198602134-4-10-2025-11-AS-EMAZ-DHPPCR-20250616111220

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602134
Report Date: 04/10/2025
Date Signed: 04/10/2025 04:33:47 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
02/03/2025 and conducted by Evaluator Antonine Richard

COMPLAINT CONTROL NUMBER: 11-AS-20250203140724

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: 94	DATE:	04/10/2025
		UNANNOUNCED	TIME BEGAN:	01:25 PM
MET WITH:	Catherine Dacara		TIME COMPLETED:	04:50 PM

ALLEGATION(S):

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Staff is stealing residents personal property.

INVESTIGATION FINDINGS:

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On 04/10/2025, Lincensing Program Analyst (LPA) Antonine Richard conducted a subsequent complaint visit regarding the above allegation. The department met with the Administrator Catherine Dacara, and explained the reason for the visit.

The investigation consisted of the following:
On 02/05/2025, (LPA) and staff toured the facility inside and visit room #225 and room #228. LPA Richard reviewed and requested, staff and resident's roster. Individual Services Plan (ISP), Physician's Report for Residential Care for the Elderly (RCFE). Admission Agreement, Theft/Loss Policy, resident Safeguard of Valuables/Property. LPA Richard interviewed six (6) residents (R2-R7), and four (4) staff (S1-S4), and other documents.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2025

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-20250203140724

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: 04/10/2025

NARRATIVE

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Allegation: Staff is stealing residents' personal belongings.

It is being alleged that staff at Glen Park in Long Beach have stolen resident jewelry and paintings and have stolen other resident belongings.

On 02/05/2025, between 11:00 AM, and 12:00 PM, LPA Richard interviewed four (4) staff (S1- S4). 4 out of 4 staff denied the allegation against them. They stated that all the residents have their key, and if a resident is not in the room, the staff is not allowed to enter except to clean resident rooms. They also stated that the facility makes sure all the residents' belongings are protected, and no resident ever complained to them about missing jewelry or other items inside their rooms.

On 02/05/2025, between 12:00 PM and 2:00 PM, LPA Richard interviewed seven (7) residents (R1- R7). 6 out of 7 denied that staff ever stole their personal belongings. They also stated that each resident has a key to their room, and they can lock their room if they are not there. They also stated that the staff usually knocked before entering inside their room. LPA interviewed seven (7) residents (R1- R7). 1 out of 7 residents was unable to provide any details of the items stolen, the dates when it occurred, or the names and descriptions of the individuals involved about the allegation that staff is stealing residents’ personal belongings.

Continued LIC9099-C

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2025

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20250203140724

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: 04/10/2025

NARRATIVE

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On 04/09/25, LPA interviewed Witness (W1), who stated that R1 did inform W1 that some items were missing from R1 room and that happened 3 years ago under a different Executive Director, but W1 could not describe the items, names of the staff who stole the items, and date when it happened. W1 also stated that it was a resident who stole the item and returned it to R1 when confronted. On 02/05/2025, LPA Richard reviewed various documents related to (R1), including Safeguard of Valuables/Property (dated 04/25/17), the record indicating that there were several items listed but no mention of one the items reporting missing. On 02/05/25, LPA reviewed the Theft/Loss Policy, which indicated that lost or stolen property with a value of $ 25 or more shall be documented on an Unusual Incident Form (LIC624) within 72 hours of discovery. Stolen property with a value of $ 100 or more shall be reported to the Police. LPA did not observe any documents about R1 missing items in records.

Based on the information gathered, interviews, and record reviews, there is not enough evidence to support the allegation mentioned above. 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 the Administrator, Catherine Dacara. A copy of the report was provided.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2025

LIC9099 (FAS) - (06/04)

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