197802560-2-9-2023-28-AS-RORN-CP4MQP-20230216084900

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197802560
Report Date: 02/09/2023
Date Signed: 02/09/2023 02:29:19 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
12/17/2020 and conducted by Evaluator Luis Mora

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20201217072904

FACILITY NAME:	GLEN PARK AT MONROVIA		FACILITY NUMBER:	197802560
ADMINISTRATOR:	ACHARYA, NIRJARA		FACILITY TYPE:	740
ADDRESS:	110 N MOUNTAIN AVE		TELEPHONE:	(626) 357-6818
CITY:	MONROVIA	STATE: CA	ZIP CODE:	91016
CAPACITY:	49	CENSUS: 38	DATE:	02/09/2023
		UNANNOUNCED	TIME BEGAN:	08:28 AM
MET WITH:	Pamela Ogot - Administrator		TIME COMPLETED:	02:47 PM

ALLEGATION(S):

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Staff are abusing residents
Staff are stealing from residents, staff and residents' family members
Staff steals residents' medication
Uncleared adult present at the facility
Facility is not maintained clean
Residents are not allowed to attend day programs

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Luis Mora conducted an unannounced complaint visit to determine the validity of the above-mentioned allegations. LPA met with Pamela Ogot (Administrator) and explained the reason for the visit.

The investigation consisted of the following: On 12/22/2020, LPA Joe Katrdzhyan conducted a telephone initial complaint visit and interviewed facility manager due to Covid-19. On 02/09/2023, LPA Mora obtained copies of resident staff rosters, interviewed Administrator, Facility Manager, Staff 1 - Staff 4 (S1 - S4), Resident 1 - Resident 6 (R1 - R6), and Day Program Director. LPA conducted a tour of the facility common areas, medication room and 6 random residents rooms.

The investigation revealed the following: regarding the allegation "staff are abusing residents", it is alleged that the facility's owner, CEO, CEO's significant other and a staff from corporate come to the facility to verbally and physically abuse the residents. (Continued to LIC 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3969
LICENSING EVALUATOR NAME: Luis Mora	TELEPHONE: 323-981-3964
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2023

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 28-AS-20201217072904

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: GLEN PARK AT MONROVIA	FACILITY NUMBER: 197802560
	VISIT DATE: 02/09/2023

NARRATIVE

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Staff interviewed denied the allegation and stated that these individuals do not work at this facility and it is very rare for these individuals to come to the facility. Residents interviewed could not corroborate with the allegation. LPA reviewed the staff roster with their work schedules and the individuals mentioned above are not listed on the roster.

Regarding the allegation "staff are stealing from residents, staff and residents' family members", it is alleged that the facility's owner, CEO, CEO's significant other and a staff from corporate steal money and belongings from residents, residents' family and facility staff. Staff interviewed denied the allegation. Resident interviewed could not corroborate the allegation.

Regarding the allegation "staff steals residents' medication", it is alleged that the facility's CEO comes to the facility to steal residents' medication. Staff interviewed denied the allegation and stated that the medication is kept locked at all times inside the medication room which also has a camera inside. Residents interviewed could not corroborate with the allegation and stated there has been no issues with their medications. LPA toured the medication room and confirmed medication is kept locked and that there is a camera inside the medication room.

Regarding the allegation "uncleared adult present at the facility", it is alleged that the facility's CEO significant other comes to the facility and this individual does not have background clearance to be at the facility. Staff interviewed denied the allegation. Residents interviewed could not corroborate with the allegation.

Regarding the allegation "facility is not maintained clean", it is alleged that the facility's CEO and a staff from corporate office force the residents to live in a very filthy environment. Staff interviewed denied the allegation and stated the housekeeping staff does a good job in maintaining the facility clean. Residents interviewed could not corroborate with the allegation. LPA toured the facility's common areas and 6 random residents' rooms and observed a clean facility.

Regarding the allegation "residents are not allowed to attend day programs", it is alleged that the facility's CEO and a staff from corporate office did not allowed residents to attend the day program. Interviews with Administrator and Facility Manager revealed that during 2020 they only had 1 resident that was attending a day program, but due to Covid-19 the day program could not provide in person services.
(Continued to LIC 9099C)

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3969
LICENSING EVALUATOR NAME: Luis Mora	TELEPHONE: 323-981-3964
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 28-AS-20201217072904

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: GLEN PARK AT MONROVIA	FACILITY NUMBER: 197802560
	VISIT DATE: 02/09/2023

NARRATIVE

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Interview with the Day Program Director revealed that per LA County Public Health and CDC guidelines they were not allowed to provide in-person services to consumers from Community Care Facilities. However, they provided virtual services to the resident at this facility. He also confirmed that from this facility they only serve one resident.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.

Exit interview held and a copy of the report was provided

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3969
LICENSING EVALUATOR NAME: Luis Mora	TELEPHONE: 323-981-3964
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2023

LIC9099 (FAS) - (06/04)

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