198602134-7-7-2026-11-AS-PMAA-DWFQGS-20260729121003

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602134
Report Date: 07/07/2026
Date Signed: 07/07/2026 04:28:29 PM

Unsubstantiated

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
03/27/2026 and conducted by Evaluator Zina Brown

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20260327155037

FACILITY NAME:	GLEN PARK AT LONG BEACH		FACILITY NUMBER:	198602134
ADMINISTRATOR:	CATHERINE BRINAS DACARA		FACILITY TYPE:	740
ADDRESS:	1046 E 4TH ST		TELEPHONE:	(562) 432-7468
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90802
CAPACITY:	208	CENSUS: 114	DATE:	07/07/2026
		UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Catherine Dacara (Assistant Adminstrator)		TIME COMPLETED:	04:45 PM

ALLEGATION(S):

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Facility staff did not meet residents’ care needs, resulting in resident obtaining multiple UTI’s
Resident sustained multiple bruises due to staff neglect.
Facility staff did not ensure that residents have clean linen.
Facility staff did not provide adequate laundry service
Facility is not providing adequate food service resulting in resident weight loss.
Facility staff did not respond to resident's call button in a timely manner.

INVESTIGATION FINDINGS:

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On 07/07/2026 at 08:45am, the department made an unannounced visit at this facility to conduct an subsequent visit to reveal the investigation findings for the allegations above. During today’s visit, the department met with Catherine Dacara (Assistant Administrator) and explained the purpose of the visit.

The investigation consisted of the following: On 04/01/2026, the department interviewed Administrator (A1), Staff (S1 - S7) Residents (R1- R10), between the hours of 09:27am - 2:33pm. LPA requested copies of Staff Roster (dated 03/19/2026), Resident Roster (dated 03/25/2026), Resident 1 (R1): LIC 601: Identification & Emergency Information (date 10/30/2024); LIC 602: Physician Report for Residential Care Facilities for the Elderly (dated 08/04/2025), LIC 603: Preplacement Appraisal Information (dated 10/14/2024); LIC 625: Needs & Service Appraisal (dated 02/12/2026), Admission Agreement (dated 10/31/2024) Medication Administration Record (MAR) (dated January 2026 - March 2026) Internal Resident Incident Report (dated 01/21/2026, 11/23/2025, 10/11/2025, & 07/08/2025), Weight Record (March 2026) Power of Attorney (dated 05/11/2024), Resident Laundry Schedule for March 2026 and Spring 4 Week Food Menu Cycle.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2026

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 12

Control Number 11-AS-20260327155037

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: 07/07/2026

NARRATIVE

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Allegation : Facility staff did not provide communication with authorized representative.
It was alleged that the facility failed to communicate with the authorized representative regarding the resident’s care and condition.

On 04/01/2026 between 9:27am - 9:50am, the Department interview A1 regarding the allegation. A1 denied the allegation and stated not being aware of any concerns. A1 stated multiple staff communicate with families as needed.

On 04/01/2026, between 10:00am - 11:50am, the Department interviewed seven (7) staff in regards to the allegation. 7 out of 7 staff denied the allegation and stated they would refer the representative to the Administrator, med tech, or front desk.

On 04/01/2026, between the hours of 2:24pm - 3:05pm, the Department interviewed ten (10) residents in regards to the allegation. 8 of out 10 residents denied the allegation and expressed no concerns with communication. Several residents independently manage their own communication or do not have family. 2 out of 10 residents did not confirm nor deny the allegation and mentioned having no family (R8) and or does not communicate with their family (R4).

On 05/18/2026, between the hours of 3:00pm - 4:00pm, the Department conducted a records review and observed the following: R1 has a POA, according to a document titled Power of Attorney for California (dated on 05/11/2024). This POA is also mentioned on the LIC 601 has the person responsible for final affairs, payment for care and legal guardian if any and this is also indicated on LIC 603 that POA is the person who manages R1’s finances.

