Ivy Park at Wood Ranch.

Licensing Program Analysts (LPAs), Martha Arroyo and Brian Balisi conducted an unannounced annual inspection today. At approx 09:50 a.m. LPAs met with  Executive Director (ED) Kellie Smith and explained the reason for the visit. At approx 10:30am, the LPAs along with the Executive Director and Maintenance Director, toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed: Facility dining room and commercial kitchen were inspected and found to be in compliance with Title 22 regulations. The LPAs observed sufficient perishable and non-perishable foods to meet the minimum two day and seven day supply of food and water.  Refrigerator and food pantry were checked for proper labels and expiration dates and food labels had expiration date clearly marked. LPAs observed ten (10) resident rooms total six (6)  in the assisted living side and four (4) resident rooms in memory care. All resident rooms were furnished appropriately, with clean linens and appropriate furnishings. The bathrooms were sufficiently stocked with supplies and paper towels.  Starting at 10:38am, the hot water temperature was measured in seven (7) assisted living bathrooms and four (4) memory care bathrooms, between 109 – 117.4 degrees Fahrenheit. The common areas on the first floor consists of the bistro, 2 separate dining areas, a living room, movie room, and multiple activity rooms.  Also, on the first floor were observed several offices, staff lounge, a copy room, and a supply room.  The second-floor common areas consists of the beauty salon, dining room, leisure/lounge room, offices, and multiple other activity rooms.  LPA's observed common areas to be clean and in good condition. There are games and/or activity supplies in the activity rooms as well as throughout the facility. 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 The common areas were appropriately furnished, and the lighting was adequate. Smoke alarms, carbon monoxide detectors, sprinklers and fire extinguishers were observed throughout the facility.   The emergency exiting plans/sketch are posted throughout the hallways.  The facility has required postings, including emergency exit plan, Licensing Complaint Poster, Resident Personal Rights, Theft and Loss Policy, and Resident Council Rights.  There is a functioning telephone on the premises.  Emergency evacuation chairs were present in all stairways. The facility has approved delayed egress systems in the Memory Care unit. There is a secured patio area with tables and chairs for residents within the Memory Care unit. There is also a large outdoor space with shaded areas and adequate furniture for resident use throughout the facility.  All passageways, walkways, driveways, steps and patios are free from obstructions and hazards at this time. Several fire extinguisher were observed  throughout the facility  to be fully charged and last serviced on 12/18/2024. LPAs reviewed ten (10) resident records and ten (10) personnel records starting at 11:50am. Ten resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, Consent for Treatment form, and current needs and services plan. (10) personnel files including the current Executive Director’s file were reviewed for, but not limited to: personnel records, health assessments with TB results, criminal record clearances, first aid/CPR training, and the appropriate yearly training.  All files appeared to be in order during the visit. LPAs reviewed medications at approximately 1:30pm.  The medications are centrally stored in a med rooms on the 2nd floor. All medications including PRNs were labeled, stored, and locked inaccessible to residents in care. PRNs have physicians order on file. Medications are properly documented on the centrally stored medications and destruction record. Medications appeared to be given as prescribed at the time of the visit. During today’s visit, the LPAs reviewed the facility's infection control policy as well as their emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Daily vehicle inspection list and California Highway Patrol Inspection report was reviewed for facility vehicles. The last fire safety inspection was completed on 05/6/2025 and was found to be in compliance with Fire Code Regulations at the time of inspections.  Emergency disaster drills conducted quarterly as per regulation; last disaster drill conducted on 06/26/2025. No citations issued. Exit interview conducted. Report was reviewed and copy provided.

Continued from 9099 Since then, interviews conducted and records review revealed Ecolab has conducted additional visits for preventative measures on 05/09/2025, 05/30/2025 where no new bed bug activity was found. On 06/09/2025 during an Ecolab service call, one (1) bed bug was found in room 227. The room was treated on 06/13/2025. Since 06/09/2025, no additional bed bug activity has been reported by staff. During the LPA's physical inspection of rooms, 226, 225, 227, 223, 217, 231,  surrounding rooms, and adjacent areas, no evidence of bed bugs was observed. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegation “Staff did not keep the facility free of bedbugs” is deemed Unsubstantiated at this time. Exit interview conducted and copy of report issued.

Licensing Program Analyst (LPA) Brian Balisi conducted a subsequent unannounced Case Management - Incident visit at approx 11:00 a.m. to continue the investigation of a self-reported incident that was initially conducted  on 09/05/2024 between 12:30 p.m. - 02:30 p.m. Upon arrival LPA met with Executive Director Lilit Mnatsakanyan and explained the reason for the visit. At approx 11:15 a.m. LPA conducted physical plant, interviewed staff, residents and reviewed and obtained copies of additional pertinent documentation relevant to the investigation. On 08/23/2024, the Department received an incident reports stating on 08/15/2024 at approx 8am, Staff #1 (S1) was observed to be handling Resident #1(R1) in a firm manner while R1 attempted to swing their arms in an agitated manner, resulting in discoloration / bruising on R1's forearms. R1 did not indicate any discomfort or additional injuries. Interviews conducted with staff and Executive Director revealed on 08/15/2024 at approx 8:00 a.m.  Staff #2 (S2) attempted to change R1's clothes for breakfast. R1 reacted with increased agitation and became combative towards S2. S1 entered the room to provide assistance to S2. R1's agitation and combative behavior escalated towards both staff members. S1 then restrained R1 by grasping both wrists, which led to bruising on R1's forearms. LPA's records review indicated S1 was suspended pending an investigation, both law enforcement and R1's family were notified of the incident on the same day it occurred. Additionally, S1 voluntarily resigned from their position following the incident. Based on the investigation's findings, there is sufficient evidence to conclude that S1 handled R1 in a rough manner , resulting in bruising on R1's forearms. Pursuant to Title 22 of the CA Code of Regulations, the following deficiency was cited (refer to 809-D). Exit interview conducted. Copy of report and appeal rights were reviewed and issued during today's visit.

