Glen Park At Glendale - Mariposa St

Licensing Program Analyst (LPA) Cynthia Chan conducted a complaint investigation for the allegations listed above. LPA arrived unannounced and met with Administrator, Susan Park. The purpose of the visit was explained. The investigation consisted of the following: LPA Chan toured the facility and obtained copies of the staff roster, resident roster, and housekeeping assignment sheet. Interviews were held with the Administrator, 5 Staff, and 7 Residents. The investigation revealed the following: For allegation - Staff are not ensuring residents are not exposed to hazardous smells. It is alleged that the smoke and/or smells from the kitchen is polluting the facility and making residents sick. Administrator Park denied any hazardous smells that are causing any residents to be sick. She stated that this concern was brought to her attention and it has been addressed. UnsubstantiatedRead the full finding— CDSS inspection report, December 13, 2022 · control 28-AS-20221207084028

Licensing Program Analyst (LPA) Kruz Long conducted an unannounced complaint investigation at the facility. Upon arrival, LPA met with Susan Park (Administrator) and explained the purpose of the visit. During today's visit, LPA obtained a copy of the Staff/Resident rosters, Resident #1's (R#1) Physician's Report, 30 Day Notice to Quit and Medical Records. LPA also interviewed Staff #1 in the Activity Room and interviewed Skilled Nursing Social Worker via telephone. In regards to the allegation: Facility staff refused to accept resident back after hospital stay. Interview with Staff #1 indicate R#1 was admitted to the hospital on 11/21/22 and was later transferred to a Skill Nursing facility on 12/02/22. R#1 returned to the facility on 12/05/22 from the Skilled Nursing facility and was not refused acceptance back to the facility. Review of medical records indicate R#1 was admitted to the hospital on 11/21/22. LPA verified with the Skilled Nursing facility Social Worker that R#1 was at tRead the full finding— CDSS inspection report, December 8, 2022 · control 28-AS-20221201141010

This report supersedes the complaint investigation report created on 11/03/2022 due to the initial report containing client confidential information (diagnostic). No other changes have been made to the report. On 11/03/2022, Licensing Program Analyst (LPA) Elizabeth Irra conducted the initial visit to investigate the above allegation. LPA met with Susan Park and explained the purpose of today's visit. During this visit, LPA obtained a copy of the resident roster, staff roster, interviewed Staff #1 through Staff #3 (S-1 through S-3) and reviewed file for Resident #1 (R-1) and obtained copies of relevant documentation. R-1 is no longer residing at this facility. LPA attempted to interview R-1 via telephone at R-1's current location and was unable to interview as R-1 did not understand interview questions. Refer to LIC 9099C for the continuation of this report. UnsubstantiatedRead the full finding— CDSS inspection report, November 28, 2022 · control 28-AS-20221028082245

Licensing Program Analyst (LPA) Elizabeth Irra conducted the initial visit to investigate the above allegation. LPA met with Susan Park and explained the purpose of today's visit. During this visit, LPA obtained a copy of the resident roster, staff roster, interviewed Staff #1 through Staff #3 (S-1 through S-3) and reviewed file for Resident #1 (R-1) and obtained copies of relevant documentation. R-1 is no longer residing at this facility. LPA attempted to interview R-1 via telephone at R-1's current location and was unable to interview as R-1 did not understand interview questions. Per record review, R-1 is diagnosed with Dementia. Refer to LIC 9099C for the continuation of this report. UnsubstantiatedRead the full finding— CDSS inspection report, November 3, 2022 · control 28-AS-20221028082245

