Glen Park at Glendora

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Gabriela Castro conducted an unannounced required annual inspection using the Compliance and Regulatory Enforcement (CARE) Tool. LPA was greeted by facility staff and informed them of the purpose of the visit. LPA was provided a tour of the facility and assisted by Edgar Littaua, Office Manager. Administrator Stacie Anderson was contacted via telephone. The facility’s fire clearance is approved for thirty-four (34) non-ambulatory residents, ages 60 and over, of whom ten (10) may be bedridden in Rooms 3, 4, 7, 8, 12, and 14. The facility also maintains a hospice waiver for ten (10) residents. At the time of the inspection, no residents were receiving hospice care. Facility Tour & Observations: Required postings, including Personal Rights (LIC 613C), Long-Term Care Ombudsman information, Complaint Poster (PUB 475), and the nondiscrimination notice, were observed posted in a common area and accessible to residents and visitors. Residents were observed to have access to personal space, privacy, and adequate storage for personal belongings. No firearms or other weapons were present at the facility. Physical Plant Facility Tour & Physical Plant: The facility is located in a residential area and consists of a single-story building divided into three (3) wings. Upon entering the facility, LPA observed the front lobby/reception area, conference room, and Administrator’s office. The South Wing consists of a nurses’ station, medication room, public restroom, staff break room, and four (4) resident bedrooms. Room #7 was observed to be undergoing renovations at the time of the inspection. The North Wing consists of six (6) resident bedrooms and a public restroom. During the inspection, LPA observed that the window screens in Room #14 needed replacement. The West Wing consists of the activity room/dining area, kitchen, storage room for cleaning supplies, laundry room, and five (5) resident bedrooms. LPA observed a sufficient supply of food, including emergency food supplies. Office Manager Edgar Littau reported that the facility receives food deliveries for breakfast, lunch, and dinner from their other location in Monrovia. Room #3 was reported to be undergoing upgrades at the time of the inspection. An office utilized by the Activity Coordinator is located behind the laundry room. LPA also observed an additional bedroom that was not in use and another room utilized for storage. The facility’s boiler equipment is located near the laundry room area. During the inspection, LPA observed water leaking directly from the boiler equipment. Resident bedrooms observed contained required furnishings, including beds, mattresses, linens, dressers, chairs, and adequate lighting. Bathrooms inspected were observed to be clean and maintained in sanitary condition. Bathrooms were equipped with required safety features, including grab bars near toilets and bathing areas and non-skid surfaces/mats to reduce the risk of falls. Toilets, sinks, and bathing fixtures were observed to be operational. Hot water was available for resident use. Cleaning supplies, toxic substances, and other potentially hazardous items were stored in designated areas and inaccessible to residents. Extra linens and towels were available for resident use. Smoke and carbon monoxide detectors were observed, and fire extinguishers were available throughout the facility. Passageways, hallways, and exits were observed to be clear and unobstructed. No bodies of water were observed on the premises. The outdoor patio area was observed to be well maintained and provided ample shaded seating areas for residents’ use. Food Service Refrigerators and freezers were maintained at proper temperatures (refrigerators at a maximum of 40°F and freezers at 0°F) and contained a sufficient supply of food, including at least two (2) days of perishable food and seven (7) days of non-perishable food. Fresh produce, proteins, and dry goods were stocked. Health-Related Services & Records Four (4) resident files were reviewed. Files contained current required documentation including Admission Agreements, signed consents, Needs and Service Plans, Physician’s Reports documenting TB results and ambulatory status, and Resident Rights acknowledgments. Four (4) residents’ medications were reviewed. Medications were observed to be centrally stored in a locked in med room and med carts. (continued on 809C) Disaster Preparedness: The most recent fire/earthquake drill was conducted on August 28, 2026, with staff and resident participation. The facility’s fire alarm and fire sprinkler systems were last inspected/serviced by Earl Security, Inc. on September 2, 2026. The LIC 610D Emergency Disaster Plan was available for review and was in the process of being updated at the time of the inspection. Emergency supplies, including water, food, flashlights, batteries, and first aid supplies, were observed and available for use in the event of an emergency. Personnel Records & Training Four (4) staff files were reviewed and included criminal record clearances, CPR/First Aid, required training and TB screenings. Administrator Certificate for Stacie Anderson was valid through October 15, 2027. An exit interview was conducted with Edgar Littaua, Office Manager. During the inspection, deficiencies were observed and cited on the attached LIC 809D/809C in accordance with Title 22, Division 6 regulations. A copy of this report, LIC 809D/809C, and appeal rights will be provided.the state’s words, verbatim · CDSS document, Sep 28, 2026

