Ivy Park at Palo Alto

Allegation investigated: -Staff are not changing the resident's linens. -Staff are not providing laundry services to a resident in care. -Staff did not respond to resident's call button. -Staff are not disposing of the resident's trash. -Facility did not ensure that staff are properly trained. -Staff did not administer medication as prescribed.

On 07/09/2026, Licensing Program analyst (LPA) Yi Sam Jian conducted an unannounced complaint investigation visit. LPA met with the Executive Director, Stephanie Brice, and disclosed the purpose of the visit. Regarding the allegation that staffs are not changing resident’s linens, interviews conducted during the investigation indicated that the facility maintained a routine schedule for linen changes and that services were provided to residents on an ongoing basis. The investigation did not identify sufficient evidence demonstrating that the facility failed to provide linen services. Regarding the allegation that staffs are not providing laundry services, information obtained during the investigation indicated that laundry services were routinely provided by the facility and that residents also retained the ability to complete laundry independently if desired. Unsubstantiated Regarding the allegation that staffs did not respond to resident call lights, interviews conducted during the investigation did not identify sufficient evidence demonstrating that staff did not respond to resident requests for assistance. Regarding the allegation that staff did not dispose of resident’s trash, information obtained during the investigation indicated that the facility maintained routine housekeeping practices, including regular trash removal. Regarding the allegation that the facility did not ensure that staff were properly trained, documentation obtained during the investigation indicated that the facility maintained records of training for the staff. Regarding the allegation that staff did not administer medications as prescribed, documentation obtained during the investigation indicated that the facility maintained medication administration procedures and safeguards. Although the above allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. No deficiencies cited during today's visit. An exit interview was conducted and a copy of the report provided to facility representatives.the state’s words, verbatim · CDSS document, Jul 9, 2026 · control 26-AS-20260429103707

Type of visit: Case Management - Annual Continuation

On 7/7/2026, Licensing Program Analyst(LPA) John Calandra arrived at the facility to complete the Annual 1-year required inspection. LPA Calandra was greeted by Stephanie Brice, Executive Director and explained the purpose of the visit. A review of Centrally stored medications indicated that medications for residents were properly labeled with instructions on dosage and times of day and matched the Centrally Stored Medication records kept at the facility. No deficiencies cited during today's visit. An exit interview was conducted and a copy of the report was provided to facility representative.the state’s words, verbatim · CDSS document, Jul 7, 2026

Type of visit: Required - 1 Year

On 7/3/2026, Licensing Program Analyst(LPA) John Calandra arrived at the facility, to conduct the Annual 1-year required inspection. LPA Calandra was greeted by Stephanie Brice, Executive Director and explained the purpose of the visit. LPA toured the physical plant. This is a 1-story building with 4 floors(the first, second, and fourth floors are Assisted Living and third floor is memory care) a kitchen, dining room, offices, parking garage, and front and backyards. All bedrooms had the required furniture and sufficient lighting. All bathrooms had the required grab bars and anti-skid flooring. No accessible bodies of water or hazards were observed. The facility's smoke alarms and Carbon monoxide detectors were observed to be in working order. The facility's fire extinguisher was last checked on December 23, 2025 and was observed to be fully charged. The facility's first aid kit was observed to have all of the required items. The facility had the required 7 days of non perishables and 2 days of perishables on site. No food was expired. All sharp objects, soap, detergents, and poisons were observed to be locked and in-accessible to persons in care. LPA reviewed 5 resident files and 5 staff files. All were observed to be complete. During the visit, LPA collected the facility's Liability Insurance policy and asked the facility to send their LIC 500 Personnel Summary Report by 7/10/2026. No deficiencies cited during today's visit. This Annual will be completed at a later date. An exit interview was conducted and a copy of the report provided to the facility representative.the state’s words, verbatim · CDSS document, Jul 3, 2026