Licensing Program Analyst (LPA) V. Maldonado made an unannounced subsequent visit to the facility for the purpose of delivering findings for the complaint regarding the above-mentioned allegations. LPA Maldonado met with Administrator Susan Park and explained the purpose for the visit. On 10/20/22, LPA Maldonado made an initial visit to the facility for the purpose of investigating the above-mentioned allegations. During the visit, LPA reqested a copy of the resident and staff roster, and the Facesheet and Physician's Repor for Residents# 1-7 (R1-R7). LPA also requested copies of the following documents for R1: Psychiatric Evalutions and Incident Reports for the months of March 2022-October 2022, Eviction Notice, Copy of House Rules, and written warning of possible eviction. The following documents were obtained for Staff# 1-3 (S1-S3): Personnel Records and Required Training Certification. Interviews were conducted with R1-R7 and S1-S3. (Report Continued on LIC9099-C...) SubstantiatedRead the full finding— CDSS inspection report, October 31, 2022 · control 28-AS-20221018112737

Licensing Program Analyst (LPA) Joe Katrdzhyan conducted an unannounced 10 day complaint visit to this facility. Upon arriving at the facility, LPA met with Staff / Darkis Giron and was later joined by the Administrator / Susan Park who assisted with the visit. LPA Katrdzhyan explained the purpose of today’s visit is to discuss the above mentioned allegation of "Facility is retaliating against a resident". During today's visit, LPA interviewed the Administrator, the Assistant Administrator and Resident 1 (R1). Also, copies of the following documents were obtained and reviewed in reference to R1; • Identification and Emergency Information • Physician's Report • Admission Agreement • Unusual Incident/Injury Reports • 30 Day Notice to Quit • Friendly Reminder/Final Written Order • House Rules • Medical Reports from LA Downtown Medical Center (LADMC) Please see LIC 9099C for additional information UnsubstantiatedRead the full finding— CDSS inspection report, October 24, 2022 · control 28-AS-20221017102430

Licensing Program Analyst (LPA)/Retired Annuitant (RA) Elizabeth Ceniceros made an unannounced visit to the facility and was greeted by Asst. Administrator (A2: Rachel de Chavez). LPA/RA spoke to A2 prior to entering the facility to conduct a risk assessment. A2 informed LPA/RA that the facility has no COVID cases nor do any of the residents or staff have symptoms. The purpose of today’s visit is to deliver the findings pertaining to the above-mentioned allegations. An initial 10-Day visit was conducted by LPA Nicol Wesley on 10/01/21. LPA/RA Ceniceros re-interviewed (between 2:15 p.m. - 2:40 p.m.) Asst. Administrator (A2: Rachel de Chavez) and Witness #1 (W1: Dr. James Lee, M.D.). Resident #1 was not re-interviewed; as the resident moved on 08/16/22 and the contact numbers were out of service. LPA/RA Ceniceros reviewed (between 2:45 p.m. – 3:20 p.m.) the requested documents: Emergency I.D. & Information Face Sheet, Physician’s Report (dated 06/22/22) - including additional documents:Read the full finding— CDSS inspection report, September 15, 2022 · control 28-AS-20210924163328

Licensing Program Analyst (LPA) Angelica Rea conducted a visit in response to the above allegations. On today's visit, LPA met with Assistant Administrator Rachel De Chavez who assisted with the visit. Regarding the allegation that staff do not assist resident #1 with making phone calls as needed, the investigation consisted of : Interviews with Assistant Administrator, Staff #1 and Resident #1- Resident #6 and review of Resident #1's file. Assistant Administrator and Staff #1 stated that resident(s) who receive phone calls at the facility are assisted when needed. Staff interviewed stated that if a call comes in for a resident, staff will page the resident, and will transfer the phone call to another phone for the resident. Resident(s) interviewed were unable to corroborate the allegation. Five out of Six resident(s) interviewed stated that staff do provide assistance to resident(s) with phone calls when needed. Regarding the allegation that Resident #1 is not accorded dignity in persRead the full finding— CDSS inspection report, August 18, 2022 · control 28-AS-20220812093156

