<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602134
Report Date: 04/23/2021
Date Signed: 04/23/2021 02:47:06 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
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 Jennifer Jones
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20201217083158
FACILITY NAME:GLEN PARK AT LONG BEACHFACILITY NUMBER:
198602134
ADMINISTRATOR:PINK, MARINA EFACILITY TYPE:
740
ADDRESS:1046 E 4TH STTELEPHONE:
(562) 432-7468
CITY:LONG BEACHSTATE: CAZIP CODE:
90802
CAPACITY:208CENSUS: 67DATE:
04/23/2021
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Melissa Flores, Administrator TIME COMPLETED:
01:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are stealing from residents

INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Jennifer Jones initiated a subsequent complaint investigation and delivered findings for the allegations listed above. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, today’s complaint investigation was conducted telephonically with Melissa Flores, Administrator.

Investigation consisted of the following: LPA Cardenas Interviewed Miss Guzman, LPA asked questions relevant to the nature of the complaint, LPA toured the facility common areas, dining area, facility reception area, and kitchen. LPA requested resident and staff roaster, and SIRs relating to allegations.

On 04/23/2021, LPA Jones conducted interviews with residents 1-8 and staff 1 and 2. On another date LPA conducted interviews with staff 3-5 via telephone
The allegation revealed the following: for allegation (Staff are stealing from residents). It was alleged
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Angela J KendrickTELEPHONE: (323) 629-7815
LICENSING EVALUATOR NAME: Jennifer JonesTELEPHONE: (323) 516-3833
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2021
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 5
Control Number 11-AS-20201217083158
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: GLEN PARK AT LONG BEACH
FACILITY NUMBER: 198602134
VISIT DATE: 04/23/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
that staff are stealing from residents in care. Residents 2-8 reveal during their interviews that money and personal items has been stolen from them. Some of the residents revealed during their interviews that management is working on recovering their money and others stated that nothing was done about their lost. Staff 1 and 2 revealed during their interview that some of the residents have complained about missing money and other personal items. Staff 3-5 stated they have heard about residents having money and personal belongings stolen from them but they have not witnessed it.

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

A telephonic exit interview was conducted with Melissa Flores and an electronic copy was provided via email for signature.
SUPERVISOR'S NAME: Angela J KendrickTELEPHONE: (323) 629-7815
LICENSING EVALUATOR NAME: Jennifer JonesTELEPHONE: (323) 516-3833
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2021
LIC9099 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
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 Jennifer Jones
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20201217083158

FACILITY NAME:GLEN PARK AT LONG BEACHFACILITY NUMBER:
198602134
ADMINISTRATOR:PINK, MARINA EFACILITY TYPE:
740
ADDRESS:1046 E 4TH STTELEPHONE:
(562) 432-7468
CITY:LONG BEACHSTATE: CAZIP CODE:
90802
CAPACITY:208CENSUS: 67DATE:
04/23/2021
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Melissa Flores, administorTIME COMPLETED:
01:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are abusing the residents
Staff member lacks qualifications
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Jennifer Jones initiated a subsequent complaint investigation and delivered findings for the allegations listed above. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, today’s complaint investigation was conducted telephonically with Melissa Flores.

Investigation consisted of the following: LPA Cardenas Interviewed Miss Guzman, LPA asked questions relevant to the nature of the complaint, LPA toured the facility common areas, dining area, facility reception area, and kitchen. LPA requested resident and staff roaster, and SIRs relating to allegations.

On 04/06/2021, LPA Jones conducted interviews with residents 1-8 and staff 1 and 2. On another date LPA conducted interviews with staff 3-5 via telephone.
The investigations revealed the following: For allegation (Staff are abusing the residents.) It was alleged
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Angela J KendrickTELEPHONE: (323) 629-7815
LICENSING EVALUATOR NAME: Jennifer JonesTELEPHONE: (323) 516-3833
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 11-AS-20201217083158
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: GLEN PARK AT LONG BEACH
FACILITY NUMBER: 198602134
VISIT DATE: 04/23/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
that staff are abusing residents in care. LPA Jones interviewed resident 1-8 about the allegation. R1-8 revealed during their interviews that they have never been physically abused by any of the staff and has not witnessed staff being abusive with the residents. R1 stated that staff was rushing while assisting him and cut his arm with the wheelchair, R3 stated that staff use to be aggressive but they are better now and R4 said he's heard about staff being abusive but never witnessed it. Staff 1 and 2 revealed during their interviews that they have not received any complaints about staff being abusive. Staff 3 stated that she heard about a staff member dragging residents to their rooms but has not observed it and staff 4 stated that she has never heard or observed staff being abusive to residents in care and staff 5 revealed during her interview that she has heard about abuse but never witnessed it.

For allegation (Staff member lacks qualifications) It is being alleged that staff lack qualifications. Resident 1 stated that staff are ok but rush when assisting, R2 and R3 stated during their interviews that they feel staff are qualified, R4 stated that staff can use some training and only about 1 or 2 are good caregivers and R5- R8 stated that they think staff are qualified. Staff 1 and 2 revealed during their interviews that staff are qualified and have the credentials. Staff 3-5 stated that some of the staff lack qualifications because the facility hires a lot of staff from temporary agencies.

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

A telephonic exit interview was conducted with, and an electronic copy was provided via email for signature.
SUPERVISOR'S NAME: Angela J KendrickTELEPHONE: (323) 629-7815
LICENSING EVALUATOR NAME: Jennifer JonesTELEPHONE: (323) 516-3833
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 11-AS-20201217083158
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: GLEN PARK AT LONG BEACH
FACILITY NUMBER: 198602134
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/23/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/30/2021
Section Cited
CCR
87217(b)
1
2
3
4
5
6
7
Safeguards for Resident Cash, Personal Property, and Valuables Every facility shall take appropriate measures to safeguard residents' cash resources, personal property and valuables which have been entrusted to the licensee or facility staff. This requirement was not met as evidence
1
2
3
4
5
6
7
The administrator will submit a plan to the LPA explaining how the facility will safeguard resident's money and personal belongings and send to LPA by POC due date.
8
9
10
11
12
13
14
by: The administrator failed to safeguard residents' money and personal items.
8
9
10
11
12
13
14
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: Angela J KendrickTELEPHONE: (323) 629-7815
LICENSING EVALUATOR NAME: Jennifer JonesTELEPHONE: (323) 516-3833
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2021
LIC9099 (FAS) - (06/04)
Page: 5 of 5