Ivy Park at Walnut Creek

Type of visit: Required - 1 Year

On 04/24/2026 at 09:45 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct this Required One Year inspection. Upon entry, the LPA stated the purpose of the visit to Executive Director (ED) Linda Nguyen. The LPA toured the interior and exterior of the facility, including but not limited to, residents’ rooms, bathrooms, kitchen, common areas, and the court yard. The LPA observed adequate lighting for the comfort and safety of residents in all rooms. Inside and outside areas are free of obstruction and no bodies of water. The temperature in the lobby was measured at 72.1 degrees Fahrenheit. The LPA interviewed the Maintenance Director, Tony Raymundo, who stated that he measures the maximum hot water temperature in every room in the facility each week. He keeps the temperature between 110 and 115 degrees Fahrenheit. The residents’ bathrooms are equipped with grab bars and slip-resistant mats. There is more than the minimum of a one week supply of nonperishable foods and 2 days of perishable foods. The LPA observed the required postings in the facility. Smoke detectors, carbon monoxide detectors, and fire sprinkler system were tested and found to be in operating condition on 01/24/2026. The fire extinguishers were fully charged and last serviced on 10/15/2025. The Emergency Disaster Plan was reviewed within the past year; the most recent review was on 12/05/2025. Emergency, disaster, and fire drills were conducted on a quarterly basis; the most recent was 04/23/2026. The LPA observed the Electronic Medication Administration Record (MAR) being used to track, document, and verify the dosage and time medications are being administered to residents. First aid kit was observed to be complete. The liability insurance for the facility expires on 05/01/2026. Continued on LIC 809-C . . . . . . Continued from LIC 809 The LPA reviewed 5 resident records and 5 staff records. No citations were issued during the inspection. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Apr 24, 2026

Allegation investigated: Facility staff did not meet the care needs of the residents.

On 10/23/2025 at 10:00AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct complaint investigation and to deliver complaint findings for the allegation above. LPA met with Executive Director, Linda Nguyen and explained the purpose of the visit. During the investigation, LPA interviewed 3 residents, 5 staff, 2 witnesses, and complainants. LPA reviewed and obtained documents including staff schedule, physician's report, care plan, emergency information, home health notes, incident reports, shower/skin sheets, and staff roster with contact information. Physician's report dated 4/9/2025 stated that R1 has a history of skin breakdown and home health was ordered. Interview with staff indicated that R1 was repositioned every two hours and R1 receives incontinence care every 2 hours. Interview with witnesses revealed that facility staff are caring, tentative, and W4 observed R1's wounds healed fast. (Continue on LIC9099C...) Unsubstantiated R1's care plan indicated R1 needed two person during transfers. Witnesses have observed two facility staff when transferring R1. W4 stated facility staff used safe technique during transfer and R1 was well supported. Staff stated there are two person when transferring R1. Interview with staff revealed there are enough staff to meet the needs of the residents. S1 stated there are 3-4 caregivers for morning and afternoon shifts, and 2 caregivers for night shift. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is UNSUBSTANTIATED. No deficiencies are being cited on this date. Exit interview conducted. A copy of this report provided.the state’s words, verbatim · CDSS document, Oct 23, 2025 · control 15-AS-20250714141403

Allegation investigated: Staff did not properly assess a resident Staff did not prevent a resident from wandering from the facility Staff did not provide adequate care and supervision to a resident