Licensing Program Analyst(s) (LPA) Mary Flores conducted an unannounced subsequent complaint investigation visit regarding the above allegation(s). LPA Flores met with Siranush Aleksanyan - Receptionist and explained the reason for the visit. The investigation consisted of the following: On 4/4/22 LPA Flores requested a copy of staff/resident roster. LPA and assistant administrator tour rooms #20,12,32,29,48,96,90, hallways, and dining room. LPA Flores interviewed residents #1,#2,#3,#4,#5,#6,#7, assistant administrator(S1), and staff #2(S2),#3(S3),#4(S4),#5(S5). LPA Flores reviewed medication for residents #1(R1),#2(R2),#3(R3),#4(R4),#5(R5),#6(R6),#7(R7) and requested copies of medication sheets (MARS) for January, February, March 2022 for R1,R2,R3,R4,R5,R6,R7, training for staff, call logs for physician/pharmacy contacts, contract for roof repairs. On 7/14/22 LPA Flores requested copy of staff/resident roster, Med-Tech notes for March, and delivered findings for the above allegations.Read the full finding— CDSS inspection report, July 14, 2022 · control 28-AS-20220328134143

Licensing Program Analyst (LPA) Alma Gonzalez conducted an unannounced complaint visit to gather information pertaining to the above-mentioned allegation. LPA met with Assistant Administrator Rachel De Chavez and explained the reason for the visit. The investigation consisted of: LPA conducted interviews with Assistant Administrator Rachel De Chavez, Receptionist Darkis Giron and Resident 1-7 (R1-7). LPA obtained copies of Staff and Resident Rosters. LPA reviewed R1's facility file and collected copies of the following documents: Identification and Emergency Information (LIC601),Physician's Report for Residential Care Facilities for the Elderly (RCFE) dated 2/8/22, Functional Capability Assessment (LIC9172) dated 2/14/22, Individual Service Plan (ISP) dated 2/9/22, Physician's Orders for Life Sustaining Treatment (POLST) dated 11/24/20 and Internal Resident Incident Reports for dates 2/17/22 - 6/1/22. LPA also attempted a call to The Gardens of El Monte. (See LIC9099C for continuation)Read the full finding— CDSS inspection report, June 9, 2022 · control 28-AS-20220603145532

Licensing Program Analyst (LPA) Glenn Trueman made an unannounced visit to the facility and was greeted by Assistant Administrator Rachel De Chavez and explained the reason for the visit. The purpose of the visit is to investigate the above allegation. Interviews were conducted from 9:30 AM to 11:30 AM with Assistant Administrator Rachel De Chavez and Resident's R1-R8. File was reviewed for Resident R8 and SIR's, Physician's Report, and Emergency ID page were submitted. In regards to the allegation Resident is being discriminated against while in care, based on interviews conducted and information gathered all 8 residents interviewed had not observed any discrimination. Resident R 8 confirmed that staff are respectful on a daily basis and staff are ok. Stated that unhappy that family member isn't able to stay overnight. 7 of 8 resident's interviewed stated staff are nice, respectful and do a good job. Staff interviewed stated that they do person centered care and there is no discriminaRead the full finding— CDSS inspection report, June 2, 2022 · control 28-AS-20220525084343

Licensing Program Analyst (LPA) Tao conducted an Initial 10-Day complaint investigation regarding the above allegations. LPA discussed the purpose of the visit with Assistant Administrator, Rachel De Chavez. Investigation consisted of the following: interviews of staff from Staff #1 (S1) through Staff #4 (S4); interviews of residents from Resident#1 (R1) through Resident #6 (R6); reviewed resident#1’s (R1) record reviews, and a facility tour. LPA obtained copies of the Staff and Resident Rosters; and residen files for Resident #1 (R1) with relevant information. The investigation revealed the following: For the allegation of “resident belongings not safeguarded”, it was alleged that resident#1 had several items stolen from resident's room. (-continued in LIC 9099 C) UnsubstantiatedRead the full finding— CDSS inspection report, June 2, 2022 · control 28-AS-20220524162211

