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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 496804017
Report Date: 10/17/2025
Date Signed: 10/17/2025 02:43:57 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/30/2025 and conducted by Evaluator Robert Frank
COMPLAINT CONTROL NUMBER: 21-AS-20250730131807
FACILITY NAME:IVY PARK AT SANTA ROSAFACILITY NUMBER:
496804017
ADMINISTRATOR:STEPHANIE LIMBERGFACILITY TYPE:
740
ADDRESS:4225 WAYVERN DRIVETELEPHONE:
(707) 538-2590
CITY:SANTA ROSASTATE: CAZIP CODE:
95409
CAPACITY:114CENSUS: 101DATE:
10/17/2025
UNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Stephanie Limberg, Executive DirectorTIME COMPLETED:
02:55 PM
ALLEGATION(S):
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Staff did not safeguard resident funds
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Robert Frank arrived unannounced to deliver findings regarding the above allegation and met with Executive Director (ED) Stephanie Limberg.

During the investigation LPA interviewed facility Administrator, one (1) resident, and reviewed files.

The complaint alleges that the staff did not safeguard resident funds. The alleged theft occurred on 6/9/2025. The facility self reported the incident to Community Care Licensing (CCL) on 6/10/2025 by submitting an LIC 624 Unusual Incident/Injury Report and an SOC 341 Report of Suspected Dependent Adult/Elder Abuse form. On 6/10/2025 the facility reported the alleged theft to the Santa Rosa Police Department. The report was filed online as the Santa Rosa Police Department requires that all thefts, under five-thousand dollars ($5,000) and without a known suspect be reported in this manner. The Santa Rosa Police Department case number is SR250L00544.0. The Santa Rosa Police Department did not come to the facility to investigate the alleged theft. Continued on 9099-C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Robert Frank
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2025
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 2
Control Number 21-AS-20250730131807
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: IVY PARK AT SANTA ROSA
FACILITY NUMBER: 496804017
VISIT DATE: 10/17/2025
NARRATIVE
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...Continued from 9099

Resident R1 left the facility for an outing on 6/9/2025. When R1 returned they left the allegedly stolen money in their apartment and went to the dining room for a snack for approximately one (1) hour. When they returned to their apartment, they discovered that the money was not where it was left. During the time frame of the alleged theft, there were nine (9) staff members that had the ability to access R1’s apartment. This number does not include executive staff. The facility does not have a video monitoring system.

As there is no video or forensic evidence available, LPA was unable to ascertain who committed the alleged theft. So, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

No deficiencies cited during today's visit.



Exit interview conducted. LIC 9099 and LIC 9099-C discussed and provided to ED Limberg. Signature on form confirms receipt of documents.
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Robert Frank
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2