Type of visit: Case Management - Other

On 03/19/2026, Licensed Program Analyst (LPA) Yi Sam Jian arrived at the facility to deliver amended copies of LIC9099. LPA met with administrator, Stephanie Brice. LPA explained the purpose of the visit. LPA conducted interview with staffs and residents. Reports were reviewed with administrator and copies were provided to facility.the state’s words, verbatim · CDSS document, Mar 19, 2026

Allegation investigated: Facility staff do not receive training as required Facility staff are mismanaging residents' medications

THIS IS AN AMENDED REPORT FROM AN ORIGINAL REPORT DATED 02/19/2026. On 2/19/2026, Licensing Program analyst (LPA) Yi Sam Jian conducted an unannounced complaint investigation visit. LPA met with the Executive Director, Stephanie Brice, and disclosed the purpose of the visit. Regarding the allegation that facility staff do not receive training as required, the Department conducted investigation. Interviews with staff indicated that staff reported receiving training. A review of facility records showed documentation of staff training. Regarding the allegation that facility staff are mismanaging residents’ medications, the Department conducted investigation. Medication Administration Records (MARs) for residents in care were reviewed and reflected medications being documented and administered according to facility procedures. Residents and staff interviewed reported that medications were received as prescribed. Although the above allegations may have happened or are valid, there is not a preponderance of evidence to prove whether the allegations did or did not occur, therefore the above allegations are UNSUBSTANTIATED. Report is reviewed and a copy of this report is provided to the administrator. Unsubstantiatedthe state’s words, verbatim · CDSS document, Feb 19, 2026 · control 26-AS-20251202141717

Allegation investigated: - Staff member worked while under the influence of alcohol/drugs, impairing their ability to provide adequate care and supervision, which presents a risk to the residents in care

THIS IS AN AMENDED REPORT FROM AN ORIGINAL REPORT DATED 02/19/2026. On 2/19/2026, Licensing Program analyst (LPA) Yi Sam Jian conducted an unannounced complaint investigation visit. LPA met with the Executive Director, Stephanie Brice, and disclosed the purpose of the visit. During the visit, LPA interviewed staff and residents and collected documents. Regarding the allegation that a staff member worked while under the influence of alcohol or drugs, impairing their ability to provide adequate care and supervision and presenting a risk to residents in care, the Department conducted investigation. Interviews with residents and staff indicated that staff were observed performing their duties without signs of being under the influence of alcohol or drugs, and residents reported no concerns related to staff substance use. Review of facility records indicated that staff had received the facility’s drug and alcohol free policy and relevant trainings. Although the above allegations may have happened or are valid, there is not a preponderance of evidence to prove whether the allegations did or did not occur, therefore the above allegations are UNSUBSTANTIATED. Report is reviewed and a copy of this report is provided to the administrator. Unsubstantiatedthe state’s words, verbatim · CDSS document, Feb 19, 2026 · control 26-AS-20251201101232

Type of visit: Case Management - Other

On 08/27/2025, Licensing Program Analyst (LPA) Kiran Jain arrived unannounced at the facility to conduct a Case Management - Other visit. Upon arrival, LPA met with the Executive Director, Stephanie Brice, and disclosed the purpose of the visit. On 06/20/2025, 08/12/2025, and 08/21/2025, the LPA conducted Complaint investigations at the facility for complaint #26-AS-20250616122012. On 07/23/2025 and 08/20/2025, 5 of 5 staff members (ED, S1-S4) stated and acknowledged that homeless individuals had entered the premises on multiple occasions between November 2024 and May 2025. Two (2) residents (R1 and R2) reported missing/stolen cash/money from their rooms in the past five (5) months. On 08/21/2025, the LPA reviewed the facility’s records for past Incident Reports and found that no incident reports had been submitted by the facility to CCL regarding homeless individuals entering the facility premises. On 08/21/2025, the LPA reviewed the facility’s records for past Incident Reports and found that no reports had been submitted by the facility to CCL regarding residents reporting missing cash/money from their rooms. On 08/27/2025, the facility was not able to provide copies of notification to the local law enforcement agency regarding stolen cash/money incidents from R1 and R2’s room for more than $100. No deficiencies were cited during today's visit. Advisory Notes were being issued today, see LIC9102. An exit interview was conducted with the Executive Director. A copy of this report was provided to the Executive Director, Stephanie Brice, whose signature on this form confirms receipt of the report.the state’s words, verbatim · CDSS document, Aug 27, 2025

