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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006764
Report Date: 04/15/2026
Date Signed: 04/15/2026 03:35:33 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/29/2026 and conducted by Evaluator Alvaro Ramirez Jr.
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20260129091147
FACILITY NAME:IVY TERRACE AT SANTA ANAFACILITY NUMBER:
306006764
ADMINISTRATOR:TORRES, JUDITHFACILITY TYPE:
740
ADDRESS:3730 S. GREENVILLE STREETTELEPHONE:
(714) 641-0959
CITY:SANTA ANASTATE: CAZIP CODE:
92704
CAPACITY:72CENSUS: 40DATE:
04/15/2026
UNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Anna Pastores-Executive DirectorTIME COMPLETED:
03:50 PM
ALLEGATION(S):
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Staff did not allow the resident to have visitors
Staff did not allow resident to have private telephone calls
Staff are overmedicating resident
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit to deliver findings on the above allegations received on January 29, 2026. LPA was greeted and granted entry into the facility and met with Executive Director (ED) Anna Pastores. LPA explained the reason for the visit.

This Department has investigated the complaint alleging that staff did not allow the resident to have visitors. Regarding the allegation the following was revealed: During the investigation LPA reviewed the Ivy Terrace at Santa Ana Resident sign in/sign out sheets dated August 5, 2025, through February 4, 2026. Per Resident sign in/sign out sheets, on January 23, 2026, and January 27, 2026, Resident's (1) family visited and sign out R1 for an outing. During the investigation LPA reviewed the Ivy Terrace at Santa Ana Admission Agreement dated August 15, 2025, for R1. Per Admission Agreement, under Visits and Communication it states visitors are welcome at any time provided that they respect the rights of other residents and staff and abide by visitation policy.
CONTINUED ON LIC9099-C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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Control Number 22-AS-20260129091147
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: IVY TERRACE AT SANTA ANA
FACILITY NUMBER: 306006764
VISIT DATE: 04/15/2026
NARRATIVE
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During the interviews with residents, Resident 1 (R1) reported that her family can visit anytime. R1 stated that she has never been denied visitors. Per R2, his wife visits everyday. R3 reported that she can have visitors. During the interviews with staff, S1 reported that the residents are always allowed to have visitors. During the interviews the ED reported that there are no restrictions on visitations unless there is a restraining order. Per ED, staff are not having visitation restrictions for R1.

Regarding the allegation that staff did not allow resident to have private telephone calls, the following was revealed: During the investigation LPA reviewed the Ivy Terrace at Santa Ana Admission Agreement for R1. Per Admission Agreement, under Resident's Personal Rights it states to have reasonable access to telephones, to both make and receive confidential calls. During the interviews with residents, R1 reported that she has privacy and stated that she was never told to put the telephone on speaker. Per R2, he can make private calls. During the interviews with staff, S1 reported that she has never witness residents being forced to put the telephone on speaker. During the interviews the ED reported that the residents use the front lobby telephone and stated that staff give the residents privacy when making a call.

Regarding the allegation that staff are overmedicating resident, the following was revealed: During the investigation LPA reviewed the Physician Report dated July 24, 2025, for R1. Per Physician Report R1 is not able to manage and store own medications. During the course of the investigation LPA reviewed documents including the Medication Administration Record (MAR) dated January and February 2025, for R1. Per MAR, R1 is being administer her medications as prescribed. During the interviews with residents, R1 reported that she does not take medications. Per R2, staff give him his medication as needed. During the interviews with staff, S1 reported that the residents are never overmedicated. During the interviews the ED reported that R1 is not being overmedicated and stated that the medications are given as prescribed.

Based on the information gathered during the investigation and review of documents obtained, LPA is unable to ascertain if the allegations occurred as reported due to conflicting information. Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove or refute the alleged violations occurred; therefore, these allegations are deemed UNSUBSTANTIATED.

For today’s visit, there were no citations issued per Title 22, Division 6 of the California Code of Regulations.

LPA conducted an exit interview with facility representative, and a copy of this report was provided to the facility.

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2026
LIC9099 (FAS) - (06/04)
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