The Ivy Home

Type of visit: Required - 1 Year

On September 3, 2025, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with administrator Ivan Bravo and explained the purpose of today’s visit. The facility is licensed to operate for six (6) elderly residents non-ambulatory ages 60 and above. The facility consists of the following: four (4) resident rooms downstairs with two bathrooms, living room, dining room, kitchen, outside laundry room. The second floor consists of three (3) staff bedrooms, an office, and spare room. LPA and administrator toured the physical plant. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured 105.1-degree F. A comfortable temperature of 77-degree F. was maintained in the facility. LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. Evaluation Report Continues LIC 809-C Fire extinguisher was charged, smoke detectors and carbon monoxide were operable. The last fire drill conducted on 07/01/25. A landline telephone was in working condition. During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. All mandated inspection control posters were posted. The facility has current liability insurance on file effective 03/28/25 through 03/28/26 policy #0100291673-1. An audit of residents #1-#2 (R1-R2) service files were complete, and staff #1-#2 (S1-S2) maintained in order and had all the required licensing records. The facility is not current with Community Care Licensing Annual dues with an open balance $495. The facility has a current Administrators Certificate on file for Ivan Bravo #7005889740 - 08/08/2024 through 08/07/2026. Deficiencies: LPA audited the personnel records of Staff #1 and Staff #2 and found that they did not have current CPR/First Aid Certificates on file; both certificates expired in 2015 and 2017, respectively. Additionally, LPA identified that both Resident #1 and Resident #2 were using full bed rails, yet neither was on hospice care nor had a physician's prescription on file authorizing their use. Upon reviewing the service file for Resident #2, who is diagnosed with (NCD), LPA noted that there was no current Resident Appraisal available. The last appraisal documented was from 2018. Deficiencies are listed on LIC 809-D An exit interview conducted with Ivan Bravo and a copy of report and appeal rights were provided.the state’s words, verbatim · CDSS document, Sep 3, 2025

Type of visit: Required - 1 Year

On 08/07/2024 at 9:30 am Licensing Program Analyst (LPA) David España conducted an unannounced Required-1-year annual visit. Upon arriving at the facility, LPA met Ivan Bravo, Administrator who assisted with the visit. The purpose of today’s visit was discussed. Upon arrival at the facility, LPA conducted a risk assessment at the front door. Based on the assessment, the facility is clear of Covid-19 infection. LPA was granted access and allowed to enter the facility to conduct inspections. LPA met with Administrator Ivan Bravo and explained the purpose of today’s visit. The facility is a Residential Care Facilities for the Elderly (RCFE) licensed for six (6) non-ambulatory clients. Currently, there is three (3) residents residing in the facility, all 60 or older. The facility is a two-story structure located in a residential neighborhood. It consists of the following: four (4) resident rooms downstairs with two bathrooms, living room, dining room, kitchen, outside laundry room. The second floor consists of three (3) staff bedrooms, an office, and spare room. No weapons are stored in the premises. Kitchen was inspected and observed to be clean and operational. LPA and Administrator toured the physical plant. There were no bodies of water or obstructions on the premises. Beds and bedding supplies were in good condition, adequate lighting provided, storage for client personal belongings was observed. Facility Evaluation Report continued LIC-809-C Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Toilets and water faucets worked properly, grab bars were secure, the shower was free of mold/mildew, and a non-skid mat was in place. There are no security bars or weapons on the premises. The water temperature measured at 108.8 degrees Fahrenheit and 120 degrees Fahrenheit. Bathrooms were found to be within Title 22 regulations and were clean and operational. LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Cleaning supplies and toxins, sharps objects are stored in locked kitchen drawers and cabinets, locked and not accessible to clients. The kitchen was inspected and there is a 2-day supply of perishable and a 7-day supply of non-perishable food available, maintained properly. Two (2) fully charged fire extinguishers were found in both upstairs and downstairs hallway that were charged, smoke detectors, and carbon monoxide were operable. During the visit, LPA observed that the facility has an approved Mitigation Plan Report on file with CCLD. There were deficiencies cited during this inspection visit. Staffing - Type B: 1569.618(c)(3) - LPA and the administrator observed and reviewed 2023 annual to address deficiencies identified during the last annual visit. Specifically, there remains a lack of evidence that Staff #1, #2, and #3 have received the required First Aid Training. This oversight continues to pose potential risks to the health, safety, and personal rights of individuals in care. An exit interview was conducted, and a copy of this report and appeal rights was provided to Ivan Bravo, Administrator.the state’s words, verbatim · CDSS document, Aug 7, 2024

Type of visit: Required - 1 Year

On 11/18/2023 at 8:30 am Licensing Program Analyst (LPA) David España conducted an unannounced Required-1-year annual visit. Upon arriving at the facility, LPA met Ivan Bravo, Administrator who assisted with the visit. The purpose of today’s visit was discussed. Upon arrival at the facility, LPA conducted a risk assessment at the front door. Based on the assessment, the facility is clear of Covid-19 infection. LPA was granted access and allowed to enter the facility to conduct inspections. LPA met with Administrator Ivan Bravo and explained the purpose of today’s visit. The facility is a Residential Care Facilities for the Elderly (RCFE) licensed for six (6) non-ambulatory clients. Currently, there is three (3) residents residing in the facility, all 60 or older. The facility is a two-story structure located in a residential neighborhood. It consists of the following: four (4) resident rooms downstairs with two bathrooms, living room, dining room, kitchen, outside laundry room. The second floor consists of three (3) staff bedrooms, an office, and spare room. No weapons are stored in the premises. Kitchen was inspected and observed to be clean and operational. LPA and Administrator toured the physical plant. There were no bodies of water or obstructions on the premises. Beds and bedding supplies were in good condition, adequate lighting provided, storage for client personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Toilets and water faucets worked properly, grab bars were secure, the shower was free of mold/mildew, and a non-skid mat was in place. There are no security bars or weapons on the premises. The water temperature measured at 108.8 degrees Fahrenheit and 120 degrees Fahrenheit. Bathrooms were found to be within Title 22 regulations and were clean and operational. LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Cleaning supplies and toxins, sharps objects are stored in locked kitchen drawers and cabinets, locked and not accessible to clients. The kitchen was inspected and there is a 2-day supply of perishable and a 7-day supply of non-perishable food available, maintained properly. Facility Evaluation Report continued LIC-809-C Two (2) fully charged fire extinguishers were found in both upstairs and downstairs hallway that were charged, smoke detectors, and carbon monoxide were operable. During the visit, LPA observed that the facility has an approved Mitigation Plan Report on file with CCLD.LPA observed staff were wearing face coverings, all mandated inspection control posters were posted. There were deficiencies cited during this inspection visit. Staffing - Type B: 1569.618(c)(3) - Licensing Program Analyst (LPA) David España. and Ivan Bravo, Administrator did not observe First Aid Training for Staff #1-#3. Resident Rights/Information - 87468(c)(2)(A) - Licensing Program Analyst (LPA) David España. and Ivan Bravo, Administrator did not observe PUB 475 20"X26" posted at the main entryway of the facility. Disaster Preparedness - Technical Violation: 1569.695(a)(5) - Licensing Program Analyst (LPA) David España and Ivan Bravo, Administrator did not observe LIC 610 Emergency Disaster Plan. Advisories are on attached 9102. An exit interview was conducted, and a copy of this report and appeal rights was provided to Ivan Bravo, Administrator.the state’s words, verbatim · CDSS document, Nov 18, 2023

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.