Type of visit: Case Management - Incident

On July 03, 2025, Licensing Program Analyst (LPA) Kiran Jain arrived unannounced at the facility to conduct a Case Management – Incident visit regarding an incident that occurred on 06/20/2025 when the resident (R1) eloped from the facility. Upon arrival, LPA met with the Executive Director (ED), Stephanie Brice, and disclosed the purpose of the visit. LPA interviewed one (1) staff member: ED, and one (1) resident (R1). The ED stated that on 06/20/2025, at approximately 7 PM, S1 responded to the first-floor stairwell exit alarm. S1 did not see anyone around the exit, so S1 immediately called out on the walkie-talkie for the team to start apartment checks to ensure all residents were accounted for. At approximately 7:05 PM, S1 reported to the ED that R1 could not be located. Apartment checks continued, and other facility staff members began searching the outside areas and the immediate neighborhood. ED stated R1 lives on the fourth floor, and they are not sure if R1 took stairs from the fourth or any other floor. ED stated that at approximately 7:10 PM, the facility received a call from R1's former Physical Therapist (PT), who stated that R1 was with them and that they were bringing R1 back to the community. The ED contacted R1’s Responsible Party (RP) to inform them about the incident. R1 was brought back to the community. The PT informed the ED that they had seen R1 at the corner of El Camino and California Avenue. R1 stated that they had gone for a walk but forgot how to get back. ED stated that before the elopement incident on 06/20/2025, R1 was not wearing a safety bracelet. But after R1 returned, the facility ensured that R1 is wearing wander guard bracelet all the time. Med techs are checking three times a day to ensure R1 is wearing a wander guard bracelet. Continued on LIC809-C LPA reviewed R1’s Physician’s Report (LIC 602), dated 03/30/2025, R1 was non-ambulatory, had a primary diagnosis of Alzheimer's Dementia, was deemed not able to leave the facility unassisted. LPA reviewed R1’s Individualized Service Plan (ISP), dated 04/01/2025, which stated that R1 was ambulatory and unable to leave the community unsupervised. The ISP further stated that R1 was required to wear a safety bracelet while residing in the Assisted Living. LPA conducted a health and wellness check on R1 by visiting R1’s room. R1 stated that they did not have any recollection of whether they had exited the building alone without anyone accompanying them. R1 also stated that they liked to walk outside and inside the facility and use the elevators to go down to the first floor. R1 resided in the Assisted Living unit of the facility and was not wearing a safety bracelet at the time of the elopement. Facility staff did not ensure that R1 didn’t leave the facility unaccompanied, and a safety bracelet was not placed on R1’s arm prior to the elopement incident. Facility staff placed a wander guard bracelet on R1 only after the elopement incident occurred on 06/20/2025. A deficiency was cited based on LPA observations, records reviewed, and interviews conducted in accordance with the California Code of Regulations, Title 22, see LIC809D. An exit interview was conducted, and Plans of Correction were reviewed and developed with the Executive Director. A copy of this report and appeal rights were discussed and provided to the Executive Director, Stephanie Brice, whose signature on this form confirms receipt of these documents.the state’s words, verbatim · CDSS document, Jul 3, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87411(a) · Plan of correction due date: Jul 4, 2025

87411 Personnel Requirements – General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This requirement was not met as evidenced by: The facility staff were not able to prevent the resident (R1) from eloping the facility. R1 has dementia, is deemed not able to leave the facility unassisted, and was able to leave the facility unaccompanied around 7 PM on 06/20/2025, which posed an immediate health, safety, or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jul 3, 2025

Plan of correction: The ED will submit a POC plan to ensure that R1 wears a wander guard bracelet and is safe all the time. The ED will provide a copy of the plan to CCLD by 07/04/2025.

