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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602134
Report Date: 03/04/2026
Date Signed: 03/04/2026 04:58:18 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/14/2026 and conducted by Evaluator Jose Anguiano
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20260114115021
FACILITY NAME:GLEN PARK AT LONG BEACHFACILITY NUMBER:
198602134
ADMINISTRATOR:MICHAEL MENDOZAFACILITY TYPE:
740
ADDRESS:1046 E 4TH STTELEPHONE:
(562) 432-7468
CITY:LONG BEACHSTATE: CAZIP CODE:
90802
CAPACITY:208CENSUS: 114DATE:
03/04/2026
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Catherine DecaraTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Staff did not ensure resident medication was taken as prescribed
INVESTIGATION FINDINGS:
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On 03/04/2026 around 12:00 PM, Licensing Program Analyst (LPA) Jose Anguiano conducted an subsequent unannounced complaint visit. LPA met with Administrator Catherine Decara.
The investigation consisted of the following:
On 01/22/2026, during the visit, LPA interviewed 11 residents (R1–R11) and 8 staff members (S1–S8). LPA collected the staff roster for the week of 01/18/2026 to 01/24/2026, the resident roster dated 01/20/2026, and Medication Administration Records (MARs) for two residents (R1–R2) for November 2025, December 2025, and January 2026. LPA also reviewed the facility’s Plan of Operation and Personnel Policies. On 03/04/2026, LPA collected a sample medication/treatment administration record for March 2026 for R2 and the MARs for December 2025 and January 2026 for R1.
Investigation revealed the following:
Regarding the allegation “Staff did not ensure resident medication was taken as prescribed,” it is being alleged that Resident (R1) time-sensitive medications were consistently administered later than prescribed.
Please see report continuation on LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Jose Anguiano
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 11-AS-20260114115021
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: GLEN PARK AT LONG BEACH
FACILITY NUMBER: 198602134
VISIT DATE: 03/04/2026
NARRATIVE
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Interviews Conducted revealed: Staff (1-6) confirmed the facility’s medication scanner was functioning properly from January 2026 to present date. R1 stated that routine medications are often not administered on time. Staff (S1–S6) confirmed that MAR entries include the medication name, dosage, administration time, and staff initials, stamped at the time of administration. Observations: LPA observed a demonstration by five staff members (S1–S5) of the medication scanner scanning a sample resident medication. The printed timestamp accurately reflected the time, date, and medication description at the time the sample was conducted. Records Review: MARs for R1 from December 2025 and January 2026 indicate multiple routine medications were administered 1–2 hours after the prescribed time. The scanner demonstration confirmed equipment is operational, eliminating equipment malfunction as a justification for late administration as previously stated. Based on the evidence gathered, interviews conducted, observations, and records reviewed, the preponderance of evidence standard has been met; therefore, the allegation is SUBSTANTIATED. This is a violation of California Code of Regulations, Title 22, §87465, Incidental Medical and Dental Care.
A citation is being issued on the attached LIC-9099D. An exit interview, a copy of this report, and appeal rights were provided to the Administrator.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Jose Anguiano
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 11-AS-20260114115021
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: GLEN PARK AT LONG BEACH
FACILITY NUMBER: 198602134
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/04/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/11/2026
Section Cited
CCR
87465(a)(1)
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87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility.The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following: (1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents. This requirement is not met as evidenced by
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Administrator agreed to send LPA a plan of correction on due date. jose.anguiano@dss.ca.gov
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Based on observation, records, and interviews, the facility failed to ensure that routine, time-sensitive medications for Resident R1 were administered at the prescribed times. This violation poses/posed a potential health and safety risk to persons in care.
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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: Ulysses Coronel
LICENSING EVALUATOR NAME: Jose Anguiano
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3