On 07/07/2026 between 11:45am – 1:00pm, the Department conducted further review of four (4) internal resident incident reports dated (2) on 07/08/2025, 11/23/2025, and 01/21/2026. The incident report dated 07/08/2025 documented that R1 was sent to the hospital and the written narrative stated that the POA was notified; however, the “Responsible Party” section reflected “No” for contact made. The incident report dated 07/08/2025 documented R1’s return from the hospital and indicated that discharge paperwork was scanned to GPDocs, the pharmacy, and the former office desk manager, and that the POA was notified; however, the “Responsible Party” section again reflected “No” for contact made. The incident reports dated on 10/11/2025 of an unwitnessed fall, on 11/23/2025 R1 screaming and shaking and on 01/21/2026 documented a witnessed fall in which 911 was called; however, the “Responsible Party” section reflected “No” for contact made. Based on the 4 incident reports, the Department observed that “No” was consistently checked for contact made to the responsible party, indicating that the authorized representative was not contacted at the time of each incident. The Department did not observe supplemental documentation indicating that communication occurred outside of the incident reports.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2026

LIC9099 (FAS) - (06/04)

Page: 10 of 12

Control Number 11-AS-20260327155037

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: 07/07/2026

NARRATIVE

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Based on information gathered through interviews and record reviews, there is not enough evidence to support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is UNSUBSTANTIATED.

Allegation : Facility staff did not respond to resident’s call button in a timely manner.
It was alleged that staff failed to respond promptly when the resident activated the call button and left without prompt assistance when using the call bell, with delays reported up to 30 minutes.

On 04/01/2026 between 9:27am - 9:50am, the Department interview A1 regarding the allegation. A1 denied the allegation and stated not being aware of any delays and ensure staff responds right away. A1 stated no response logs are maintained.

On 04/01/2026, between 10:00am - 11:50am, the Department interviewed seven (7) staff in regards to the allegation.
6 out of 7 staff denied the allegation. 1 out of 7 staff did not confirm nor deny the allegation & reported that call light delays occur when caregivers are assisting other residents.

On 04/01/2026, between the hours of 2:24pm - 3:05pm, the Department interviewed ten (10) residents in regards to the allegation. 5 out of 10 confirmed the allegation & reported delayed call light response with R2 mentioning waiting two hours at one time. 4 out of 10 residents denied and stated they do not use the call button. 1 out 10 residents did not confirm nor deny the allegation but mentioned a time period of 10 -15 minutes wait.

On 04/01/2026 at 2:34pm, the Department conducted a call light inspection in room 245. At 2:41pm, facility staff entered room 245 to respond to the activated call light, resulting in a total response time of 7 minutes.

On 07/07/2026 between 2:02pm – 2:23pm, the Department continued conducting call light inspections and observed the following: at 2:02pm, the call light was activated in room 137 and answered at 2:06pm, resulting in a four-minute response time. At 2:08pm, the call light was activated in room 115. At 2:09pm, two (2) staff walked by and did not acknowledge the call light. The call light was answered at 2:10pm by another staff, resulting in a two-minute response time. At 2:11pm, the call light was activated in room 130. At 2:13pm, two staff walked by and did not acknowledge the call light. At 2:14pm, a third staff walked by and did not address the call light. Between 2:15pm – 2:21pm, two additional staff walked by and did not address the call light. Between 2:11pm – 2:21pm, the call light in room 130 remained unanswered, resulting in a ten-minute period with no staff response. At 2:22pm, a staff informed a caregiver that the resident in room 102 needed a diaper change. The caregiver stated they were attending to two other residents and asked the staff to notify someone at the front desk. At 2:23pm, another caregiver entered room 102 with diapers to assist the resident with the diaper change, resulting in a one-minute response time.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2026

LIC9099 (FAS) - (06/04)

Page: 7 of 12

Control Number 11-AS-20260327155037

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: 07/07/2026

NARRATIVE

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Allegation: Facility is not providing adequate food service resulting in resident weight loss.
It was alleged that a resident experienced weight loss due to inadequate food services. It was reported that meals were not consistently consumed and that staff did not ensure adequate food intake.

On 04/01/2026 between 9:27am - 9:50am, the Department interview A1 regarding the allegation. A1 denied the allegation and stated there was no documented weight loss and no special diet per LIC 602. A1 stated no concerns were raised by the family and no physician or dietitian was consulted.

On 04/01/2026, between 10:00am - 11:50am, the Department interviewed seven (7) staff in regards to the allegation.
6 out of 7 staff denied the allegation. 1 out of 7 staff did not confirm nor deny the allegation and reported the resident sometimes does not finish meals but stated concerns are reported to the nurse.

