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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 277209411
Report Date: 02/05/2026
Date Signed: 02/10/2026 08:16:45 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
12/05/2025 and conducted by Evaluator Vadim Gorban
COMPLAINT CONTROL NUMBER: 24-AS-20251205145348
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: 101DATE:
02/05/2026
UNANNOUNCEDTIME BEGAN:
10:43 AM
MET WITH:Administrator Andrea RamirezTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff do not tend to the residents bathing needs
Staff do not respond to resident's calls for assistance in a timely manner
Staff do not ensure that residents are eating their meals
Staff leave resident on the floor after falls for a prolonged period of time
INVESTIGATION FINDINGS:
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On 02/05/2026 Licensing Program Analyst (LPA) Gorban unannounced visited the facility to deliver findings to complaint investigation. LPA introduced self and met by administrator. LPA stated purpose of the visit and was allowed entry.
During this complaint investigation LPA toured the facility conducting health and safety checks, reviewed records, and interviewed administrator and staff.

Allegations: Staff do not tend to the residents bathing needs, Staff do not ensure that residents are eating their meals. Based on staff interviews and records review, each resident's offered baths according to contract. Refused showers/ baths documented and followed up on. Regarding meals, Residents consuming meals in dinning area or in private room, residents assisted by staff with meals set up. Baths and meals intake documented in facility records.

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

DATE: 02/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2026
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-20251205145348
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: 02/05/2026
NARRATIVE
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Allegations: Staff leave resident on the floor after falls for a prolonged period of time, Staff do not respond to residents calls for assistance in a timely manner.
Based on staff interviews facility area is monitored by staff every 2 hours during NOC shift. During the day, staff attend to residents more frequently because of meals, baths, care plans, and medications procedures. Additionally, facility equipped with call light system that allows residents to request help when staff is not in proximity. Based on records review falls documented and reported to Licensing office.
Although the alleged violations may have happened or are valid, there are not a preponderance of evidence to prove the alleged violations did occur, therefore the allegations are Unsubstantiated.


Exit interview conducted, report signed and copy of this report provided to administrator for facility records.
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2