019201597-6-30-2026-15-AS-BFOG-DWAVCX-20260724161952

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 019201597
Report Date: 06/30/2026
Date Signed: 06/30/2026 01:50:11 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
E BAY DELTA AC/SC, 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
06/02/2026 and conducted by Evaluator Lori Alexander-Washington

PUBLIC

COMPLAINT CONTROL NUMBER: 15-AS-20260602152538

FACILITY NAME:	IVY PARK AT LIVERMORE		FACILITY NUMBER:	019201597
ADMINISTRATOR:	ESPINOZA, CHELSEA		FACILITY TYPE:	740
ADDRESS:	35 FENTON STREET		TELEPHONE:	(925) 443-7200
CITY:	LIVERMORE	STATE: CA	ZIP CODE:	94550
CAPACITY:	115	CENSUS: 77	DATE:	06/30/2026
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Ranjeeta Kumar, Health Services Director		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Staff physically abused resident in care

INVESTIGATION FINDINGS:

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On 06/30/2026 at 11:30 AM, Licensing Program Analyst (LPA) L. Alexander conducted a subsequent visit and met with Health Services Director, Ranjeeta Kumar, to deliver findings of above allegation. LPA explained the purpose of the visit with Ranjeeta Kumar.

During the course of the investigation the Department obtained Staff (S) Roster (LIC 500), Resident (R) Roster, Residents' (R) R1's, face sheet, ID/Emergency Info., admissions agreement, physician's report, pre-appraisal, Individualized Service Plan, incident report (dated 05/23/26), email, police case number, staff rosters, staff schedules April-May '26.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Lori Alexander-Washington
LICENSING EVALUATOR SIGNATURE:	DATE: 06/30/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2026

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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Control Number 15-AS-20260602152538

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
E BAY DELTA AC/SC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: IVY PARK AT LIVERMORE	FACILITY NUMBER: 019201597
	VISIT DATE: 06/30/2026

NARRATIVE

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Allegation: Staff physically abused resident in care
Finding: Unsubstantiated

On 06/03/2026 LPA interviewed S1, S2 and S3 who all stated that R1 requires two-person assist with toileting. S1, S2 and S3 stated that caregivers were assisting R1 to toileting by transferring R1 from wheelchair to the restroom. S1, S2 and S3 stated that during the transfer they wait for R1's upper body to move first, followed by the legs, before pivoting and positioning R1 safely. S2 stated that during one transfer, R1 expressed pain while placing their hands on their stomach, prompting S2 to call S4 for assistance. S2 and S3 stated that they did not witness R1 fall, be shoved into a wall, or experience any form of physical abuse. S1 further stated that the hospice nurse conducted a full-body assessment of R1 and did not observe any signs of injury or bruising. LPA interviewed R2, R3, R4 and R5 all stated that they have no issues of concerns with staffing, any abuse, and they have not heard of any issues of abuse with staffing by any other resident.

Although the 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 visit. Exit interview conducted and a copy of this report provided.

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Lori Alexander-Washington
LICENSING EVALUATOR SIGNATURE:	DATE: 06/30/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2026

LIC9099 (FAS) - (06/04)

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