Ivy Park Of Belmont

Allegation investigated: Licensee does not ensure facility has sufficient staff to provide adequate supervision to residents in care Staff do not ensure call signal systems are responded to in a timely manner Staff does not ensure reporting requirements are being met Staff does not ensure resident receives all of his/her meals Staff does not ensure food is of good quality

On May 26, 2026, Licensing Program Analyst (LPA) Komal Curley conducted an unannounced complaint visit to deliver the findings for the above allegations. LPA met with Administrator, Anne Buerhaus and explained the purpose of the visit. Regarding the allegation, Licensee does not ensure facility has sufficient staff to provide adequate supervision to residents in care and staff do not ensure call signal systems are responded to in a timely manner, according to the reporting party, there is insufficient staffing and lack of supervision that has resulted in Resident 1 (R1) falling frequently. In addition, according to the reporting party, due to the lack of staffing, residents have to wait longer for staff to respond to their call buttons. During the investigation, LPA interviewed staff, reviewed staff schedule, interviewed residents and reviewed the average call button response times for the entire facility. According to staff interviewed, they are fully staffed and are able to respond tthe state’s words, verbatim · CDSS document, May 26, 2026 · control 14-AS-20260420110648

Allegation investigated: Staff admitted residents into the facility with incomplete physician reports Staff did not ensure residents medications were dispensed as prescribed Staff did not ensure care and supervision was provided to resident resulting in an elopement from the facility

On March 11, 2026, Licensing Program Analyst (LPA) Komal Curley conducted an unannounced complaint visit to deliver the findings for the above allegations. LPA met with Administrator, Anne Buerhaus and explained the purpose of the visit. Regarding the allegation, staff admitted residents into the facility with incomplete physician reports, according to the reporting party, the facility admitted Resident 1 (R1) and Resident 2 (R2) to the facility without ensuring the LIC602 Physician’s Reports were completed. During the investigation, LPA reviewed R1 and R2’s file. Based on the admission agreement reviewed for both residents, the admission agreement was signed on 12/30/25 and R1 and R2 physically moved into the facility on 1/6/25. Based on R1 and R2’s physician’s report, both physician’s reports were completed, signed and dated on 9/5/25. (continue to 9099C) Unsubstantiatedthe state’s words, verbatim · CDSS document, Mar 11, 2026 · control 14-AS-20260112113350

Allegation investigated: Staff did not ensure the facility telephone is properly operating Staff provided a resident an inappropriate heating device Staff did not provide a comfortable temperature for a resident

On March 11, 2026, Licensing Program Analyst (LPA) Komal Curley conducted an unannounced 10-day complaint visit. LPA met with Administrator, Anne Buerhaus and explained the purpose of the visit. Regarding the allegation, staff did not ensure the facility telephone is properly operating, according to the reporting party, on March 2, 2026, he/she received phone calls from the facility's main line, however when he/she tried returning the call, there was no answer. Reporting party indicated that on March 3, 2026, he/she tried calling the facility in the morning again, however there was no answer. During the investigation, LPA interviewed administrator, staff and tested the facility's main number. LPA confirmed that the facility phone is in good working condition. The administrator indicated that she received at call at 11:37pm on 3/2/26, notifying her that the facility's main phone was not working. The administrator immediately notified the Health Services Director who worked with the Resithe state’s words, verbatim · CDSS document, Mar 11, 2026 · control 14-AS-20260304103141

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: Facility failed to report incidents and death to CCLD

On October 7, 2025, Licensing Program Analyst (LPA) Komal Curley conducted an unannounced complaint visit to deliver the findings for the above allegation. LPA met with Administrator, Anne Buerhaus and explained the purpose of the visit. Regarding the allegation facility failed to report incidents and death to CCLD, according to the reporting party, they are unsure if CCLD was notified regarding Resident 1's (R1's) falls and if CCLD was notified regarding R1's death. During the investigation, LPA interviewed staff and reviewed facility's and Department's records. Based on Department's records, although the facility reported R1's death, the facility failed to report R1's falls to CCLD. According to records reviewed, although the facility submitted a death report for R1 to CCLD, the facility did not submit any incident reports to CCLD in regarding to R1. According to staff interviewed and records reviewed, there were internal facility reports regarding R1's falls and hospice and responsithe state’s words, verbatim · CDSS document, Oct 7, 2025 · control 14-AS-20250529111732

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.