Licensing Program Analyst (LPA) Angelica Rea conducted an unannounced complaint visit in response to the above allegation. LPA met with Administrator, Marina Pink and Assistant Administrator, Rachel De Chavez who assisted with today's visit. Regarding the allegation that Administrator does not ensure a safe and healthful environment to residents, the investigation consisted of interviews with Administrator, Assistant Administrator, Staff #1 and Resident #1- Resident #6. Administrator and staff interviewed denied the allegation. They stated that the facility does ensure a safe and healthful environment for residents. Residents interviewed were unable to corroborate the allegation. 5 out of 6 residents stated that the environment at the facility is safe and healthful. Regarding the allegation of financial abuse, the investigation consisted of interviews with Administrator, Assistant Administrator, Staff #1 and Resident #1- Resident #6. Adminstrator and staff interviewed denied the allegaRead the full finding— CDSS inspection report, April 6, 2022 · control 28-AS-20220329161435

Licensing Program Analyst (LPA) Cynthia Chan conducted a complaint investigation for the allegations listed above. LPA met with Assistant Administrator, Rachel De Chavez, and explained the purpose of the visit. The investigation consisted of the following: LPA obtained copies of the staff roster, resident roster, food menu, staff schedule and duties, list of diabetic residents, and a resident tracking sheet. A tour of the dining room and kitchen was conducted with Staff. LPA also interviewed 6 Staff and 7 Residents today. The investigation revealed the following: Regarding allegation - Staff do not meet the residents dietary needs. The facility has started a seasonal menu which began on March 6, 2022 and menu will change every quarter. Per the Administrator, the food menu is created by a licensed dietitian from the New Menus Solution Company, who looks at the dietary needs of residents on low sodium, low carbs, and/or those with diabetes. UnsubstantiatedRead the full finding— CDSS inspection report, March 30, 2022 · control 28-AS-20220324093208

Licensing Program Analyst (LPA) Alma Gonzalez conducted a subsequent complaint visit to deliver investigation findings for the above stated allegation. LPA met with Assistant Administrator Rachel De Chavez and explained the reason for the visit. The investigation consisted of: During the initial visit conducted on 11/16/20, LPA conducted a telephone interview with Office Manager Leticia Flores and also conducted a televisit via Facetime with Office Manager for the purpose of conducting a health and safety check. LPA Gonzalez and Office Manager Flores toured the facility. Health and safety check included a tour of the entire facility including lobby and dining room and a sample of resident rooms. LPA did not observe any signs of neglect, abuse or other immediate health and safety threats. LPA additionally requested and received copies of Staff and Resident Rosters. On 12/16/21, LPA Gonzalez interviewed Assistant Administrator Rachel De Chavez, Office Manager Leticia Flores and Licensee/Read the full finding— CDSS inspection report, December 16, 2021 · control 28-AS-20201113111739

Licensing Program Analyst (LPA) Tao conducted an unannounced complaint visit in response to the above allegations. LPA met with Administrator, Marina Pink and Assistance Administrator, Rachel De Chavez who assisted with today's visit. The investigation consisted of interviews with administrator, assistant administrator, staff #3 to staff #7, interviews with residents #1 to resident #7, and review of resident #1 files. Regarding the allegation that Staff does not treat residents with dignity and respect, it was alleged that Staff#7 (R7) talk to Resident# 1 (R1) in a disrespectful manner. Per staff interviews, seven (7) of seven (7) staff denied the allegation. Staff interviews revealed staff treat residents with respect and dignity. Per resident interviews, seven (7) of seven (7) residents could not corroborate the allegation. LPA observed that staff treat residents with respect and dignity during the visit. (-continued in LIC 9099 C-) UnsubstantiatedRead the full finding— CDSS inspection report, December 8, 2021 · control 28-AS-20211129121019

