Ivy At Golden Gate, The

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Client's care needs not met by staff

On 6/5/2025, Licensing Program Analyst (LPA) Tobola arrived unannounced for the purpose of delivering complaint investigation findings and was greeted by Regional Operations Specialist, Alan Fox. LPA toured the facility, interviewed residents, staff and outside parties, reviewed records and made observations during the course of the investigation. Complaint alleges client (R1) care needs are not being met by staff regarding R1 being observed in poor condition. Upon interview with R1's responsible party (I1), witness (I2) and facility Executive Director (S1), it was explained that R1 had been transferred to the UCSF emergency room after an incident occurred during a scheduled medical appointment. R1 was transferred from the UCSF primary medical center, not from the residential care facility. Observed wounds were pre-existing and were being treated appropriately by the facility along with additional documented outside medical agency care. Continued onto LIC9099-C Unsubstantiatedthe state’s words, verbatim · CDSS document, Jun 5, 2025 · control 14-AS-20250314144621

Allegation investigated: Staff did not distribute resident's medication as prescribed Staff did not maintain current resident records Staff are not communicating with responsible party regarding resident's care service

On 5/2/2025, Licensing Program Analyst (LPA) Tobola arrived unannounced for the purpose of delivering complaint investigation findings and was greeted by Executive Director, Katherine Rauhkman. LPA interviewed staff, reviewed resident records and made observations during the course of the investigation. Complaint alleges staff did not distribute resident's (R1) medication as prescribed. LPA conducted a spot review of R1’s medication administration records and did not identify any medication not properly administered. Upon additional interview with Reporting Party, LPA received contradicting information to the initial complaint intake statement. LPA was not provided specific information on medication errors by Reporting Party. Continued onto LIC9099-C Unsubstantiatedthe state’s words, verbatim · CDSS document, May 2, 2025 · control 14-AS-20250212155932

Allegation investigated: Staff did not ensure that resident was dispensed their medication as prescribed Staff did not refill resident’s medication prescription in a timely manner

On 5/2/2025, Licensing Program Analyst (LPA) Tobola arrived unannounced for the purpose of delivering complaint investigation findings and was greeted by Executive Director, Katherine Rauhkman. LPA interviewed staff, reviewed resident records and made observations during the course of the investigation. Complaint alleges, staff did not ensure that resident was dispensed their medication as prescribed for resident (R1). Upon interviews with staff and information provided by Reporting Party, LPA found consistent information regarding staff observing resident R1 to be asleep and unable to administer a (as needed/PRN) narcotic to R1 because of R1's observed status. In addition, staff did administer medication upon observation as needed when R1 had awoken later within the hour. Upon review of R1’s medication administration records, LPA was unable to find corroborating evidence supporting the allegation. Continued onto LIC9099-C Unsubstantiatedthe state’s words, verbatim · CDSS document, May 2, 2025 · control 14-AS-20250221141055

Allegation investigated: Facility did not issue a refund

On 12/10/2024, Licensing Program Analyst (LPA) Tobola conducted an unannounced visit for the purpose of delivering complaint investigation findings and was greeted by Executive Director, Katherine Raukhman. LPA interviewed staff, outside parties, reviewed resident records and made observations during the course of the investigation. Complaint alleges facility did not issue a refund to residents (R1 & R2). Reporting party claims that a refund of all expenses paid to the facility, including community move-in fees and first month rent should be owed to R1 & R2. Based upon interviews with staff (S1) and outside party (I1), it was confirmed that residents R1 & R2 had signed an admissions agreement with an effective date of 7/31/2024. Upon review of records, LPA found that In the admission agreement, it is stated that 100% of the community fee will be refunded if residents decide to withdraw prior to assessment and signing agreement. LPA however found that the facility had conducted a pre-apthe state’s words, verbatim · CDSS document, Dec 10, 2024 · control 14-AS-20240917181205

Allegation investigated: Facility did not issue refund

On 12/4/2024, Licensing Program Analyst (LPA), Tobola arrived unannounced for the purpose of delivering complaint investigation findings and was greeted by Executive Director, Katherine Raukhman. LPA Interviewed staff, outside parties and reviewed resident records during the course of the investigation. Complaint alleges facility did not issue refund regarding resident (R1). Upon interview with staff (S1) and outside parties (I1) it was found that resident R1 had been moved out of the facility on 7/13/2024 with all remaining personal property removed by 7/27/2024. Based upon documents gathered, LPA found that R1's responsible party had submitted a written notice on 7/1/2024, to terminate agreement (30) days prior. Based upon R1's admission agreement it is indicated that upon self-termination, "you will continue to be responsible for all fees and charges accruing under this Agreement until the later of the expiration of the thirty (30) day period or you have vacated your Residence..". Cthe state’s words, verbatim · CDSS document, Dec 4, 2024 · control 14-AS-20240905102251

Allegation investigated: Facility staff failed to provide safe, healthful and comfortable accommodations. Facility failed to provided tray service when resident is ill. Facility staff failed to provide medication according to the physician's directions. Facility staff failed to accord dignity in their personal relationships with other persons. Facility Staff did not clean and disinfect COVID positive resident room.

On September 6, 2024, Licensing Program Analyst(LPA) John Calandra arrived at the facility to deliver conclusionary findings for a complaint opened on February 7, 2024. LPA Calandra was greeted by Katherine Raukhman, Executive Director and explained the purpose of the visit. During the initial visit, LPA gathered information including relevant records and conducted staff interviews. Based on information gathered, the facility provided a work order for carpet cleaning service due to the need for maintenance services because a section of the resident’s room was found to be unsanitary and unclean due to the resident’s temporary illness. The facility was notified by responsible party during a visit that the room needed to be cleaned again on January 18, 2024 and the facility took action on that date. Regarding allegation of meals not being provided to residents who have to isolate in their rooms, there was an occasion where a resident was ill and required to be isolated to his room for appthe state’s words, verbatim · CDSS document, Sep 6, 2024 · control 14-AS-20240129162503

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.