On 7/02/2025, at 2:45 PM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to investigate the allegations above. Upon arrival, the LPA informed Executive Director (ED) Linda Nguyen of the purpose of the visit. The complaint alleges staff did not properly assess Resident R1. The LPA interviewed Witness W1 by telephone. At the facility, the LPA interviewed the ED and reviewed R1's file, including the Physician's Report, Preplacement Appraisal, and the 1/31/2025 incident investigation report. The Physician's Report, dated 1/3/2025, indicated no Inappropriate Behavior, no Aggressive Behavior, no Wandering Behavior, and no Exit Seeking Behavior. During the 1/31/2025 incident, R1 demonstrated all those behaviors. The preplacement appraisal was based on information collected and observations made in an environment and from people R1 knew and trusted. Like the Physician's Report, it was only an indicator and not a predictor of R1's behavior in an unfamiliar place and with unfamiliar people. The data collected and analyzed by the LPA shows that the staff did properly assess R1, which does not confirm the allegation. Continued on LIC 9099-C . . . Unsubstantiated . . . Continued from LIC 9099 The complaint alleges staff did not prevent Resident R1 from wandering from the facility. The LPA interviewed Witness W1 by telephone. At the facility, the LPA interviewed the ED and reviewed R1's file, including the Physician's Report, Preplacement Appraisal, and the 1/31/2025 incident investigation report. When R1 wandered out of his room in the middle of the night, it was his right to do so in Assisted Living. When R1 wandered outside of the facility, he was never left alone. The staff acted appropriately with R1 when he spoke to them inappropriately and threatened them with his cane and walker. The staff did what they were supposed to do by escorting him and redirecting him from the outside at the back to the inside at the front of the building. The data collected and analyzed by the LPA shows that the staff did prevent R1 from wandering from the facility, which does not confirm the allegation. The complaint alleges staff did not provide adequate care and supervision to Resident R1. The LPA interviewed Witness W1 by telephone. At the facility, the LPA interviewed the ED and reviewed R1's file, including the Physician's Report, Preplacement Appraisal, and the 1/31/2025 incident investigation report. When R1 wandered outside of the facility, he was never left alone. The data collected and analyzed by the LPA shows that the staff did provide adequate care and supervision to R1, which does not confirm the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove it; therefore, the allegation is UNSUBSTANTIATED. Exit interview conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Jul 2, 2025 · control 15-AS-20250702094439

Allegation investigated: Staff do not allow resident to participate in decision making regarding their care. Staff did not provide resident copies of their records. Staff did not safeguard resident's personal items.

On 4/24/2025, at 2:30 PM, Licensing Program Analyst (LPA) James Sampair arrived unannounced at the facility to investigate the allegations above. Upon entry into the facility, the LPA identified himself and stated the purpose of the visit to Executive Director (ED) Linda Nguyen. The complaint alleges that staff do not allow resident to participate in decision making regarding their care. The LPA interviewed Witness W1 and the ED. The LPA reviewed records concerning R1's participation in decision making regarding their care. The data collected does not support the allegation. The complaint alleges that staff did not provide resident copies of their records. The LPA interviewed Witness W1 and the ED. The ED stated that never once had R1 personally asked for a copy of their records. The only requests came when a friend, Witness W2, made the request or wrote a letter signed by R1. The data collected does not support the allegation. Continued on LIC 9099-C . . . Unfounded . . . Continued from LIC 9099 The complaint alleges that staff did not safeguard resident's personal items. The LPA interviewed Witness W1 and the ED. The ED stated that had R1 never reported anything missing, nor had facility staff taken anything way from R1 unless it was dangerous and not allowed in memory care. The data collected does not support the allegation. The allegations are false, could not have happened, and/or are without a reasonable basis. Therefore, the allegations are UNFOUNDED. Exit interview conducted with ED and a copy of this report was provided.the state’s words, verbatim · CDSS document, Apr 24, 2025 · control 15-AS-20250421135946

Type of visit: Required - 1 Year

On 03/13/2025 at 1:00PM, Licensing Program Analysts (LPAs) Y. Brown and J. Sampair arrived unannounced to conduct the Required Annual Inspection of the facility. Upon arrival, LPAs stated the purpose of the visit to Executive Director Linda Thuong. The LPAs inspected the facility inside and outside. All outdoor and indoor passageways were free of obstruction. Outside, there were no bodies of water. Inside, the temperature was measured at 73 degrees Fahrenheit. The LPAs observed adequate lighting in all of the rooms for the comfort and safety of the residents. The hot water temperature in a common bathroom was in a safe temperature range of 105. LPAs observed 7 days of nonperishable and 2 days of perishable foods on hand. Sharps were stored inaccessible to residents. Smoke and carbon monoxide detectors were in operating condition. Fire extinguisher was observed to be fully charged and last serviced on 03/07/2025. The LPAs reviewed the records of 5 residents and 5 staff members all were complete. No citation issued. Exit interview conducted and a copy of this report provided to the Executive Director.the state’s words, verbatim · CDSS document, Mar 13, 2025

