198602134-5-29-2025-11-AS-JHAD-DHX226-20250623170012

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602134
Report Date: 05/29/2025
Date Signed: 05/29/2025 09:45:18 AM

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
05/06/2025 and conducted by Evaluator Zina Brown

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20250506180252

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:	05/29/2025
		UNANNOUNCED	TIME BEGAN:	08:20 AM
MET WITH:	Catherine Dacara (Assistant Administrator)		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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Staff do not ensure that resident has transportation to receive substance abuse and mental health treatment.

INVESTIGATION FINDINGS:

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On 05/29/2025, at 9:20am, Licensing Program Analyst (LPA) Zina Brown conducted a subsequent complaint visit at this facility to deliver the complaint findings. During today’s visit, LPA met with Catherine Dacara (Assistant Administrator) and explained the purpose of the visit.

The investigation consisted of the following:
An initial complaint visit was completed by the department on 05/12/2025 during the visit conducted interviews with Administrator (A1), Staff (S1-S8) and Residents (R1-R11) from 9:51am – 2:30pm. The department received the following documents: Resident Roster (dated 05/28/2025), Staff Roster (dated 04/17/2025), LIC 601 Identification and Emergency Information (for R1) - dated 03/12/2025, LIC 602: Physician Report for RCFE (for R1) - dated 03/04/2025, LIC 603A: Resident Appraisal (for R1) - dated 03/13/2025, LIC 624: Unusual Incident/Injury Report - dated 04/25/2025, Admission Agreement – (dated 03/12/2025) and Medication/Treatment Administration Record March 2025 - May 2025.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2025

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-20250506180252

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: 05/29/2025

NARRATIVE

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The investigation revealed the following:

Allegation - Staff do not ensure that resident has transportation to receive substance and mental health treatment

It is alleged that the facility had 911 respond due to individual needing a ride to a weekly appointment to get methadone. Glen Park does not have the ability to provide this individual with methadone and/or a ride to appropriate facility for such.

On 05/29/2025 at 9am, LPA conducted a review of R1's file. In the Admission Agreement, on page 13 of 27 of the facility admission agreement is stated under Transportation Services: Transportation for our Activity related programs is free. We will assist residents with signing up for transportation services with community transportation resources if applicable such as Dial-a-Ride and/or ACCESS. The community will transport residents within a 7-mile radius of community for all matters. The residents will need to inform the front front desk of transportation needs, and the receptionist will decide with the driver. In R1's file it is documented resident can not determine his need for prescription and or nonprescription PRN medication and cannot clearly communicate his symptoms indicating a need for nonprescription PRN medication (licensee must contact physician before each dose). R1 receives methadone shots weekly. Coastal Recovery arranges transportation for R1. However if Coastal Recovery does not show up to provide R1 transportation, the facility assist R1 with public transportation via city bus and or uber/lyft to ensure resident did not his sessions.

On 05/12/2025, the department interviewed Administrator (A1), Staff (S1–S8), and Residents (R1–R11) from 9:51 a.m. to 2:30 p.m. about the allegation. Four (4) of nine (9) staff denied the allegation. The remaining five (5) out of nine (9) staff did not confirm or deny the allegation. The department interviewed residents (R1–R6) about the allegation, and two (2) of eleven (11) confirmed the allegation. Six (6) of 11 residents denied the allegation. Three (3) of eleven (11) resident didn’t confirm nor deny the allegation. Most residents interviewed stated that they are provided transportation assistance to attend their appointments and have not experienced issues with accessing their treatment providers.

Based on records review, interviews and observation LPA did not find sufficient 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 for this allegation.

An exit interview was conducted, and a copy of this report was provided to Catherine Dacara (Assistant Administrator)

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2025

LIC9099 (FAS) - (06/04)

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