The state marks this report as 7 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Prelicensing

Licensing Program Analysts (LPAs) Blanca Gonzalez and Nune Margaryan conducted an announced subsequent Pre-Licensing Inspection visit and met with Administrator Pamela Ogot, Chief Executive Officer Tillman Pink Jr and Quality Assurance Director Melissa Flores. This Pre-Licensing Inspection is due to a change of ownership. On 09/25/2025 LPAs conducted the initial Pre-Licensing inspection visit which consisted of a physical walk through of the facility’s interior and exterior, inspections of resident bedrooms, bathrooms and common living areas. The purpose of today’s subsequent visit is to conduct a tour to address corrections required to meet Title 22 regulations. LPAs observed the following corrections: • Outdoor furniture was observed to be clean and seat cushions were in good repair • Umbrellas were added to provide shaded outdoor seating areas • Water temperature in bathroom for rooms #17 and #18 was adjusted and measured 111.9°F, which is within the required range of 105-120°F • Grab bars were added to shower in bathroom for rooms #17 and #18 • Room #14 was converted from activity room back to resident bedroom, as described on facility sketch continued on LIC 809C continued from LIC 809 • Licensee furnished all 17 resident bedrooms to contain required furnishing consisting of: for each resident, a chair, nightstand, a lamp, or lights sufficient for reading, a bed including blankets, bedspreads, top bed sheets, bottom bed sheets, pillowcases, mattress pads. • Licensee added combination smoke/carbon monoxide detectors in the hallway outside of rooms #17 and #18 LPAs reviewed five (5) resident and three (3) staff files and observed that all files are updated. Component III is waived: Licensee is currently operating a facility of the same category. Facility made all corrections and is now ready for license. The Pre-licensing is complete, and the facility has no deficiencies. Exit interview conducted and a copy of this report was provided to Administrator Pamela Ogot. LPA will submit a copy of this facility evaluation report to the Central Applications Bureau (CAB) for review. If the applicant has questions regarding the status of the application, Licensee has been instructed to communicate with the CAB Analyst who assigned his application.the state’s words, verbatim · CDSS document, Oct 10, 2025

