198602134-9-16-2021-11-AS-MCAA-C8CVW9-20211101164734

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602134
Report Date: 09/16/2021
Date Signed: 09/16/2021 03:01:05 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
09/10/2021 and conducted by Evaluator Jade Jordan

COMPLAINT CONTROL NUMBER: 11-AS-20210910125628

FACILITY NAME:	GLEN PARK AT LONG BEACH		FACILITY NUMBER:	198602134
ADMINISTRATOR:	PINK, MARINA E		FACILITY TYPE:	740
ADDRESS:	1046 E 4TH ST		TELEPHONE:	(562) 432-7468
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90802
CAPACITY:	208	CENSUS: 74	DATE:	09/16/2021
		UNANNOUNCED	TIME BEGAN:	09:56 AM
MET WITH:	Melissa Flores		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Resident is not awarded privacy
Staff are not safeguarding resident's property

INVESTIGATION FINDINGS:

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On 09/16/21 Licensing Program Analysts (LPAS) Jade Jordan and Ana Soto conducted an unannounced visit to conduct an investigation regarding the allegations above. The LPA’s were met by Facility Administrator Melissa Flores, and the purpose of the visit was explained.

The investigation consisted of : Resident / Staff interviews, Video Surveillance, Requested Pertinent documents regarding the allegation.

Regarding Allegation: "Staff do not award resident Privacy." The investigation revealed based on resident interviews, that all residents generally stated that they feel they are awarded privacy by staff, and Staff do not invade their personal space. Based on LPAS observation, LPAS did observe any staff being intrusive to any resident in care. Therefore “Although the allegation may have happened or is valid, there is not preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Michael Cava	TELEPHONE: (323) 400-7397
LICENSING EVALUATOR NAME: Jade Jordan	TELEPHONE: (650) 388-2300
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2021

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-20210910125628

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: 09/16/2021

NARRATIVE

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Regarding Allegation: Staff are not safe guarding Residents Personal Property.

The investigation revealed that the Personal Inventory of RP did not show a dollar amount listed over $150.00. According to admissions agreement Resident cash over $25 shall be held by the front office who will maintain an ink written transaction cash record. No Cash/Record was received or documented by the facility. LPAs Observed facility Video surveillance dated 09/11/21, where Rp appeared to pulled wallet out of pocket, placed wallet on a chair, and wheeled oneself away. LPA observed on the surveillance that after placing wallet on chair, RP Appeared to purposely stay within several feet away from the chair with wallet. Footage shows within the same hour other resident's arrived and spot the wallet, pointing it out, but not touching it. RP is then observed to wheel oneself back over to the chair, where residents where standing, and claimed the wallet.

LPA interviews revealed that All Residents in care have the capability to lock their rooms. All residents interviewed generally stated that their personal items such as towels have not gone missing, and facility towels are made available upon request. Residents stated that they have not had other residents come to their room and take their personal property. Therefore based on LPAs Interviews, and observation LPA'S find that “Although the allegation may have happened or is valid, there is not preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated

SUPERVISOR'S NAME: Michael Cava	TELEPHONE: (323) 400-7397
LICENSING EVALUATOR NAME: Jade Jordan	TELEPHONE: (650) 388-2300
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2021

LIC9099 (FAS) - (06/04)

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