Type of visit: Post Licensing

On March 7, 2025 at 1:15 PM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct this post licensing inspection. The LPA informed Executive Director (ED) Linda Nguyen of the purpose for this visit. The LPA inspected the inside and outside of the facility. The inspection included the kitchen, dining area, common areas, bedrooms, and yard outside common areas. An adequate amount of food supplies were observed, more than the required minimum of 2 days of perishable and 7 days of non-perishable food. The central storage for medications was locked. The cleaning supplies and dangerous objects were stored in locked cabinets. The Facility has working smoke and carbon monoxide detectors. The staff of the facility conduct disaster / emergency and fire drills on a quarterly basis; records showed that the most recent drill was conducted on November 27, 2024. The fire extinguishers were all replaced on January 16, 2025. The indoor temperature was 76.8 degrees Fahrenheit, within the acceptable range. The maximum hot water temperature was 113.3 degrees Fahrenheit. The LPA reviewed 5 resident and 5 staff records. 1 Type-A citation and a civil penalty for $500 were issued during this inspection. Refer to LIC 809-D and LIC 421BG for details. Exit interview conducted and a copy of this report and the Appeals provided.the state’s words, verbatim · CDSS document, Mar 7, 2025

Allegation investigated: Staff did not ensure resident was utilizing medical devices. Licensee did not obtain resident appraisal before admittance.

On March 6, 2025, at 1:30 PM, Licensing Program Analyst (LPA) James Sampair arrived unannounced at the facility to investigate the allegations above. Upon entry into the facility, the LPA identified himself and stated the purpose of the visit to Executive Director (ED) Linda Nguyen. The complaint alleges that staff did not ensure resident was utilizing medical devices. The LPA interviewed Witness W1, Resident R1, and the ED. The LPA reviewed documentation concerning R1's hearing and hearing aid. Based on the interview of R1 with no hearing aid, documentation concerning the hearing aid, and statements from the ED, R1 was admitted into the facility with no hearing aid and the use of a hearing aid is not required to communicate with R1. The data collected does not confirm the allegation. Continued on LIC 9099-C. . . Unsubstantiated . . . .Continued from LIC 9099 The complaint alleges that Licensee did not obtain resident appraisal before admittance. The LPA reviewed the preadmission appraisal of R1 and documentation from John Muir Medical Center dated November 13, 2024 stating that R1 does not have the capacity to make informed medical decisions. The data collected does not confirm the allegation. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove it; therefore, the allegations are UNSUBSTANTIATED. Exit interview conducted with ED and a copy of this report was provided.the state’s words, verbatim · CDSS document, Mar 6, 2025 · control 15-AS-20250226123111

Allegation investigated: Staff did not ensure resident was allowed visitors while in care.

On March 6, 2025, at 1:30 PM, Licensing Program Analyst (LPA) James Sampair arrived unannounced at the facility to investigate the allegation above. Upon entry into the facility, the LPA identified himself and stated the purpose of the visit to Executive Director (ED) Linda Nguyen. The complaint alleges that staff did not ensure resident was allowed visitors while in care. The LPA reviewed facility documentation. In an email from the ED, she stated that between February 15 and February 20, 2025, the facility put in guidelines for visitations with Resident R1 that allowed R1 to meet with any visitor only in common areas of the community and for a maximum of 20 minutes per visit. Those restrictions confirmed the allegation. Continued on LIC 9099-C. . . Substantiated . . .Continued from LIC 9099 The preponderance of the evidence standard has been met, and the allegation is SUBSTANTIATED. Deficiency is cited under the California Code of Regulations listed on LIC 9099-D. Failure to submit proof of correction (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted with ED. Appeal Rights and a copy of this report provided via email.the state’s words, verbatim · CDSS document, Mar 6, 2025 · control 15-AS-20250306081749

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(11) · Plan of correction due date: Mar 13, 2025

Personal Rights of Residents in All Facilities (a) . . . have all of the following personal rights: (11) To have their visitors . . . during reasonable hours and without prior notice, provided that the rights of other residents are not infringed upon. This requirement was not met as evidenced by: Email from ED to ombudsperson dated February 26, 2025 stated the dates when restrictions on visitation rights had been implemented by the facility.the state’s words, verbatim · CDSS document, Mar 6, 2025

Plan of correction: Deficiency cleared before visit on February 20, 2025.

