198602134-9-14-2026-11-AS-PMAA-DXXU6G-20260915151818

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602134
Report Date: 09/14/2026
Date Signed: 09/14/2026 05:21:34 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
09/10/2026 and conducted by Evaluator Ernand Dabuet

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20260910133735

FACILITY NAME:	GLEN PARK AT LONG BEACH		FACILITY NUMBER:	198602134
ADMINISTRATOR:	ACE HUYNH		FACILITY TYPE:	740
ADDRESS:	1046 E 4th St		TELEPHONE:	(562) 432-7468
CITY:	Long Beach	STATE: CA	ZIP CODE:	908021634
CAPACITY:	208	CENSUS: 106	DATE:	09/14/2026
		UNANNOUNCED	TIME BEGAN:	01:36 PM
MET WITH:	ACE HUYNH		TIME COMPLETED:	04:59 PM

ALLEGATION(S):

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Staff are not following reporting requirements as necessary.

INVESTIGATION FINDINGS:

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On September 14, 2026, the California Department of Social Services/Community Care Licensing (CDSS/CCL) Licensing Program Analyst (LPA), Ernand Dabuet, conducted an initial unannounced complaint visit. Ace Huynh, Executive Director, greeted the LPA. (LPA) explained that the purpose of the visit is to investigate the allegation mentioned above.

The investigation, a collection of documents, and a tour of the facility. A review of Personnel Report LIC 500 (dated 08/12/26), Resident Roster (dated 09/14/26), (R1’s) Identification and Emergency LIn cientIC 601 (dated 07/07/25), Physician’s Report Lic 602A (dated 01/31/25), Medication List (dated 01/31/25), Unusual Incident Report LIC (dated 08/25/26) and other pertinent records associated with this complaint. Interviews conducted with Executive Director and Witness #1 (W1).

(Evaluation Report continues LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2026

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 11-AS-20260910133735

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: 09/14/2026

NARRATIVE

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INVESTIGATION REVEALED THE FOLLOWING:

Allegation: Staff are not following reporting requirements as necessary.

It is alleged that staff did not follow the required reporting requirements concerning Resident #1 (R1). Reports indicate that (R1’s) primary physician or responsible party were not informed of (R1's) inpatient medical stabilization when (R1) was hospitalized on August 26, 2026. There are concerns regarding the lack of communication and documentation about (R1’s) rights related to not allowing the resident to return to the facility. No further detailed information was provided.

On September 14, 2026, between 2:30 PM and 3:00 PM, the Department interviewed staff member identified as Executive Director (ED). The Executive Director (ED) denied failing to report any incidents. The (ED) stated that they knew the facility's reporting procedures and understood when to report incidents to the proper authorities. (ED) confirmed that the facility submitted LIC 624 Unusual Incident Report and contacted Community Care Licensing (CCL) when required. (ED) also indicated that (R1's) primary physician was notified by fax on August 24, 2026. Furthermore, Licensing and the Long-Term Ombudsman were informed on August 25, 2026, that (R1) was undergoing an emergency medical evaluation. The responsible party for (R1) was notified by telephone on August 24, 2026, at 7:25 PM according to the facilities telephone charting log.

On September 14, 2026, between 2: 32 PM and 2:42 PM, the Department interviewed witness identified as (R1’s) responsible party Witness #1 (W1). (W1) verified that no staff from Glen Park contacted (W1) for (R1’s) emergency hospitalization on August 24, 2026. (W1) stated to have been contacted by primary physician provider and the hospital facility where (R1) was undergoing emergency medical evaluation. (W1) confirmed that (R1) had returned to the facility following (W1's) recent visit.

The Department reviewed documentation for reported incident with Unusual Incident Report LIC 624 (dated 08/25/26) occurring within the relevant time frame. The records showed the facility had documented the incident internally and had submitted required reports to CCL when incident met the criteria outlined in Title 22. Facility Internal Reporting Log and Facility’s Telephone Charting Log (dated 08/24/26) verified (R1’s) primary care physician and responsible party were notified.

(Evaluation Report continues LIC 9099-C)

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2026

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20260910133735

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: 09/14/2026

NARRATIVE

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Further review of (R1’s) Identification and Emergency LIC 601 (dated 07/07/25), Physician’s Report LIC 602A (dated 01/31/25), Medication List (dated 01/31/25).

The Department observed that (R1) had returned to the facility and confirmed that (R1’s) included in the facilities Resident Roster (dated 09/14/26).

Based on the information gathered, there is insufficient evidence to support the allegation mentioned above.

Based on the information collected from the facility inspection, observations, interviews, and records analysis, the Department found no evidence to support the above allegation. The allegation may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is Unsubstantiated.

No deficiencies cited.

An exit interview was conducted with ACE HUYNH, and copies of the reports were provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2026

LIC9099 (FAS) - (06/04)

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