435202744-5-30-2025-26-AS-RMAO-DHG297-20250608171127

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435202744
Report Date: 05/30/2025
Date Signed: 05/30/2025 03:05:20 PM

Substantiated

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
05/21/2025 and conducted by Evaluator Manuel Monter

COMPLAINT CONTROL NUMBER: 26-AS-20250521085417

FACILITY NAME:	IVY PARK AT MILPITAS		FACILITY NUMBER:	435202744
ADMINISTRATOR:	MEGHIAN GEUL		FACILITY TYPE:	740
ADDRESS:	80 CEDAR WAY		TELEPHONE:	(408) 770-9575
CITY:	MILPITAS	STATE: CA	ZIP CODE:	95035
CAPACITY:	225	CENSUS:	DATE:	05/30/2025
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Administrator Meghian Geul		TIME COMPLETED:	03:10 PM

ALLEGATION(S):

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Staff does not ensure facility has hot water.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Monter conducted an unannounced complaint inspection to deliver the findings on the above allegation. LPA met with Administrator Meghian Geul

On May 21, 2025 the Department received a complaint alleging Staff does not ensure facility has hot water.

On May 19, 2025, the Department received an incident report from the facility. The incident report stated, "on May 16, 2025 (Friday), around 10am this morning residents reported no hot water when they took a shower. The water heater was checked and we found both water heaters were not working.... Water heater will be repaired tomorrow, Saturday May 17, 2025.

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Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 05/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2025

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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Control Number 26-AS-20250521085417

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: 05/30/2025

NARRATIVE

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On May 19, 2025, LPA Manuel Monter spoke to ADM. ADM stated the water heater went out and the only water heater in the facility that was working was in the kitchen. ADM stated the hot water was out Friday mid morning and on 5/19/2025, the water heaters have been fixed. LPA asked ADM if there was any plan/alternative to give residents hot water to bathe during the time period where the water heater wasn’t working. ADM stated No.

On May 21, 2025, LPA Manuel Monter interviewed residents R1-R5. Residents R2 – R5 stated the hot water in the facility stopped working on Friday, 5/16/25. R1 stated the hot water at the facility stopped working on Thursday, 5/15/25.

R1 stated he/she was informed the water heater was repaired on two different dates, but the water heater was not repaired. All residents interviewed stated the water heater was repaired on 5/20/2025. All residents interviewed stated the facility did not provide any other options/ alternatives for resident to shower/ bathe with hot water, while the water heater was in repair.

On May 21 and 30, 2025 LPA Monter interviewed staff S1-S4. S1 stated the hot water was not working in the facility back last Friday, 5/16/25. S1 stated the water was fixed, then it was out again, then fixed again. S1 the plumber last came in on Tuesday. S2 stated that hot water was out on Friday, May 16, 2025. S2 stated the hot water was working at the facility on 5/20/2025. Staff S3 stated the hot water was not working on Friday evening. Staff S4 stated he/she was informed the hot water was not working on May 16, 2025. S4 stated he/she was informed the water heater had been fixed on May 17, 2025. S4 stated he/she was not working from the 18-26th of may, and doesn't know whole scope of the event.

All staff interviewed stated the facility did not provide any other options/ alternatives for resident to shower/ bathe with hot water, while the water heater was in repair.

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SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 05/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2025

LIC9099 (FAS) - (06/04)

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Control Number 26-AS-20250521085417

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: 05/30/2025

NARRATIVE

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On May 22, 2025, LPA Manuel Monter interviewed witness W1. W1 stated he/she responded to the water heater at Ivy Park Milpitas not functioning. W1 stated he/she was called to investigate the cause of a water heater not working at approximately 2:22 PM May 20, 2025. W1 stated he/she arrived at Ivy Park at approximately 2:24 PM to investigate and was shown the water heater. W1 stated the water heater was at 89 degrees when he/she arrived. W1 stated he/she diagnosed the problem and went to work up an estimate. W1 stated based on the part of the water heater that was in disrepair, there wasn’t anything the facility could do to prevent it from failing. W1 stated it a part that will eventually over time be in disrepair. W1 stated because this was an uncommon part, he/she had to contact all local providers in a 30 mile radius. W1 stated he/she located and acquired the materials necessary to restore hot water and returned to Ivy Park Milpitas at 3:34PM May 20, 2025. W1 stated he/she restored hot water at approximately 4:44PM.

Based on interviews conducted and documents reviewed, although the facility did hire a plumbing company to address the water heater that was in disrepair, the facility did not implement a plan any other options/ alternatives for resident to shower/ bathe with hot water, while the water heater was in repair. Based on interviews with facility ADM, the water heater was in disrepair from 5/16/2025- 5/20/2025.

Based on interviews and documents review the preponderance of evidence standard has been met therefore the above allegations is found to be SUBSTANTIATED.

Deficiencies were cited from California Code of Regulations, Title 22 during today’s visit, see LIC 9099-D. This report was reviewed with Administrator Meghian Geul and a copy of the report was provided. Appeal Rights was provided.

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SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 05/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2025

LIC9099 (FAS) - (06/04)

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Citations on this Visit Report are Under Appeal!

Control Number 26-AS-20250521085417

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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/30/2025

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Under Appeal Type A 05/31/2025 Section Cited CCR 87468.1(a)(2)	1 2 3 4 5 6 7	87468.1 Personal Rights of Residents in All Facilities (a) (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement was not met as evidenced by;	1 2 3 4 5 6 7	ADM stated the water heater are now working. ADM stated she will send a letter of understanding regarding the regulation. ADM stated she will send to LPA by POC date.
	8 9 10 11 12 13 14	Based on interviews & records reviewed, the facility did not ensure safe, healthful and comfortable accommodations, by not providing access to hot water during the time period where the water heater was malfunctioning.	8 9 10 11 12 13 14	(Cont) This poses an immediate health, safety and personal rights risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 05/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2025

LIC9099 (FAS) - (06/04)

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