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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 277209411
Report Date: 09/16/2025
Date Signed: 09/17/2025 08:00:38 AM

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
09/08/2025 and conducted by Evaluator Vadim Gorban
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20250908120257
FACILITY NAME:IVY PARK OF MONTEREYFACILITY NUMBER:
277209411
ADMINISTRATOR:ANDREA RAMIREZFACILITY TYPE:
740
ADDRESS:1110 CASS STREETTELEPHONE:
(818) 643-2400
CITY:MONTEREYSTATE: CAZIP CODE:
93940
CAPACITY:112CENSUS: 104DATE:
09/16/2025
UNANNOUNCEDTIME BEGAN:
10:43 AM
MET WITH:administrator Andrea RamirezTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff did not timely address the residents change in medical condition
Staff are not meeting the residents bathing needs
INVESTIGATION FINDINGS:
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On 09/16/2025, Licensing Program Analyst (LPA) V. Gorban arrived unannounced to deliver findings on a complaint investigation. LPA explained the purpose of the visit to administrator Andrea Ramirez and was allowed entry.

During the course of the investigation, LPA conducted a facility tour, conducted interviews, and reviewed records.
The Department has investigated the allegations: Staff did not timely address the residents change in medical conditions. Based on interviews and record reviews, resident (R1) was provided medication for rush once resident skin was evaluated during shower time. The residents was provided with cream per prescription.

Report continues on attached LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2025
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 2
Control Number 24-AS-20250908120257
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: IVY PARK OF MONTEREY
FACILITY NUMBER: 277209411
VISIT DATE: 09/16/2025
NARRATIVE
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Regarding, Staff are not meeting the residents’ bathing needs. Based on staff interviews and reviews, residents offered showers as scheduled. Resident refusal documented and tried on different schedule. During the tour, resident was observed in common area, cleaned, with no odor. 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 above allegations are UNSUBSTANTIATED.

No deficiencies issued.

Exit interview conducted. Report signed on-site. A copy of this report with appeal rights was discussed and provided to the facility representative.
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2