Type of visit: Prelicensing

On May 28, 2025, the Licensing Program Analyst (LPA) Kiran Jain arrived announced at the facility to conduct a Pre-licensing Change of Ownership inspection. The LPA met with the Executive Director, Stephanie Brice, and disclosed the purpose of the inspection. The facility has an approved fire clearance for (89) non-ambulatory and (8) bedridden residents. The facility is a four-story building with first, second, and fourth floor for Assisted Living and third floor for Memory Care. Assisted Living had 60 rooms and Memory Care had 28 rooms. The ED informed the LPA that the facility had 66 residents in care at the time. At 10:25 AM, LPA initiated a walk-through of the facility, accompanied by ED. LPA inspected randomly selected eight (8) resident rooms in Assisted Living and Memory Care units. The rooms were found to be clean, well-lit, and equipped with the required furniture. Emergency pull cords were observed to be functioning in the resident rooms with an average response time of 15 minutes. LPA inspected the private bathrooms in random rooms. The bathrooms contained soap, grab bars, towels, a trash can, and non-slip flooring. The hot water temperature at the sink faucets measured between 111.7°F and 116.4°F. “Oxygen in Use/No smoking” signs were observed posted outside the residents’ room where oxygen was administered. LPA inspected activity areas, library, media room, Theater room, exercise room, and other commons areas and observed residents actively engaged in recreational programs and activities. Activity calendar was observed posted at various locations throughout the facility. All common areas were free from obstructions, and hallways were well-lit. Continued on LIC809-C LPA inspected laundry rooms on each floor and observed working washer and dryer units. Sharp objects, detergents, and chemicals were observed to be locked and inaccessible to persons in care. LPA observed locked centrally stored medication carts in the Assisted Living and Memory Care units. Medications were organized separately for each resident. Narcotics were locked. All medication bottles and bubble packs were properly labeled. Centrally Stored Medication Records were reviewed and found to be complete. LPA inspected the main kitchen and found it clean. The refrigerator, freezer, and pantry cabinets were checked, and there was a sufficient supply of fresh perishable food for two (2) days and nonperishable staples for seven (7) days. No expired food items were found. Open food items were wrapped and dated. The dining rooms in Assisted Living and Memory Care was inspected and were found to be clean, with all furniture in good repair. LPA toured the outside patio area and found passageways in good condition, free of obstructions, and without any blocking or tripping hazards. The patio area had patio tables, chairs, and umbrellas for residents’ use. Delayed egress was observed on exterior exit doors. No accessible bodies of water were observed. LPA reviewed five (5) staff personnel records and five (5) resident records, and found them complete. LPA inspected the fire extinguishers mounted on the hallway walls in Assisted Living and Memory Care and found them fully charged, with the last service tag dated 01/06/2025. The Automatic sprinkler systems are tested quarterly and annually, with the last inspection completed on 03/12/2025. The smoke detectors are tested annually by a third-party vendor, Fortify Fire Protection. A staff member tested the carbon monoxide detector in the hallway in LPA’s presence, and it was found to be functional. LPA inspected the first aid kit and found it fully stocked. Emergency Drill Logs were reviewed, and it was observed that Emergency Disaster (Fire and Earthquake) Drills were conducted monthly, with the most recent drill completed on 05/15/2025. COMP III was reviewed and completed with the Executive Director. No issues were noted during the Pre-licensing inspection prior to the licensure. An exit interview was conducted with the Executive Director. A copy of this report was provided to the Executive Director, Stephanie Brice, whose signature on this form confirms receipt of the report.the state’s words, verbatim · CDSS document, May 28, 2025

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 97 Census (if any clients in care): COMP II Participants: STEPHANIE BRICE/ADMINISTRATOR Interview Method: Telephone interview On 5/15/25], applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, May 15, 2025