On 04/01/2026, between the hours of 2:24pm - 3:05pm, the Department interviewed ten (10) residents in regards to the allegation. 2 out of 10 resident confirmed the allegation, of which one resident mention weight loss, while the other resident mentioned not receiving enough food and missing meals. 7 out 10 residents denied the allegation and had no concerns with food service. Of the 8 residents who denied the allegation ; 1 resident mentioned losing weight but did not attribute it to food service. 1 out of 10 resident did not confirm nor deny the allegation but mentioned sometimes not receiving enough food.

On 05/18/2026, between the hours of 3:00pm - 4:00pm, the Department conducted a records review and observed the LIC 625 Appraisal/Needs & Service Plan documents R1 is on a NAS diet with thin liquids but according to the LIC 602A Physician's Report for RCFE documented that the resident was not on a special diet and required “No Added Salt” with thin liquids. The Department reviewed the March 2026 weight log, which documented three consecutive refusals (“Refused x3”) for scheduled weigh-ins by R1. No weight loss was documented.

On 07/07/2026 between the hours of 12:30pm - 12:45pm, the Department reviewed the facility's four-week menu cycle utilized during Spring 2025. Although the menus are labeled "Spring 2022" and "Spring 2023," facility Administrator indicated these menus were the menus in use during Spring 2025. The menus reflected planned daily breakfast, lunch, dinner, and evening snacks, including a variety of proteins, fruits, vegetables, grains, dairy products, and beverages. Breakfast meals included items such as eggs, oatmeal, pancakes, waffles, French toast, breakfast meats, toast, cereal, fruit juice, coffee, tea, and milk. Lunch and dinner menus included a variety of entrees consisting of chicken, turkey, beef, pork, fish, tuna, and pasta dishes, accompanied by vegetables, rice, potatoes, beans, salads, soups, bread, fresh fruit, and desserts. Evening snacks included items such as yogurt, pudding, muffins, granola bars, fruit, crackers, cookies, ice cream, and nutritional beverages

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2026

LIC9099 (FAS) - (06/04)

Page: 6 of 12

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
03/27/2026 and conducted by Evaluator Zina Brown

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20260327155037

FACILITY NAME:	GLEN PARK AT LONG BEACH		FACILITY NUMBER:	198602134
ADMINISTRATOR:	CATHERINE BRINAS DACARA		FACILITY TYPE:	740
ADDRESS:	1046 E 4TH ST		TELEPHONE:	(562) 432-7468
CITY:	LONG BEACH	STATE:CA	ZIP CODE:	90802
CAPACITY:	208	CENSUS: 114	DATE:	07/07/2026
		UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Catherine Dacara (Assistant Adminstrator)		TIME COMPLETED:	04:45 PM

ALLEGATION(S):

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Facility staff did not provide communication with authorized representative.

INVESTIGATION FINDINGS:

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Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 9 of 12

Control Number 11-AS-20260327155037

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: 07/07/2026

NARRATIVE

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SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2026

LIC9099 (FAS) - (06/04)

Page: 8 of 12

Control Number 11-AS-20260327155037

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: 07/07/2026

NARRATIVE

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The investigation revealed the following:

Allegation: Facility staff did not meet resident’s care needs, resulting in resident obtaining multiple UTIs.
It was alleged that for several months, a resident had not been provided with adequate hygiene and incontinence care. A resident was reportedly found soiled on multiple occasions, not changed. It was further alleged that a resident developed multiple urinary tract infections due to untimely hygiene care.

On 04/01/2026 between the hours of 9:27am – 9:50am, the Department interviewed Administrator (A1) in regards to the allegation. A1 denied the allegation and stated being unaware of any UTIs occurring while the resident was in care. A1 reported that a physician visited the resident the prior week but did not leave notes or orders. A1 stated the facility’s protocol for UTI prevention includes encouraging hydration, contacting the physician, and following any orders provided. A1 stated that residents receiving incontinence care are changed regularly in the morning, noon, night, and overnight, or upon request, with documentation maintained in ADL logs. A1 stated no incident reports or nursing notes were completed because no physician orders for labs or treatment were issued.