Type of visit: Prelicensing

Licensing Program Analysts (LPAs) Blanca Gonzalez and Nune Margaryan conducted an announced Pre-Licensing Inspection visit and met with Administrator Pamela Ogot, Chief Executive Officer Tillman Pink Jr and Quality Assurance Director Melissa Flores. This Pre-Licensing Inspection is due to a change of ownership. The facility has an approved fire clearance to be licensed to serve twenty-four (24) non-ambulatory residents and ten (10) bedridden for a total capacity of 34 adults aged 60 and older. Bedridden rooms are #3, # 4, #7, #8, #12 and #14. The facility has a census of 5 residents. LPAs and Applicant toured the physical plant interior and exterior. The following was observed/inspected: The facility is in a residential neighborhood of Glendora and consists of 17 resident bedrooms, 13 bathrooms, kitchen, living room/dining room/activity room, medication room, nurse station, administrator office, conference room, lobby, reception area and garden/outdoor area. The facility temperature at the time of visit was comfortable. Required postings observed in the hallway. Auditory devices on doors leading to exterior were observed and operable. No delayed egress on exterior doors. continued on LIC 809C continued from LIC 809 (page 2) Smoke detectors and four (4) fire extinguishers were observed throughout the facility. The facility is equipped with a fire alarm and sprinkler system. A carbon monoxide detector was observed in the hallway, was tested and is operable. A secured hallway closet contained cleaning supplies, toxins and disinfectants that were inaccessible to residents. Dining room/living room/activity room were observed clean and comfortable with sufficient seating for residents in care. Vending machines observed in dining area. LPAs observed sufficient space to accommodate both indoor and outdoor activities. Activities calendar was posted in the hallway. Garden/outdoor area was easily accessible to residents through the dining room, protected from traffic, but did not have adequate shaded seating areas. Outdoor furniture was dirty with bird droppings and seat cushions were in disrepair. Passageways were clean and free of obstructions. No pools or large bodies of water. Kitchen was observed clean and free of litter, rodents, vermin and insects. Refrigerator and freezers were observed clean and operating at time of visit. Currently, due to only having five (5) residents, meals are not prepared on site. Prepared meals are brought from sister facility in Monrovia. Pantry was observed to have enough non-perishable food supply for 7 days. Centrally stored medications are maintained in a secured med room inaccessible to residents. Medication room was inspected and medication was reviewed. Locked laundry room was observed to be clean and detergent secured. Washing machine and dryer were in working order. Extra clean linens were observed in linen storage area. LPAs inspected all bedrooms (occupied and non-occupied) and observed that a few resident bedrooms did not contain the required furniture. Bed linens were clean and in good repair. There was closet space for clothing and other belongings. Bedroom #14 is designated for bedridden and is currently used and furnished as an activity room. continued on LIC 809 C (page 3) Resident bathrooms were observed clean. Grab bars and non-slip mats observed in all bathrooms besides the bathroom located in the hallway for residents to use for bedrooms #17 and #18. Also, the water temperature measured 129°F, which is not within the required range of 105-120°F and did not have grab bars in the shower. Resident bedrooms #17 and #18 located at the back of the facility are attached to the main building, connected by the laundry room. Rooms #17 and #18 have additional access through the Garden/outdoor area accessible through the dining room. LPAs observed that the area where Rooms #17 and #18 are located did not have smoke detectors (need clarification). The following Corrections need to be made prior to clearing the facility for License: • Outdoor furniture must be cleaned and seat cushions in good repair • Adjust water temperature in bathroom for rooms #17 and #18 to measure within the required range of 105-120°F • Add grab bars to shower in bathroom for rooms #17 and #18 • Convert room #14 from activity room back to resident bedroom, as described on facility sketch • Licensee will ensure all 17 resident bedrooms contain required furnishing consisting of: for each resident, a chair, nightstand, a lamp, or lights sufficient for reading, a bed including blankets, bedspreads, top bed sheets, bottom bed sheets, pillow cases, mattress pads. Pre-licensing is incomplete with corrections to be resolved by October 6. Facility administrator will advise LPA of corrections. A follow up inspection to verify corrections have been made will be conducted. Exit interview conducted and a copy of this report was provided to Administrator Pamela Ogot. Accordingly, LPA will submit a copy of this facility evaluation report to the Central Applications Bureau (CAB) for review. If the applicant has questions regarding the status of the application, they have been instructed to communicate with the CAB Analyst assigned to their application.the state’s words, verbatim · CDSS document, Sep 25, 2025

Type of visit: Office

Component II completion: Successful Facility Type: Residential Care Facility for the Elderly (RCFE) Application Type: Change in Ownership (CHOW) Capacity: 34 Census (if any clients in care): 6 COMP II Participants: Tillman Pink, Applicant Pamela Ogot, Administrator Melissa Flores, Quality Assurance Interview Method: Virtual interview (Microsoft Teams) On September 11, 2025, Applicant, Administrator, and staff participated in COMP II. Identification of the Applicant, Administrator, and staff was verified through interview questions based on photo ID and other identifying personal information. During COMP II, Applicant, Administrator, and staff confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant, Administrator, and staff understanding of following areas: 1. Facility Operation: License Type, Client/Resident Populations, and Program. 2. Admission Policies 3. Staffing Requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General Provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing Readinessthe state’s words, verbatim · CDSS document, Sep 11, 2025