Type of visit: Case Management - Incident

On 8/2/2024 at 9:00 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced for a case management visit concerning the 7/28/2024 incident with Resident R1 who eloped from the facility. Upon entering the facility, the LPA stated the purpose of visit to Executive Director (ED) Linda Nguyen. During the visit, the LPA interviewed the ED and Health Service Director (HSD) Sarah Summers about the incident. The HSD explained what had occurred on 7/28/2024 when R1 eloped. R1 moved into the facility on 7/17/2024 into Assisted Living. The HSD stated that though R1 wore a WanderGuard and the staff responded quickly when notified that R1 had left the building, R1 is a very fast walker and had left before staff arrived. In their post incident follow up, family member F1 stated that R1 had been "triggered" to elope due to family issues. Because this event revealed the potential risk of R1 eloping again in the future, on 8/5/2024, R1 will be moving into a memory care unit in a different facility. No citations issued during this visit. Exit interview was conducted with the ED. A copy of this report was provided.the state’s words, verbatim · CDSS document, Aug 2, 2024

Allegation investigated: Staff do not ensure the residents have hot water while in care

On 4/30/2024 at 3:00 PM, Licensing Program Analysts (LPAs) J. Sampair and A. Gharachorloo arrived at the facility unannounced to conduct the initial 10-day complaint investigation of the allegation above. Upon entry, the LPAs informed Executive Director (ED) Gilbert Castro the purpose of the visit. The complaint alleges that staff do not ensure the residents have hot water while in care. The LPAs interviewed the ED who stated that he had been informed of the plumbing problem wiith the hot water on 4/25/2024. He provided written proof that the plumbers were notified and inspected the affected apartments on the same day, 4/25/2024. The repairs were approved the following day, 4/26/2024, and the repairs were completed as soon as the parts arrived. In the meantime, the residents were given access to and made use of alternative locations to safely shower. Additionally, the residents were given credit of approximately $100 for the inconvenience for each resident. Report Continued on LIC9099-C... Unsubstantiated ...Report Continued from LIC9099 Although the allegations may have happened, or are valid, there is not a preponderance of evidence to prove them; therefore, the allegations are UNSUBSTANTIATED. Exit interview conducted with ED Castro. Appeal Rights and a copy of this report provided.the state’s words, verbatim · CDSS document, Apr 30, 2024 · control 15-AS-20240429144934

Type of visit: Prelicensing

On 3/27/2024, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to conduct a change of ownership prelicensing visit. Upon entry into the facility, the LPA informed Executive Director (ED) Gilbert Castro of the purpose of the visit. LPA toured the facility inside out with the ED. The LPA inspected the kitchen, dining areas, restrooms, community living spaces, bedrooms, bathrooms, trash areas, and the exterior of the facility. The facility was appropriately furnished and well lit. Professional grade equipment was installed and maintained for resident care. Food supplies were checked and observed to be sufficient and new orders come on a regular basis. No swimming pool or other body of water was on the facility grounds. Medications are centrally stored. Bathrooms and showers were observed equipped with grab bars and non-skid mats. Carbon monoxide and smoke detectors operational. First aid kit inspected. Fire extinguishers were serviced 1/31/2024. Facility has emergency lighting. Hot water temperature in one of the common areas was tested and measured at 115.9 degrees Fahrenheit at 3:14 PM. Complaint poster, Ombudsman and Personal Rights posters, Theft and Loss Policy, Rights to Resident Council and Rights to Family Council were observed posted in a prominent place. Facility passed pre-licensing inspection and Component III training provided for ED Castro. Final review of application and license to be granted by Central Applications Bureau analyst. Exit interview conducted and copy of this report provided via email to ED Castro.the state’s words, verbatim · CDSS document, Mar 27, 2024