an I-Phone and got it wet. R1's responsible party took the phone and had it repaired. After it was fixed, R1 broke the phone and their responsible party decided not to replace it. Between 2:00pm and 2:30pm, LPA spoke to R1's responsible party and they confirmed the information that facility had told to LPA.

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

It was reported that staff does not accord resident private phone calls and visitations. To investigate this allegation, between 12:00pm and 12:45pm staff interviews were initiated. Administrator denied that R1 was not allowed to make or receive private phone calls. In addition, Administrator also denied that R1 was not allowed to have private visitations. Between 2:00pm and 2:30pm, LPA spoke to R1's responsible party

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Rosaura Valenzuela	TELEPHONE: 818-596-4334
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 31-AS-20240130170529

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: GLENDALE GARDEN CARE HOME	FACILITY NUMBER: 197609007
	VISIT DATE: 02/07/2024

NARRATIVE

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and they confirmed the information that facility had told LPA. Responsible party told LPA that R1 has always been allowed to make calls and to have visitors at the facility.

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

It was alleged that staff does not allow Ombudsman access to resident's personal records. To investigate this allegation between 12:00pm and 12:45pm, staff interviews were initiated. Interviews revealed that facility Administrator contacted R1's responsible party and they did not want their family member's file to be provided to the Ombudsman. Administrator told Ombudsman that they could not release the information du to HIPPA. Ombudsman insisted and contacted R1's responsible party. Between 2:00pm and 2:30pm, LPA spoke to R1's responsible party. They told LPA that they were willing to give Ombudsman R1's file, but that they refused to take it. R1's responsible party was told to take the file to the Ombudsman's office.

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

Exit interview provided 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: 02/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024

LIC9099 (FAS) - (06/04)

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