Licensing Program Analyst (LPA) Galarza conducted an initial complaint visit to investigate the above allegation. The purpose of the visit was discussed with Administrator Marina Pink. The investigation consisted of the following: A physical plant tour of the facility, record review, staff (S1- S6), and residents (R1- R8) were interviewed. Resident (R1's) file was reviewed and documents [Admission Agreement, Face Sheet, Appraisal/Needs and Services Plan, Physician Report, Individual Service Plan (ISP), Resident Appraisal, Functional Capability Assessment, incident reports,bathing schedule, staff roster, and resident roster ] were obtained. No health and safety issues were observed during the visit. See LIC 9099C for report continuation. UnsubstantiatedRead the full finding— CDSS inspection report, November 18, 2021 · control 28-AS-20211116162531

This report supersedes report generated on 8/20/2021 to clarify previous report.********* Licensing Program Analyst's (LPA's) Linda Almaraz and Luis Mora conducted a subsequent complaint visit to investigate the allegations listed above. LPA's met with Assistant Administrator Leticia Flores and explained the reason for today's visit. The investigation consisted of the following: On 12/24/2020, LPA Almaraz interviewed Staff #1-2. On 8/20/2021, LPA's interviewed Flores, Staff #3-5, Residents #1-7 and requested a copy of staff and resident roster. The investigation revealed the following: Based on interviews conducted with staff they have not seen any other staff be abusive to residents or towards residents. Staff also stated they have not heard or been told by residents that they are being mistreated or abused. In regards to the allegation "Staff are stealing from residents," all interviews conducted stated they have not hear of any staff stealing from residents. ( Continued on an LIC 90Read the full finding— CDSS inspection report, November 6, 2021 · control 28-AS-20201217072050

Licensing Program Analyst (LPA) Angelica Rea conducted an unannounced complaint visit in response to the above allegation. LPA met with Administrator, Marina Pink and Assistant Administrator, Rachel De Chavez who assisted with today's visit. Regarding the allegation that resident is being harrassed by another resident. The investigation consisted of interviews with administrator, assistant administrator, interviews with residents #1 - resident #5, and review of resident #1 and resident #2 files. The investigation revealed that there was an incident on 9/17/21, involving resident #1 and resident #2. Resident #1 stated that resident #2 came to his room, holding an aersol can and threatening to spray it at him. Resident #2 stated that she was holding an aerosol can, but she did not threaten resident #1. Staff interviewed stated that resident #1 and resident #2 have an ongoing issue due to resident #1's playing his music too loudly for resident #2's liking. Resident #3 witnessed the incideRead the full finding— CDSS inspection report, October 22, 2021 · control 28-AS-20211020141223

Licensing Program Analyst (LPA) Alma Gonzalez conducted an unannounced complaint visit to gather information pertaining to the above-mentioned allegation. LPA met with Assistant Administrator Rachel De Chavez and explained the reason for the visit. The investigation consisted of: LPA collected copies of Staff and Resident Rosters, conducted interviews with Assistant Administrator Rachel De Chavez at 10:15am -10:30am, Office Manager Leticia Flores at 10:45am, Receptionist Siranush Aleksanyan at 11:00am, Activity Director Shirley Lee at 11:15am and Residents 1-7 (R1-7) from 11:30-12:30pm. (See LIC9099C for continuation) UnsubstantiatedRead the full finding— CDSS inspection report, September 20, 2021 · control 28-AS-20210913134558

Licensing Program Analyst (LPA) Alma Gonzalez conducted an unannounced complaint visit to gather information pertaining to the above-mentioned allegation. LPA met with Assistant Administrator Rachel De Chavez and explained the reason for the visit. The investigation consisted of: On 10/19/20, LPA conducted an interview with Office Manager Leticia Flores and obtained copies of Staff and Resident Rosters. On 9/20/21, LPA collected copies of Staff and Resident Rosters, conducted interviews with Assistant Administrator Rachel De Chavez at 10:15am -10:30am, Office Manager Leticia Flores at 10:45am, Receptionist Siranush Aleksanyan at 11:00am, Activity Director Shirley Lee at 11:15am and Residents 1-7 (R1-7) from 11:30-12:30pm. LPA also reviwed R8's facility file and (See LIC9099C for continuation) SubstantiatedRead the full finding— CDSS inspection report, September 20, 2021 · control 28-AS-20201012151908