Licensing Program Analyst (LPA) Brian Balisi conducted an unannounced Case Management – Incident visit at 12:30 p.m. for the purpose of investigating self reported incident reports. Upon arrival, LPA met Interim Executive Director Kathleen Olson and explained the reason for the visit. On 08/23/2024, the Department received an incident reports stating on 08/15/2024 at approx 8am, Staff #1 (S1) was observed to be handling Resident #1(R1) in a firm manner while R1 attempted to swing their arms in an agitated manner, resulting in discoloration / bruising on R1's forearms. R1 did not indicate any discomfort or additional injuries. At approx 12:30pm, LPA conducted physical plant interviewed staff and reviewed and obtained copies of pertinent documentation relevant to the investigation.  LPA has determine further investigation is needed and will return at a later date to complete the investigation if warranted. Exit interview conducted. A copy of the report was issued.

Licensing Program Analyst (LPA) Martha Arroyo conducted a pre-licensing visit to the above noted facility. Upon arrival, LPA was greeted by applicant representative/ Executive Director Jeanne Skondin. This is a change of ownership application, but the facility name will remain the same. Entrance interview conducted. LPA inspected facility for Fire Safety, Personal Accommodations and Services, and Food Service. The facility is two-story. At 9:45am, a physical plant tour was conducted inside and out. An approved fire clearance was received, clearing them for ninety-two (92) non-ambulatory residents; and eight (8) bedridden residents. The facility has a capacity total of one hundred (100) residents. The facility has an approved fire clearance for bedridden in any bedroom on both the first and second floors, front desk will maintain current roster of bedridden residents’ room location. There is one central kitchen that distributes food to the 3 dining rooms. The kitchen contained a walk-in pantry with a sufficient supply of canned foods, and emergency food and water. The walk-in refrigerator and freezer were observed to have an ample supply of perishable and nonperishable food supplies. The freezer was maintained at zero degrees Fahrenheit, and the refrigerator was maintained at 40 degrees Fahrenheit. Stove burners are rendered inaccessible to the residents. The supply of dishes, utensils, pots, pans, and drink ware is adequate. There are no pesticides (poisons) or toxins stored in any food storage area or preparation area with utensils. Appliances in the kitchen were clean and all appeared functional. Trash cans had tight fitting lids. Cleaning supplies are stored separately from food preparation areas in locked storage closets throughout the facility. There are three (3) laundry rooms throughout the facility for resident use. No flies or other vermin were observed. Report Continued on LIC 809C... 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 Report Continued from LIC 809... The common areas were appropriately furnished, and the lighting was adequate. The common areas on the first floor consists of the bistro, 2 separate dining areas, a living room, movie room, and multiple activity rooms. Also, on the first floor were observed several offices, staff lounge, a copy room, and a supply room. The second-floor common areas consists of the beauty salon, dining room, leisure/lounge room, offices, and multiple other activity rooms. Smoke alarms, carbon monoxide detectors, sprinklers and fire extinguishers were observed throughout the facility. LPA obtained a copy of the most recent Sprinkler and smoke detector inspection conducted. The fire extinguishers were observed and are fully charged. The emergency exiting plans/sketch are posted throughout the hallways. The facility has required postings, including emergency exit plan, Licensing Complaint Poster, Resident Personal Rights, Theft and Loss Policy, and Resident Council Rights. There is a functioning telephone on the premises. Emergency evacuation chairs were present in all stairways. The facility has approved delayed egress systems in the Memory Care unit. There is a secured patio area with tables and chairs for residents within the Memory Care unit. There is also a large outdoor space with shaded areas and adequate furniture for resident use throughout the facility. All passageways, walkways, driveways, steps and patios are free from obstructions and hazards at this time. All resident rooms are set up with beds, nightstands, lamps, chests of drawers, chairs, and closet space. The beds are furnished with box springs, comfortable mattress, and clean linen, which includes, a mattress pad, top and bottom linens, pillowcases, blanket, and a bedspread. Lighting in the rooms appeared adequate. The bedrooms were large enough to allow for easy passage between the beds and furniture with a wheelchair or walker. In addition, no bedroom was used as a passageway to another room, bath, or toilet. There are no staff rooms – awake night staff only on premises. All rooms were free of odors. All window screens were clean and maintained in good repair. Report Continued on LIC 809C... 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 Report Continued from LIC 809C... The resident bathrooms have a shower with non-skid surfaces. The toilet and shower have grab bars. The hot water temperature was tested in random resident rooms in the Assisted Living area and was found to be within the range of 105 degrees Fahrenheit and 120 degrees Fahrenheit. The hot water temperature was also tested in random resident rooms in the Memory Care area and was found to be within the range of 105 degrees Fahrenheit and 120 degrees Fahrenheit. At 11:00am, the LPA conducted a file review or resident and staff records. Resident and staff records are stored in the Business Director’s office. Medications are centrally stored in the Medications Room / Nurses Station which is located on the second floor. In addition, there are total of four (4) medication carts located throughout the facility. The first aid supplies were complete, including a thermometer and a current version of a first aid manual. They were stored in the medication room. The physical plant of this facility location is in compliance with Title 22 regulations at this time. No corrections required at this time Comp III conducted with Applicant Representative/Executive Director. This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license. Exit interview conducted. A copy of the report was provided.