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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 315920222
Report Date: 08/21/2025
Date Signed: 08/21/2025 02:34:34 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/27/2025 and conducted by Evaluator Kevin Mknelly
COMPLAINT CONTROL NUMBER: 59-AS-20250627153032
FACILITY NAME:IVY AT BLUE OAKS, THEFACILITY NUMBER:
315920222
ADMINISTRATOR:SWEARINGEN, MICHELLEFACILITY TYPE:
740
ADDRESS:275 ROSEVILLE PARKWAYTELEPHONE:
(916) 432-2878
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY:157CENSUS: DATE:
08/21/2025
UNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Michelle SwearingenTIME COMPLETED:
02:40 PM
ALLEGATION(S):
1
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9
Licensee does not ensure that there are enough staff to meet resident's hygiene needs while in care.
Staff member handled resident in care in a rough manner.
Staff member yelled at resident in care.
Licensee does not ensure that staff are adequately trained.
INVESTIGATION FINDINGS:
1
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9
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13
 On 8/21/25, Licensing Program Analyst (LPA) Kevin Mknelly conducted an unannounced complaint investigation visit to deliver the findings for the above allegations and met with Executive Director.
LPA conducted records review and extensive interviews.
LPA is unable to find and or meet the preponderance, per policy.
LPA interviewed a family member of resident alleged to not have had hygiene needs met. Family member stated that a family member is present for part of every day of resident's stay. Family member did not have concerns for care of R1. R1 was not able to recall such an incident occurring. For the allegation of staff being rough with a resident and yelling at a resident, the specific resident was not identified and the staff are no longer present at the facility. No additional evidence was available for this allegation. Regarding the allegation of insufficient staffing, this complaint was stating general staff shortages that were alleged to occur months prior. Specific incidents alleged were not substantiated. The staff alleged to not receiving training did not identify the training not provided under Title 22 requirements.
As a result of this investigation, LPA finds allegation to be (US)Unsubstantiated - A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.
Exit interview with administrator and report copy provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2025
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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