Licensing Program Analyst (LPA) Linda Almaraz conducted a subsequent complaint investigation visit regarding the allegation listed above. LPA was met by Assistant Administrator, Leticia Flores and explained the purpose of today's visit. Later during the visit, Administrator Marina Pink arrived. The investigation consisted of the following: On 7/17/20, LPA conducted telephone interviews with Flores, and Staff #1-3. On 8/31/21, LPA interviewed Staff #4-6 and attempted to interview Staff #7 and Residents' #1 (1:1) Caregiver but was unable because Staff #7 was not at the facility and the 1:1 caregiver was no longer working at the facility. LPA contacted staffing agency for the residents 1:1 caregiver but was not able to reach anyone. LPA also interviewed Residents #1-7. Resident #1's and Staff #1 and 2 file was also requested. The investigation revealed the following: On 7/11/20, an incident occurred at the facility were Resident #1 was getting the residents daily eyedrops from Staff #7 anRead the full finding— CDSS inspection report, August 31, 2021 · control 28-AS-20200716165452

Licensing Program Analyst (LPA) Nicole Spencer conducted a subsequent visit to deliver the findings for the allegation listed above. LPA Spencer met with assistant administrator Rachel de Chavez and explained the purpose of today's visit. The investigation consisted of the following: During the initial visit on 6/21/21, LPA Spencer took a tour of the physical plant and interviewed staff #1-3 (S1-S3) and residents #1-7 (R1-R7). During subsequent visit on 8/31/21, LPA interviewed staff #4-5 (S4-S5). LPA received copies of the staff roster, resident roster, theft and loss policy, and for R7: physician’s report, individual service plan (ISP), personal property inventory list and incident reports from May-July 2021. See LIC9099C for continuation of this narrative. UnsubstantiatedRead the full finding— CDSS inspection report, August 31, 2021 · control 28-AS-20210614095847

Licensing Program Analyst's (LPA's) Linda Almaraz and Luis Mora conducted a subsequent complaint visit to investigate the allegations listed above. LPA's met with Assistant Administrator Leticia Flores and explained the reason for today's visit. The investigation consisted of the following: On 12/24/2020, LPA Almaraz interviewed Staff #1-2. On 8/20/2021, LPA's interviewed Flores, Staff #3-5 and requested a copy of staff and resident roster. The investigation revealed the following: Based on interviews conducted with staff they have not seen any other staff be abusive to residents or towards residents. Staff also stated they have not heard or been told by residents that they are being mistreated or abused. In regards to the allegation "Staff are stealing from residents," all interviews conducted stated they have not hear of any staff stealing from residents. ( Continued on an LIC 9099C) UnsubstantiatedRead the full finding— CDSS inspection report, August 20, 2021 · control 28-AS-20201217072050

***This report serves as an amendment and supersedes the original complaint investigation report created on 06/01/2021. The purpose of this amended Licensing report is to change the finding to unsubstantiated. *** Licensing Program Analyst (LPA) Tao conducted an initial complaint investigation of the above allegation on 06/01/21 and subsequent visit on 06/02/22. LPA discussed the purpose of the visit to Rachel. On 06/01/21, investigation consisted of staff interviews from staff#1 to staff#4; resident interviews from resident #1 to resident #8; review of maintenance log; and obtained Resident roster and Staff roster. For the allegation of “facility is in disrepair”, investigation revealed that facility's underground water pipe had burst and water was off for a half day on 05/25/21 and 05/26/21 to complete the repair. Plumbing issue was completed on 05/26/21. Seven out of seven residents confirmed the facility’s water was off only half day and had water supply for half day. Four out of fRead the full finding— CDSS inspection report, June 1, 2021 · control 28-AS-20210526161530