Glen Park At Monrovia

Licensing Program Analysts (LPAs) Daniel Konishi and Gabriela Castro conducted a initial 10-day complaint visit in regards to the allegation listed above. LPAs explained the purpose of the visit to Martha Rosas, Assistant Administrator for the facility, and was granted entrance. Executive Director, Pamela Ogot arrived shortly after and was explained the purpose of the visit. The investigation consisted of the following: LPAs obtained resident and staff roster, Purchases of Service Dewey Pest Control Quality Assurance Reports for March 21, 2025, April 22, 2025, May 19, 2025, June 18, 2025, and June 30, 2025. LPAs interviewed Residents #1 (R1) to Resident #5 (R5), Assistant Administrator, Staff#1 (S1) to Staff #4 (S4), and also the Pest Control company representative. In regards to the allegation that "Staff did not keep the facility free from infestation", it is alleged that there are bed bugs and cockroaches in the facility. Four (4) out of five (5) residents interviewed stated that thRead the full finding— CDSS inspection report, June 30, 2025 · control 28-AS-20250623135323

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced initial complaint visit to investigate the above allegation. LPA met with Pamela Ogot, Executive Director and Martha Rosas, Assistant Administrator and explained the purpose of the visit. The investigation consisted of the following: LPA obtained copies of the Resident & Staff Rosters, Resident #1 (R1) files such as: Identification and Emergency Information (Face sheet), Admission Agreement, Physician's Report, Preplacement Appraisal, Personal Rights, Resident Appraisal, Hospital Release Records, Unusual Incident/Injury Reports (10/28/2024) related to the incident and Police report (24-0197771). LPA toured the facility's common areas including R1-R3's rooms and interviewed Staff #1 (S1) - Staff #6 (S6) and Resident #1 (R1) - Resident #7 (R7). The investigation revealed the following: In regards to the allegation: “Staff did not ensure adequate supervision was provided, resulting in a resident being injured.” It is aRead the full finding— CDSS inspection report, November 19, 2024 · control 28-AS-20241118093118

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced initial complaint visit to investigate the above allegations. Upon arrival LPA met with Martha Rosas, Assistant Administrator and explained the purpose of the visit. At 11:35 am, Pamela Ogot, Adminstrator arrived and assisted LPA with the investigation. During today’s visit, LPA toured the facility’s common areas and inspected random rooms to check call lights in Room # 4 and Room #8. LPA obtained resident & staff roster, Unusual Incident/Injury Reports (SIRs) involving Resident #1 (R1)-Resident #2 (R2) and Resident #7 (R7) (March 2024-July 2024), Staff in-service training logs on Residents' Rights (March 2024) and Medication (June 2023-Nov 2023), Residents Incontinent Tracking (June-July 2024). LPA also reviewed and obtained Resident #1 (R1)-Resident #2 (R2) and Resident #7 (R7) records and files such as Face Sheets, Admission Agreements, Physician's Reports, Needs and Services Plans and Medication Administration RRead the full finding— CDSS inspection report, July 9, 2024 · control 28-AS-20240702104018

Licensing Program Analsyts (LPA) Tena Herrrera conducted an unannounced initial complaint visit in regards to the allegation listed above. LPA met with Assistant Administrator Martha Rosas and explained the purpose for todays visit. The investigation consisted of the following: LPA obtained copies of both Staff and Resident Rosters, SIR submitted to licensing on 1/22/24 with discription of alleged incident, Copies of Resident #1's (R1's) Physician Report, Police Report Number (for alleged incident), Discharge Paperwork from hospital dated 1/18/24, follow up visits with R1's physicians post incidnet; R2's Physician's Report, R2's Special Medication Order and copies of the staff in-service training that was held on 1/23/24 covering Resident ADL's, including Medication Administration. LPA also interviewed 4 staff and 5 residnets. (Continued on 9099-C) UnsubstantiatedRead the full finding— CDSS inspection report, February 22, 2024 · control 28-AS-20240215122633

Licensing Program Analsyts (LPAs) Erik Zaragoza and Daniel Konishi conducted a subsequent complaint visit in regards to the allegations listed above. LPAs explained the purpose of the visit to Martha Rosas, Assistant Administrator for the facility, and was granted entrance. The investigation consisted of the following: During the initial visit, LPA Ashley Calderon obtained resident and staff roster, Purchases of Service Reports for 1:1 for Resident #1 (R1), October 2023 Schedule for R1's 1:1 caregiver, Dewery Pest Control Quality Assurance Reports for August and September 2023, obstained shower records and shower schedule, and also interviewed Residents #1 - 6 (R1 - R6), Staff #1 - 6 (S1 - S6), and also Witnesses #1 -2 (W1 - W2). During today's visit, LPAs Erik Zaragoza and Daniel Konishi obtained current staff and resident rosters, resident shower schedule, and interviewed Residents #7 - 9 (R7 - R9). UnsubstantiatedRead the full finding— CDSS inspection report, February 15, 2024 · control 28-AS-20231003134542

