Ivy Park at Los Gatos

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced continuation annual inspection visit and met with Operation Specialist (OS) Caroline Frangieh and Resident Care Coordinator RCC). LPA reviewed 2 memory care resident files and 2 assisted living resident files. LPA checked resident medications in Med Room with Med Tech. No citation issued today. Exit interview was conducted with OS. The report was provided to OS for review and signature.the state’s words, verbatim · CDSS document, Jun 22, 2026

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Steve Chang conducted an unannounced annual inspection visit and met with maintenance director (MD) Jonthan Ward and Memory Care Director Blanca Evia Del Puerto. The facility is a 3 story building with 78 assisted living resident rooms and 36 memory care resident rooms. LPAs toured the facility with MD. LPAs toured the first floor including main entrance, reception area, lobby, dining room, kitchen, activity room, laundry room, Bristol area, library, TV room, mail room, restrooms, Med room, assisted living resident rooms, and two court yards. Med room was observed locked. Med cart and med refrigerator were observed locked. Laundry room was observed locked. LPA toured with MD 3 AL resident room on the first floor. Room temperature was observed at 73 degree F, Hot water was measured at 112 degree F in resident room. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Carbon monoxide detectors were tested and they were working. The temperature of the freezer was measured at 0 degree F, and the temperature of the refrigerator was measured at 37 degree F. The floor of resident room bathroom were observed as resistant slipping floor. LPA checked 3 elevators, all were functional. LPA toured the second floor with MD. LPA checked 3 resident rooms and common restrooms. Continue on LIC809-C. LPA toured the third floor with MD. LPA toured the memory care dining room, activity room, Salon room, memory care small kitchen, and sun deck. LPA tested the memory care delayed opening exit doors and they were functional. Med room, med cart and med refrigerator in the third floor were observed locked. LPA checked 3 memory care resident rooms. Housekeeper rooms were observed locked. Fire extinguishers were serviced on 5/13/2025. MD stated the ire extinguishers appointment is scheduled on 6/27/2026 due to the management company change. Evacuation Chairs were observed at the 3 stairs. LPA reviewed 4 staff files. LPA will continue on reviewing another 4 resident files. A continue inspection visit will be conducted. Exit interview was conducted with MD. The report was provided to MD for review and signature..the state’s words, verbatim · CDSS document, Jun 19, 2026

Allegation investigated: Facility staff financially abusing resident in care.

Licensing Program Analysts (LPAs) Steve Chang conducted an unannounced investigation visit to deliver the investigation finding and met with Operation Specialist (OS) Caroline Frangieh. On May 1, 2026, the Department received a complaint with the allegation that Facility staff financially abusing a resident in care. It’s been alleged that resident R1 has been financially abused. On May 6, 2026, the Department interviewed Health Service Director (HSD). HSD stated resident R1 moved out from the facility in September 2025. HSD stated she hasn’t been informed of this issue occurring at the facility. Continue on LIC9099-C. Page 1 of 2. Unfounded On May 19, 2026, the Department interviewed resident R1. R1 stated he/she does not currently live in the facility at Ivy Park at Los Gatos. R1 stated he/she currently resides in another residential care facility. R1 stated recently went to the hospital 4 weeks ago. R1 stated when he/she came back to his/her current residential care facility for the elderly, he/she noticed that his/her passport and credit cards were missing. R1 provided the name of the caregiver (CG1) who involved in the finical abuse, who works at the current residential care facility for the elderly (RCFE) where he/she resides. R1 stated he/she informed the executive director where he/she currently resides about this incident. On June 3, 2026, LPA interviewed the business director (BD) of the RCFE where R1 currently resides. BD stated CG1 is currently working for the RCFE where R1 resides and has been working since July 2023. The Department reviewed CG1’s name on the Guardian background check system. CG1 is not associated with Ivy Park Los Gatos. CG1 is associated with the RCFE where R1 currently resides. On June 3, 2026, LPA interviewed responsible party (RP) of R1. RP stated R1 only lived in Ivy Park Los Gatos for a couple months last year and moved to another RCFE. RP stated R1 told him/her about the allegation, but it did not occur at Ivy Park Los Gatos. RP stated he/she does not know if it is true because R1 has a neurocognitive disorder. Based on interviews conducted and records reviewed, based on R1’s statements, the alleged financial abuse did not occur at Ivy Park Los Gatos, and has allegedly occurred at the facility where R1 currently resides. The Department has investigated the above allegation to be unfounded meaning the allegations is false, could not have happened, and/or is without a reasonable basis. This report was reviewed with OS and a copy of the report was provided to OS. Page 2 of 2.the state’s words, verbatim · CDSS document, Jun 4, 2026 · control 26-AS-20260505131604