On 04/01/2026, between 10:00am -11:50am, LPA interviewed seven (7) staff in regards to the allegation.
3 out of 7 staff denied the allegation. 2 out of 7 staff confirmed the allegation and expressed observing odor and pain.
2 out of 7 staff did not confirm nor deny that allegation of one(1) who mentioned only being aware of R1's UTI during the resident last hospital visit.

On 04/01/2026, between the hours of 2:24pm - 3:05pm, the Department interviewed ten (10) residents in regards to the allegation. 7 of 10 residents denied the allegation and expressed no concerns with hygiene or care needs.
3 of 10 resident did not confirm nor deny the allegation and reported sometimes waiting for assistance.

On 05/18/2026, between the hours of 3:00pm - 4:00pm, the Department conducted a record review and observed the LIC 602A Medical Assessment documented a “recent UTI – resolved” prior to admission, with notation that nitrofurantoin had been completed and no urinary symptoms were present at the time of assessment. The Department reviewed the resident’s Medication Administration Records (MARs) for all months in care and found no physician orders, MAR entries, or medication administration related to UTI treatment, antibiotics, or diagnostic testing such as urinalysis or urine culture. The Department reviewed all physician orders on file and found no orders for laboratory testing, diagnostic evaluation, or treatment related to UTIs. The Department reviewed the resident’s ADL logs, which documented routine incontinence care but did not contain entries indicating missed care, delayed care, or concerns related to urinary symptoms.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 12

Control Number 11-AS-20260327155037

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: 07/07/2026

NARRATIVE

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Allegation: Facility staff did not provide adequate laundry service.
It was alleged that the resident’s clothing was not washed regularly and remained soiled for extended periods.

On 04/01/2026 between 9:27am - 9:50am, the Department interviewed A1 in regards to the allegation. A1 denied the allegation and stated not being aware of any concerns regarding unwashed clothing. A1 stated laundry is washed daily, with caregivers providing additional laundry support on Sundays.

On 04/01/2026, between 10:00am - 11:50am, the Department interviewed seven (7) staff in regards to the allegation
7 out of 7 staff denied the allegation and mentioned that laundry is completed on assigned days and heavily soiled items are washed immediately.

On 04/01/2026, between the hours of 2:24pm - 3:05pm, the Department interviewed ten (10) residents in regards to the allegation.
9 out of 10 residents denied with no concerns with laundry service. 1 out 10 residents was unaware of the allegation and stated they don't because they travel a lot .

On 05/18/2026, between the hours of 3:00pm - 4:00pm, the Department conducted a records reviewed and observe Resident's Laundry Service for the month of March indicates R1's laundry day of the week was on Mondays. The LIC 500 Personnel Report, which listed designated (2) laundry staff who are assigned specifically to provide laundry services. The Department reviewed communication logs and incident reports and found no documentation of concerns regarding unwashed clothing, delays in laundry service, or extended periods without clean garments. No documentation was found indicating inadequate laundry service.

Based on information gathered through interviews and record reviews, there is not enough evidence to support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is UNSUBSTANTIATED.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2026

LIC9099 (FAS) - (06/04)

Page: 5 of 12

Control Number 11-AS-20260327155037

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: 07/07/2026

NARRATIVE

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The Department reviewed the Needs and Services Plan, which documented scheduled toileting every 2–3 hours and as needed, hydration encouragement, and incontinence care requirements. The Department reviewed all incident reports, and found no documentation of UTIs, suspected UTIs, changes in condition related to urinary symptoms, or communication with the authorized representative regarding UTIs. No documentation was found indicating multiple UTIs or unmet hygiene care needs.

Based on information gathered through interviews and record reviews, there is not enough evidence to support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is UNSUBSTANTIATED.

Allegation: Resident sustained multiple bruises due to staff neglect.
It was alleged that a resident was observed with bruising on the forearm and hand that staff could not explain. It was further alleged that the bruising may have resulted from rough handling or neglect during care.

On 04/01/2026 between the hours of 9:27am - 9:50am, the Department interviewed A1 in regards to the allegation. A1 denied the allegation and stated not being aware of any bruising, no incident reports were completed, and no concerns were brought to A1's attention. A1 stated that per protocol, the LVN assesses bruising and reports findings to the physician.