*****This report superseads report dated 01/11/2024. The reason for superseading is to include missing additonal supportive information in the original 9099. No other changes have been made to the report. Investigation findings remain the same.***** Licensing Program Analyst (LPA) Tena Herrera conducted a subsequent unannounced visit to provide additional information to the report regarding the allegations listed above. LPA was greeted by Administrator Pamela Ogot and Assistant Administrator Martha Rosas, the reason for the visit was explained. (Continued on 9099-C) Unsubstantiated— CDSS inspection report, January 23, 2024 · control 28-AS-20240102094739

Licensing Program Analyst (LPA) Tena Herrera made an unannounced subsequent visit to the facility, was greeted by Assistant Administrator Martha Rosas and explained the reason for the visit. The investigation included the following: During initial vist conducted on 1/3/24 LPA obtained copies of Resident and Staff Rosters and copies of documents within Resident #1’s (R1) file including: Admission Agreement, Identification and Emergency Information, Current Physician's Report, Appraisal and Appraisal/Needs and Services Plan, Copies of Most Current Nursing Home Podiatrist Visits, Hospice Information and Communication Log. LPA toured R1’s room and observed R1 to be clean, well groomed and social. Due to insufficient information available at the time, the above allegations needed further investigation. During subsequent visit LPA interviewed 5 Staff, 5 Residents, R1's Power of Attorney, and Hospice Staff. (Continued on 9099-C) UnsubstantiatedRead the full finding— CDSS inspection report, January 11, 2024 · control 28-AS-20240102094739

This is an amended report of original report dated 11/7/23, the purpose for amendment is to remove confidential information.This amended report does not change the findings.LPA Herrera redelivered report on 11/27/2023 and obtained signatures on the hard copy. Licensing Program Analyst (LPA) Tena Herrera conducted unannocuned subsequent compliant visit to deliver findings pertaining to the above-mentioned allegations. LPA met with Administrator Pamela Ogot who also assisted with the visit. (Continued on 9099-C) Unsubstantiated— CDSS inspection report, November 9, 2023 · control 28-AS-20231030113747

Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced complaint visit to the facility. Upon arrival, LPA met with Martha Rosas (Assistant Administraor) and explained the purpose of the visit. Investigation consisted of the following: During the initial visit conducted on 07/28/21, LPA Joe Katrdzhyan conducted an unannounced 10 day complaint visit to this facility LPA reviewed the file of Resident #1 (R1) and obtained copies of the following documents; Client Information Sheet, Admission Agreement , Agreements and Consent for Medical Treatment, Individual Program Plan (IPP), Unusual Incident/Injury Reports, Physician/Nurse Notes, Facility Progress Notes, Hospital Reports, Lab Results, Resident Roster and Staff Roster. Due to insufficient information available at the time, the allegations needed further investigation. (continued on 9099-C) UnsubstantiatedRead the full finding— CDSS inspection report, October 26, 2023 · control 28-AS-20210726164431

Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced subsequent complaint investigation to deliver findings on the above-mentioned allegations. Upon arrival, LPA met with Pamela Ogot (Administrator) and explained the purpose of the visit. The investigation consisted of the following: On 8/25/21 LPA Kruz Long conducted the inital visit and obtained a copy of the Staff schedule (June-August 2021), copy of the Resident Roster and reviewed/obtained a copy of Resident #1's (R1) records (Physician's report, Appraisal/Needs and Services Plan, Preplacement Appraisal Information, Weight Chart, Resident Appraisal, Functional Capability Assessment, House Call Medical Records, Hospital Records and the Admission Agreeement). LPA also interviewed Residents 1-8 (R1-R8). During subsequent visit today LPA Herrera obtained copies of the following documents: Staff/Resient Rosters, Current Staff Shedule and Staff Schedule from Jun-Aug 2021, (Continued on 9099-C) UnsubstantiatedRead the full finding— CDSS inspection report, August 15, 2023 · control 28-AS-20210816095011