Type of visit: Case Management - Incident

Licensing Program Analysts (LPAs) Steve Chang and Manuel Monter conducted an unannounced case management visit and met with Health Service Director (HSD) Ann Lee. On 05/05/2026, the Department received an incident report regarding a resident R1. The incident report stated, on 4/30/2026, resident R1 eloped from the facility. During today's visit, LPA's toured the memory care unit and checked the delayed opening exit doors of the memory care unit. LPA's interviewed residents and staff. At this time, the case is under review and the Department will conduct a follow visit if warranted. Exit interview was conducted . The report was provided to HSD for review. A copy of the report was provided to HSD.the state’s words, verbatim · CDSS document, May 6, 2026

Allegation investigated: Facility staff did not safeguard residents' medications.

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced investigation visit to deliver the investigation finding and met with Executive DIrector (ED) Erika Holtman. On 01/21/2026, the Department received a complaint with the allegation that facility staff did not safeguard residents' medications. On 01/28/2026, the Department conducted an initial investigation visit. LPA interviewed ED, 3 staff, and 3 residents. LPA requested residents' centrally stored medication forms, Medications Administration Records, Physician reports, care plans, and progress notes. Continue on LIC9099-C. Page 1 of 4. Unfounded The allegation is that resident R1's medication M1 was unable to find in the medication cart and medication M2 was not applied to resident R2. On 01/28/2026, LPA interviewed Health Service Director (HSD). HSD stated he/she joins the facility on 01/05/2026. HSD stated at that time the previous Health Service Director already left the facility. HSD stated the caregivers and Med Tech also kept leaving the facility before and after he/she joined the facility. HSD stated he/she brings a new Med Tech team to the facility. HSD stated the previous Health Service team is not good at documentation and maintenance of documents. LPA interviewed a staff (S1). S1 stated he/she just joined the facility. S1 stated he/she spent a lot of time to do documentation and to maintain the facility documents. S1 stated the previous team did not keep good documentation. LPA interviewed a staff (S2). S2 stated he/she just joined the facility. S2 stated many Med Techs left the facility recently. S2 stated he/she did not see resident R1's medication M1 in Med Cart, but he/she found R1's medication M1 in the Med Room. LPA interviewed Executive Director (ED) Erika Holtman. ED stated he/she just joins the facility for 10 days. ED stated for resident R1's medication M1, the doctor order is to start medication M1 from 10/16/2025, and can stop after 3 weeks if ineffective. ED stated so after 11/6/25 it is fine to stop M1 for R1 if ineffective. ED stated the previous management team might already communicate with R1's doctor regarding medication M1 to stop but the new management team is unable to find the document. ED stated the new management team requested R1's doctor to issue a doctor order in writing to discontinue R1's medication M1 because the facility cannot find the document, but R1's doctor just replied to follow the doctor's order. ED stated the facility issued a second request for doctor order to discontinue R1's medication M1. ED stated R1's doctor issued a doctor order to discontinue R1's medication M1 on 01/20/2026. ED stated resident R2 always refused medication patch M2 and claimed R2's private nurse has agreed with that R2 not to use M2 patch. ED stated the new management team requested R2's doctor to issue a doctor order to discontinue medication M2 for R2 because R2 always refused to use it. ED stated on 01/23/2026, R2's doctor issued a doctor order to discontinue R2's medication M2. Continue on LIC9099-C. Page 2 of 4. LPA interviewed resident R1. R1 stated there is no problem for his/her medications. LPA interviewed R1's spouse (FM), roommate of R1. FM stated there is no problem for the administration of R1's medication. FM stated he/she has no complaint against the facility. LPA interviewed R1's another family member (FM1). FM1 stated there is no problem for R1's medication administration including medication M1. FM1 stated medication M1 is not necessary to R1. FM1 stated R1 does not need medication M1 every day. FM1 stated he/she always takes R1 for R1's doctor appointments. FM1 stated he/she contacted R1's doctor many times. FM1 stated he/she communicated with R1's doctor regarding R1's medication M1. FM1 confirmed that R1 does not need medication M1 every day. FM stated for R1's medication M1, it is just a communication issue of the facility. FM1 stated it is not a missing of administration of medication M1 to R1 issue. FM1 stated he/she is unsure if it is the documentation issue because the facility management team had changed. LPA interviewed resident R2. R2 stated the medication M2 patch is very inconvenient. It is hard to adhere to body. R2 stated he/she does not like it. R2 stated he/she already has the prescription for the similar medication cream and is applied every day. R2 stated he/she refused medication patch M2 many times. R2 stated his/her private nurse agrees that he/she can just uses the similar medication cream and does not need to use medication M2 patch. R2 stated he/she and his/her private nurse already talked to the facility staff before. R2 stated it is a communication issue, not a missing administration of medication M2 issue. Based on review of the doctor prescription of R1's medication M1, it specifies to start on 10/16/2025, and is okay to discontinue after 3 weeks if ineffective. Based on the review of R1's doctor order on 01/20/2026 which responding to the facility 2nd request, specifies R1's medication to discontinue on 01/20/2026. Based on the review of resident R2's doctor prescription, resident R2 has similar medication cream M3 and resident R2's medication M2 is to stop on 1/28/2026. Based on the review of R2's doctor order dated 01/23/2026 which respond to the facility request, R2's Medication M2 was discontinued on 01/23/2026. Continue on LIC9099-C. Page 3 of 4. Based on the review of the Medication Administration Records in December 2025 and January 2026 of residents R1 and R2, R1 refused M1 many times and R2 refused M2 many times. R1's medication M1 was safeguarded and found in the facility medication room. The Department has completed the investigation of the above allegation. Based on interviews conducted and records review, the department has found that the above allegations were UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis. Exit interview was conducted with ED. The report was provided to ED for review. A copy of the report was provided to ED.the state’s words, verbatim · CDSS document, Mar 24, 2026 · control 26-AS-20260121115315