On 04/01/2026, between 10:00am -11:50am, the Department interviewed seven (7) staff. 6 out 7 staff denied the allegation and reported no rough handling or observed inappropriate care. 1 out of 7 staff did not confirm nor deny that allegation, yet S2 reported seeing a mark on the resident’s arm but did not know the cause.

On 04/01/2026, between the hours of 2:24pm - 3:05pm, the Department interviewed ten (10) residents.
9 out of 10 residents denied being handled roughly or observing rough handling. 1 out of 10 residents did not confirm nor deny the allegation but reported staff were rough during cleaning of their private area.

On 05/18/2026, between the hours of 3:00pm - 4:00pm, the Department conducted a record review and observed the following: no incident reports documented bruising, discoloration, skin tears, or unexplained marks. The Department reviewed the LIC 602A Medical Assessment, which documented a history of skin breakdown but did not identify bruising or unexplained injuries. The Department reviewed communication logs and found no documentation of staff reporting bruising, unexplained injuries, or neglect related to skin integrity.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 12

Control Number 11-AS-20260327155037

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: 07/07/2026

NARRATIVE

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Based on information gathered through interviews and record reviews, there is not enough evidence to support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is UNSUBSTANTIATED.

Allegation: Facility staff did not ensure that residents have clean linen.
It was alleged that the resident’s bedding was left soiled and not changed in a timely manner.

On 04/01/2026 between 9:27am - 9:50am, the Department interviewed A1 in regards to the allegation. A1 denied the allegation and stated not being aware of any issues regarding soiled bedding. A1 stated linens are changed daily and immediately if soiled.

On 04/01/2026, between 10:00am -11:50am, the Department interviewed seven (7) staff.
2 out of 7 staff confirmed the allegation and stated finding soiled bedding at times but states it changed immediately.
5 out of 7 staff denied the allegation and reported no delays in linen changes.

On 04/01/2026, between the hours of 2:24pm - 3:05pm, the Department interviewed ten (10) residents.
1 out of 10 resident confirmed the allegation and reported that bedding was not changed promptly sometimes.
9 out of 10 residents denied the allegation and had no concerns with linen changes.

On 05/18/2026, between the hours of 3:00pm - 4:00pm, the Department conducted a records review and observed the following: on page 2 of the Admission Agreement and Basic Services (signed on 10/30/2024) states that the facility provides clean bed and bath linens weekly or more often if needed. Upon further review, no incident reports, no communication logs, and no internal notes were found with concerns regarding soiled bedding, missed linen changes, or lack of clean linens. No documentation was found indicating feces on bedding, urine on sheets, or extended periods without clean linens for R1.

Based on information gathered through interviews and record reviews, there is not enough evidence to support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is UNSUBSTANTIATED.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2026

LIC9099 (FAS) - (06/04)

Page: 4 of 12

Control Number 11-AS-20260327155037

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: 07/07/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 07/21/2026 Section Cited CCR 87468.1(a)(8)	1 2 3 4 5 6 7	Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (8) To have their representatives regularly informed by the licensee of activities related to care or services including ongoing evaluations...	1 2 3 4 5 6 7	The Administrator shall retrain staff on required notification procedures for authorized representatives by ensuring responsible parties are notified of all incidents and requests, with documentation completed accordingly.
	8 9 10 11 12 13 14	This requirement was not met as incident reports dated 07/08/2025, 10/11/2025, 11/23/2025, and 01/21/2026 showed “No” contact made with R1’s authorized representative, with no documentation of communication. This poses a potential health and safety risk.	8 9 10 11 12 13 14	The facility shall submit proof of training to the Department via email at Zina.Brown@dss.ca.gov by the POC due date.
	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.

SUPERVISOR'S NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2026

LIC9099 (FAS) - (06/04)

Page: 12 of 12

Control Number 11-AS-20260327155037

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: 07/07/2026

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Based on observations and interviews which were conducted and the records that were reviewed, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED under California Code of Regulations, Title 22, Division 6 and Chapter 8 are being cited on the attached LIC 9099D.

Exit interview conducted with Catherine Dacara (Assistant Administrator) and a copy of this report was provided with appeal rights.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2026

LIC9099 (FAS) - (06/04)

Page: 11 of 12