***This report will supersede the original complaint report created on 05/02/2023. The purpose of this report is to add additional information from the original complaint report. However, the findings of the allegations will not change. *** Licensing Program Analysts (LPAs) Christine Wong and Sanjay Vaid conducted a “Subsequent” visit to ascertain additional information regarding the above-mentioned allegation(s) and for the purpose of rendering the findings. LPA met with Assistant Administrator Martha Rosas who allowed entry into the facility and was later met by Administrator Pamela Ogott who assisted with the visit. The investigation consisted of the following: On 5/2/2023, LPA interviewed four residents (R1-R4), six staff (S1-S6) and administrator and obtained copy of documents for residents and staff training (Medication Managment and Resident's right) and reviewed residents' medication. On today's date, LPA interviewed additional 4 residents (R5-R8) for additional information andRead the full finding— CDSS inspection report, August 11, 2023 · control 28-AS-20230417131724

Licensing Program Analyst (LPA) Christine Wong conducted a “Subsequent” visit to ascertain additional information regarding the above-mentioned allegation(s) and for the purpose of rendering the findings. LPA met with Assistant Administrator Martha Rosas who allowed entry into the facility and was later met by Administrator Pamela Ogott who assisted with the visit. The investigation consisted of the following: LPA interviewed four residents (R1-R4), six staff (S1-S6) and administrator and obtained copy of documents for residents and staff training (Medication Managment and Resident's right) and reviewed residents' medication. The investigation revealed of the following: Allegation#1 "Facility is abusing residents" LPA interviewed four residents and four out of four residents denied the allegation and stated that staff are good and they never witnessed or heard any staff abused residents. LPA interviewed staff and all denied the allegation. They reported they never heard or witnessed anRead the full finding— CDSS inspection report, May 2, 2023 · control 28-AS-20230417131724

Licensing Program Analyst (LPA) Ashley Calderon conducted a complaint investigation at the facility regarding the above allegation. LPA met with Assistant Administrator Martha Rosas and explained the reason for the visit. LPA Calderon requested Resident and Staff Roster, copies of Resident #1 (R1) file: Identification Emergency Information, Physician's Report, and Appraisal/Needs and Service Plan. R1's Special Incident Reports (SIRs) related to allegation stated above and Hospitalization Records. LPA received email confirmation and reporting fax confirmations. LPA interviewed Assistant Administrator Martha Rosas and telephonically called R1 but was unsuccessful and telephonically interviewed San Gabriel/ Pomona Regional Center (SGPC). Continuation on LIC 90999-C... UnsubstantiatedRead the full finding— CDSS inspection report, April 5, 2023 · control 28-AS-20230327110541

Licensing Program Analyst (LPA) Kruz Long conducted an unannounced complaint investigation at the facility. Upon arrival, LPA met with Pamela Ogot (Executive Director) and explained the purpose of the visit. During today's visit, LPA obtained and reviewed a copy of the Staff/Resident roster, Resident #1's (R#1) Physician Report, Appraisal Needs and Services Plan, Incident Reports and Hospital Records. LPA attempted to interview R#1, interview Staff #1 to #5 in the office and interviewed R#2 to R#5 in the office. In regards to the allegation: Staff did not seek medical attention for resident in a timely manner. Per allegation details, an incident occurred with R#1 who required medical attention. Review of Incident Reports provided to the department indicate facility did seek medical attention for R#1. LPA interviewed Staff and verified that facility did seek medical attention for R#1 in a time manner. Interviews with 5 of 5 Staff indicate they did not observe R#1 to have displayed symptRead the full finding— CDSS inspection report, March 23, 2023 · control 28-AS-20230321144556

Licensing Program Analyst (LPA) Luis Mora conducted an unannounced complaint visit to determine the validity of the above-mentioned allegations. LPA met with Pamela Ogot (Administrator) and explained the reason for the visit. The investigation consisted of the following: On 12/22/2020, LPA Joe Katrdzhyan conducted a telephone initial complaint visit and interviewed facility manager due to Covid-19. On 02/09/2023, LPA Mora obtained copies of resident staff rosters, interviewed Administrator, Facility Manager, Staff 1 - Staff 4 (S1 - S4), Resident 1 - Resident 6 (R1 - R6), and Day Program Director. LPA conducted a tour of the facility common areas, medication room and 6 random residents rooms. The investigation revealed the following: regarding the allegation "staff are abusing residents", it is alleged that the facility's owner, CEO, CEO's significant other and a staff from corporate come to the facility to verbally and physically abuse the residents. (Continued to LIC 9099C) UnsubstantRead the full finding— CDSS inspection report, February 9, 2023 · control 28-AS-20201217072904