198602134-9-27-2024-11-AS-JHAD-D9LPJF-20240930112126

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602134
Report Date: 05/30/2024
Date Signed: 09/27/2024 01:57:36 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
05/22/2024 and conducted by Evaluator Perry Scott

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20240522152056

FACILITY NAME:	GLEN PARK AT LONG BEACH		FACILITY NUMBER:	198602134
ADMINISTRATOR:	MICHAEL MENDOZA		FACILITY TYPE:	740
ADDRESS:	1046 E 4TH ST		TELEPHONE:	(562) 432-7468
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90802
CAPACITY:	208	CENSUS: 97	DATE:	05/30/2024
		UNANNOUNCED	TIME BEGAN:	09:29 AM
MET WITH:	Michael Mendoza		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff did not safeguard a resident's personal belongings.
Staff do not ensure that a resident's medical condition is properly managed.
Staff do not assist resident with showering.

INVESTIGATION FINDINGS:

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On 05/30/24, at 10:00am, Licensing Program Analyst (LPA) Perry Scott conducted a 10-day complaint visit to the facility and was greeted by Michael Mendoza, Executive Director. LPA explained the purpose of this visit is to gather information about the complaint and deliver findings for the allegations mentioned above.

The investigation consisted of the following: LPA investigated the allegations mentioned in this complaint; and conducted interviews with staff (S1-S4) and residents (R1-R9). Resident Roster (Dated 5/29/24), Staff Roster (Dated 5/15/24), ID/Emergency Information (Not Dated), Physicians Report (Dated 4/24/2024), Shower Schedule (Dated 5/29/24), Appraisal/Needs And Services Plan (Dated 10/23/2023), Internal Resident Incident Report (Dated 5/26/2024), and Personal Property Inventory (Dated 4/25/2017) for R1 were obtained from the facility.

The investigation revealed the following: Allegation #1- Staff did not safeguard a resident's personal belongings.

Report continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (424) 544-1027
LICENSING EVALUATOR NAME: Perry Scott	TELEPHONE: (707) 849-2315
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024

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-20240522152056

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: 05/30/2024

NARRATIVE

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The details of the complaint alleged that in January or February of 2024 someone at the facility stole R1s paint supplies and paperwork .On 05/30/24, from 10:00am-2:00pm, LPA interviewed staff (S1-S4) and residents (R1-R9) regarding the allegation. 4 of 4 staff denied the allegation that the Staff did not safeguard a resident's personal belongings. All staff (S1-S4) stated that all measures are taken to safeguard the residents’ belongings. Staff stated that the facility has installed new locks on all resident’s doors that feature more security measures; the facility has a safe for resident’s if they want to store valuables; and the facility has lock boxes for the residents who wish to have it. All staff stated they have no knowledge of any reported items stolen from R1. LPA interviewed residents R1-R9 about the allegation and 8 of 9 residents that were interviewed denied the allegation that Staff did not safeguard a resident's personal belongings. The majority of the residents stated that they have not had any issues with theft in the facility.
Based on interviews, there is insufficient evidence to support the allegation that the Staff did not safeguard a resident's personal belongings. 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 #2- Staff do not ensure that a resident's medical condition is properly managed.

The details of the complaint alleged that R1s medical condition is not properly managed. It is stated that R1 has a Foley Catheter, and the resident can care for R1s catheter by R1s self. However, R1 has developed several Urinary Tract infections that may be due to inadequate catheter care. It is alleged that staff are not monitoring R1s catheter care. On 05/30/24, from 10:00am-2:00pm, LPA interviewed staff (S1-S4) and residents (R1-R9) regarding the allegation. 4 of 4 staff denied the allegation that the Staff do not ensure that a resident's medical condition is properly managed. All staff (S1-S4) stated that whenever R1 needs assistance with R1s medical care it is provided but R1 has a history of UTI before R1 had a Foley Catheter. Staff also state that R1 has been trained by R1s physician to take care and manage R1s Foley Catheter. Staff states further that every measure is taken to keep R1s medical condition properly managed by getting timely medical care, follow up visits, assistance with personal care when needed, and taking regular showers. LPA interviewed R1-R9 about the allegation and 8 of 9 residents that were interviewed denied the allegation that Staff do not ensure that a resident's medical condition is properly managed. Residents stated that their medical condition is properly managed by the staff and are happy with the care and supervision given by the staff.

Based on interviews and records reviewed, there is insufficient evidence to support the allegation that the Staff do not ensure that a resident's medical condition is properly managed. 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.

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (424) 544-1027
LICENSING EVALUATOR NAME: Zina Brown	TELEPHONE: (707) 849-2315
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2024

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20240522152056

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: 05/30/2024

NARRATIVE

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Allegation #3- Staff do not assist resident with showering.

The details of the complaint alleged that R1 neglects to take showers thereby creating a condition that allows for urinary tract infections to occur. However, it is reported that R1 is capable of showering by R1s self, but only needs supervision. It is alleged that staff does not encourage R1 to take showers to prevent future infections from occurring. On 05/30/24, from 10:00am-2:00pm, LPA interviewed staff (S1-S4) and residents (R1-R9) regarding the allegation. 4 of 4 staff denied the allegation that the Staff do not assist resident with showering. All staff (S1-S4) stated that every resident has a shower schedule according to their care plan. Staff state that every resident is encouraged to take showers and take care of their personal care needs. If the resident needs assistance, the caregivers are here to assist them. However, staff says sometimes residents do refuse to take a shower and will put it off until another day. When this occurs an incident report is written for the resident. LPA reviewed the shower schedule and incident report for R1 and found that R1 is scheduled for showers but sometimes refuses to be showered. LPA interviewed R1-R9 about the allegation and 8 of 9 residents that were interviewed denied the allegation that Staff do not assist resident with showering. Residents stated that they have not had any problems with staff not assisting them with showers when assistance is needed. Residents state that they are happy with the care and supervision provided by the staff.

Based on interviews and records reviewed, there is insufficient evidence to support the allegation that the Staff do not assist resident with showering. 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.

No deficiencies were cited.

An exit interview was conducted with Michael Mendoza, Executive Director, and a hard copy of this report was provided.

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (424) 544-1027
LICENSING EVALUATOR NAME: Zina Brown	TELEPHONE: (707) 849-2315
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024

LIC9099 (FAS) - (06/04)

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