019200755-7-18-2024-15-AS-BFOG-D92SMB-20240912135940

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 019200755
Report Date: 07/18/2024
Date Signed: 07/18/2024 03:56:47 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/13/2023 and conducted by Evaluator Kelly Nguyen

COMPLAINT CONTROL NUMBER: 15-AS-20231013134909

FACILITY NAME:	IVY PARK AT OAKLAND HILLS		FACILITY NUMBER:	019200755
ADMINISTRATOR:	CAGULADA, DILLON R		FACILITY TYPE:	740
ADDRESS:	11889 SKYLINE BLVD		TELEPHONE:	(510) 531-7190
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94619
CAPACITY:	100	CENSUS: 60	DATE:	07/18/2024
		UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Yolanda Harrell, Executive Director		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Staff speaks inappropriately to residents.

INVESTIGATION FINDINGS:

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On this day, 7/18/2024 at 3:30PM Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to deliver the finding on the above allegations. LPA met with Executive Director, Yolanda Harrell and explained the purpose of the visit.

Allegation: Staff speaks inappropriately to residents: Unsubstantiated

It was alleged that Staff speaks inappropriately to residents. LPA interviewed 6 staff. 6 out of 6 states that “they have not heard, witness, nor themselves speak inappropriately to resident residents”. At times residents cannot heard us well, and they asked us to speak louder. LPA interviewed 5 residents. 5 out of 5 stated that “none of the staff here speaks inappropriately to us”. 5 out of 5 residents stated, “staff would not dare speaks inappropriately to us, but all the staff here are nice”.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview conducted and a copy of this report provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Bennett Fong	TELEPHONE: (510) 725-7919
LICENSING EVALUATOR NAME: Kelly Nguyen	TELEPHONE: (510) 915-8702
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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