Type of visit: Prelicensing

Licensing Program Analysts (LPAs) Steve Chang and Santino Fortes conducted an pre licensing inspection visit and met with Corporate CEO Jason Reyes, Administrator (ADM), Alana Reyes, and Assistant Executive Director Lorey Miller. The facility is a 3 story building with capacity of 110 in assisted living unit and 40 in memory care unit. LPAs toured the facility with ADM and staff. LPAs toured the main entrance, reception area, small CAFE area, dining room, kitchen, activity room, laundry room, library, TV room, mail room, restrooms and residents. Room temperature was observed at 71 degree F, Hot water was measured at 118 degree F. Fire extinguishers were serviced on 6/30/2024 and 5/13/2025. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Carbon monoxide detectors were tested and they were working. The temperature of the freezer was measured at -3 degree F, and the temperature of the refrigerator was measured at 40 degree F. The floor of resident room bathroom were observed as resistant slipping floor. The delayed opening exit doors of memory care unit were tested, and they were observed working. The elevator of the memory care unit was tested, and it needs pass code to operate. Medication rooms, medication carts and medication refrigerator were observed locked. The emergency call buttons was tested and were observed working. LPA toured the courtyard, nothing was observed abnormal. Evacuation Chairs were observed at the stairs. Component III was conducted. No deficiency noted today. Exit interview was conducted with ADM. The report was provided to ADM for review and signature. A copy of the report was provided to ADM.the state’s words, verbatim · CDSS document, Jun 5, 2025