<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 277209411
Report Date: 11/27/2024
Date Signed: 12/10/2024 04:28:27 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/22/2024 and conducted by Evaluator Vadim Gorban
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20241122101351
FACILITY NAME:IVY PARK OF MONTEREYFACILITY NUMBER:
277209411
ADMINISTRATOR:SHEARER, KELLIEFACILITY TYPE:
740
ADDRESS:1110 CASS STREETTELEPHONE:
(818) 643-2400
CITY:MONTEREYSTATE: CAZIP CODE:
93940
CAPACITY:112CENSUS: 100DATE:
11/27/2024
UNANNOUNCEDTIME BEGAN:
01:46 PM
MET WITH:Administrator Christoph SchusterTIME COMPLETED:
03:47 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff are not maintaining facility in good repair
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 11/27/2024, Licensing Program Analyst (LPA) V. Gorban visited the facility to commence complaint investigation. During this visit LPA met with facility administrator Christoph Schuster and stated the purpose of the visit. During this visit LPA toured the facility inside and out, performing safety checks and observed clients in care.

Allegation: Facility staff are not maintaining facility in good repair. Based on records review and staff interviews the facility had power generator turn in on November 5th, 2024. Residents and staff stated that besides power generator, alternative power source was provided to residents that utilize oxygen equipment. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Exit interview conducted, report signed and copy of this report with appeal rights provided to administrator for facility records.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 11/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2024
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 1