435202744-6-12-2025-26-AS-MPAA-DHRV89-20250618161222

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435202744
Report Date: 05/23/2025
Date Signed: 06/12/2025 09:56:50 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/04/2025 and conducted by Evaluator Marcela Yanez

COMPLAINT CONTROL NUMBER: 26-AS-20250304120229

FACILITY NAME:	IVY PARK AT MILPITAS		FACILITY NUMBER:	435202744
ADMINISTRATOR:	BECKER, GREGORY		FACILITY TYPE:	740
ADDRESS:	80 CEDAR WAY		TELEPHONE:	(408) 770-9575
CITY:	MILPITAS	STATE: CA	ZIP CODE:	95035
CAPACITY:	225	CENSUS:	DATE:	05/23/2025
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Meghian Geul, Administrator		TIME COMPLETED:	11:45 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff are serving food that is not of quality to residents in care.
Staff are not following a resident's admission agreement.
Staff did not ensure that activities are provided for residents in care.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

*Amended to add document review for activity director training log*
On May 23, 2025 Licensing Program Analyst (LPA) Marcela Yanez conducted an unannounced complaint investigation visit to deliver findings on the above allegations. LPA met with Meghian Geul, Administrator.

On March 4, 2025 the department received a complaint with the above allegations.

On March 12, 2025 LPA Yanez and LPA Jain interviewed Staff S1-S3, Interim Director (ID) and Residents (R1-R7). 7 out of 7 residents stated the food is ok but sometimes it is cold or not hot enough and the food is better on the weekend and occasionally the soup is too hot. 3 Out of 3 staff stated that the food served to residents is checked with a thermometer prior to serving. on May 21,2025 LPA Monter interviewed 5 staff.
The food does not meet the food quality standard based on the right temperature food is not served. 2
out of 3 staff stated that when food is returned cold to the kitchen the food is replated and not reheated.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Marcela Yanez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/23/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2025

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 3

Control Number 26-AS-20250304120229

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: IVY PARK AT MILPITAS	FACILITY NUMBER: 435202744
	VISIT DATE: 05/23/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

On occasion the facility Chef engages residents in conversation to sample food on the menu and provided their opinions and suggestions.

LPA toured the facilities kitchen and dining area. LPA observed residents in the dining area and observed food served on the menu was of good quality and nutritious.

On March 12, 2025, LPAs Yanez and Jain interviewed 7 residents (R1-R7) 1 out of 7 stated he/she missed two dental appointments due to not having a driver and stated that the Activity Director was providing rides, but went on leave.

Licensing Program Analysts (LPAs) Marcela Yanez and Kiran Jain interviewed 7 residents (R1-R7) and Interim Director regarding the facility driver and transportation services as part of the basic service as stipulated on the resident’s admission agreement. ID stated that the facility driver had resigned in January 2025 and tried to make arrangement with sister facilities if a driver can be provided but was unsuccessful.

The facility recently hired an individual to start the week of March 9, 2025, but the individual did not show up for work. The facility is actively seeking for a qualified driver that has the necessary skill and proper license to drive the facility’s van which requires a Class B License, ID stated that the facility is arranging transportation by using third party vendor rides for the residents such as Uber or Lyft. The residents could use their own app to schedule transportation, and facility reimburses the resident for the fee charged or the front desk schedules the ride for residents.

LPAs Yanez and Jain continued to interview Interim director. ID stated that the facility Activity Director is out on leave since February 2025 and stated, the direct support staff are filling in for the Activity Director. However, Activity Coordinator called out several times during the last month and the Staff filling in for the activity director and coordinator is a direct support staff.
**** Amended statement to include training log was reviewed****
During investigation LPA Yanez reviewed Training log for staff conducting activities and verified staff had been trained and experience in administering and directing activities to residents. The Direct Support Staff has been promoted to Activity director as of April 27, 2025. Kitchen staff records were also reviewed and staff had training in food handling and food preparation.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Marcela Yanez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 26-AS-20250304120229

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: IVY PARK AT MILPITAS	FACILITY NUMBER: 435202744
	VISIT DATE: 05/23/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

LPAs interviewed 7 residents (R1-R7). 7 out of 7 stated the activities does not exist or not posted on the schedule. 7 Out of 7 stated that the person conducting the activities was not experienced, and did not have the correct supplies for the activities.

LPA Yanez observed a meeting conducted by ID with approximately 20 residents in attendance. The meeting is regarding the activities not being provided according to the posted schedule and activities that the residents prefer. The facility conducted a survey among the residents and gathered suggestions for activities that would interest all the residents.

Based on document reviews, interviews and observations the department has completed its investigation and found that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove that the above allegations did or did not occur, therefore the above allegations are unsubstantiated.

No deficiencies are being cited during today’s visit based on California Code of Regulations Title 22. An exit interview was conducted with Administrator Meghian Geul and a copy of the report was provided.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Marcela Yanez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/23/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 3