198602134-8-17-2025-11-AS-JHAD-DKR2TV-20250820174121

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602134
Report Date: 08/17/2025
Date Signed: 08/17/2025 07:22:21 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
08/06/2025 and conducted by Evaluator Ernand Dabuet

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20250806102852

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: 90	DATE:	08/17/2025
		UNANNOUNCED	TIME BEGAN:	02:58 PM
MET WITH:	Roniesha Bryant		TIME COMPLETED:	04:27 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility staff failed to prevent resident from getting an infection.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On August 17, 2025, the California Department of Social Services/Community Care Licensing (CDSS/CCL) Licensing Program Analyst (LPA) Ernand Dabuet conducted a subsequent unannounced complaint visit. Roniesha Bryant, Med Tech, greeted the LPA. Executive Director Christopher Redmond and Assistant Administrator Catherine Dacara are notified by telephone. (LPA) explained that the purpose of the visit is to investigate the allegation mentioned above.

The investigation included interviews, a collection of records, and a tour of the facility. Interviews conducted with Resident #1 to Resident #10 (R1-R10) and Staff #1 and Staff #4 (S1-S4). The Department reviewed several documents, including the Personnel Report LIC 500 (dated 07/31/25), the Resident Roster (dated 08/06/25), and Resident #1 (R1)'s Physcians Report LIC 624A (dated 02/24/25), Resident Appraisal LIC603A (dated 01/01/23), Physicans Medication Orders (dated 08/07/25), Medical Clinic Record (dated 08/04/25) and DHCS ISP (dated 05/23/25), as well as other pertinent records associated with this complaint.
(Evaluation Report contiues LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2025

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 4

Control Number 11-AS-20250806102852

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: 08/17/2025

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

INVESTIGATION REVEALED THE FOLLOWING:

Allegation: Facility staff failed to prevent resident from getting an infection.

The complaint details that the facility staff failed to prevent Resident #1 (R1) from contracting an infection. It is reported that (R1) developed the infection due to inadequate sanitation within the facility and the presence of dirty or unsanitized tableware. Reports have indicated that management staff were informed, but no action has been taken. No further details have been provided on this matter.

On August 07, 2025, between 10:00 AM and 04:30 PM the Department interviewed residents identified as Resident #1 through Resident #10 (R1-R10). Eight (8) out of the ten (10) resident members could not support this claim. (R3-R10) reported that they have never experienced an infection while receiving care at this facility. While (R1-R2) both verified being diagnosed with a viral infection. (R3-R10) have expressed general satisfaction with the tableware's condition. They appreciate its cleanliness and indicate that if any issues arise, they would be willing to return it to the staff for replacement.

(R2) acknowledged having contracted the viral infection outside of the facility through contact with a close associate who does not reside at Glen Park at Long Beach. (R2) understands and has not interacted closely with the facility's residents.

During a routine medical visit, (R1) was diagnosed with a viral infection. (R1) believes this infection was contracted at the facility, likely due to the use of unclean or poorly sanitized tableware. Furthermore, (R1) stated that management has not been informed about this issue. It is assumed that the condition has been recognized as having appropriate antibiotic treatment available for (R1). (R1) indicates that, considering (R1's) health condition, the likelihood of contracting the viral infection through an intimate encounter is considerably improbable.

On August 07, 2025, and August 08, 2025, between 09:00 AM and 4:15 PM, the Department interviewed staff members identified as Staff #1 through Staff #4 (S1-S4). Four (4) out of the four (4) staff members are not able to corroborate this claim. (S1-S3) reported that they were not informed about Resident #1's (R1) existing infection. According to (S1-S2), the medical discharge paperwork for (R1) was provided, and upon review, it did not mention any infection diagnosis. The primary physician for (R1) did not communicate any concerns or symptoms related to an infection to the facility staff.

(Evaluation Report continues LIC 9099-C)

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 11-AS-20250806102852

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: 08/17/2025

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

(S1, S2 and S4) they verified that (R1 and R2) have no association with one another and are acquaintances only. (R1 and R2) do not share a room or share a table during meals. In addition, (R1) eats alone during meals as preference and does not use facility tableware supplies. (R1) preference utilizing plastic flatware.

Additionally, (S4) was only informed that a specific new medication had been prescribed for (R1) to treat a viral infection, which was to be administered over a 14-day treatment period.

(S3) communicated that, to (S3's) knowledge, there have been no reported claims from residents concerning dirty or unsanitized tableware, nor have there been any instances of infections attributed to inadequate cleanliness of tableware supplies.

A review of Resident #1's (R1's) Medical Clinic Record (dated 08/04/25) revealed no indication of a viral infection or any mention of medicine to treat the infection. Physician Report LIC 602A (dated 02/24/25) and Resident Appraisal (dated 11/01/23) revealed that (R1) can self-care, can attain personal grooming and hygiene items, can leave the facility unattended, and has a history of skin condition and atopy, which makes (R1) more susceptible to infections. Further review of the Department of Health Care Services Individual Service Plan (dated 05/23/25) revealed (R1) is at risk for skin breakdown and infection. Prescription Medication Orders (dated 08/07/25) revealed that (R1) is prescribed prescription and PNR medications of a total of (30). Eight (8) out of the thirty (30) have side effects that weaken the immune system and are more susceptible to infection (ref: National Institute of Health), and a weakened immune system can be a trigger for viral infections.

According to (ref: National Institute of Health) A viral infection can impact how long bacteria survive on utensils, but it's unlikely. Bacteria need specific conditions, like warmth and moisture, to live. Therefore, sharing utensils, cups, and straws poses a low risk for spreading an infection since the environment is not suitable for bacteria to survive long enough to infect someone else. It is unlikely due to its low survivability outside of the body.

The Department inspected the facility on August 07, 2025, and observed the facility in clean and sanitary condition including the dining and kitchen area. The Department observed Staff #3 (S3) washing, rinsing and soaking tableware in hot water with soap and bleach. Then the tableware items are stored in high temperature hood commercial dishwasher for a continuous cleaning and sanitation.

(Evaluation Report continues LIC 9099-C)

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 11-AS-20250806102852

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: 08/17/2025

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

Based on the information gathered, there is not enough 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 is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is Unsubstantiated.

No deficiencies were cited.

An exit interview was conducted with Roniesha Bryant, and copies of the reports were provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2025

LIC9099 (FAS) - (06/04)

Page: 4 of 4