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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079201116
Report Date: 07/21/2026
Date Signed: 07/21/2026 04:22:14 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 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
06/29/2026 and conducted by Evaluator David Doidge
COMPLAINT CONTROL NUMBER: 15-AS-20260629220357
FACILITY NAME:IVY PARK AT SAN RAMONFACILITY NUMBER:
079201116
ADMINISTRATOR:MORGAN, OREISHAFACILITY TYPE:
740
ADDRESS:9199 FIRCREST LANETELEPHONE:
(949) 744-5200
CITY:SAN RAMONSTATE: CAZIP CODE:
94583
CAPACITY:162CENSUS: 158DATE:
07/21/2026
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Executive Director Gilbert CastroTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Staff does not ensure facility elevator is in good repair.
INVESTIGATION FINDINGS:
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On 07/21/2026 at 2:30 PM, Licensing Program Analyst (LPA) David Doidge arrived unannounced to deliver findings regarding the allegation above. LPA met with Business Office Director Thaleana Jones and Executive Director Gilbert Castro and explained the purpose of the visit.

During the course of the investigation toured the facility, inspected the elevators. LPA interviewed S1, S2, S3, S4 and S5 as well as R1, R2, R3 and W1. LPA reviewed and obtained copies of R1, R2, and R3’s Physician’s Report, Admission Agreements, correspondence between the facility and residents, and correspondence between the facility and the repair company for the elevator (Otis) regarding the elevator

Allegations: Staff does not ensure facility elevator is in good repair.

Continued on LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: David Doidge
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 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
06/29/2026 and conducted by Evaluator David Doidge
COMPLAINT CONTROL NUMBER: 15-AS-20260629220357

FACILITY NAME:IVY PARK AT SAN RAMONFACILITY NUMBER:
079201116
ADMINISTRATOR:MORGAN, OREISHAFACILITY TYPE:
740
ADDRESS:9199 FIRCREST LANETELEPHONE:
(949) 744-5200
CITY:SAN RAMONSTATE:CAZIP CODE:
94583
CAPACITY:162CENSUS: DATE:
07/21/2026
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Executive Director Gilbert CastroTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Staff does not provide adequate food service to resident.
INVESTIGATION FINDINGS:
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On 07/21/2026 at 2:30 PM, Licensing Program Analyst (LPA) David Doidge arrived unannounced to deliver findings regarding the allegation above. LPA met with Business Office Director Thaleana Jones and Executive Director Gilbert Castro and explained the purpose of the visit.

During the course of the investigation, LPA interviewed S1, S2, S3, S4 and S5 as well as R1, R2, R3 and W1. LPA reviewed and obtained copies of R1, R2, R3's Physician’s Reports and Admission Agreements.

Allegation: Staff does not provide adequate food service to resident.

Continued on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: David Doidge
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 15-AS-20260629220357
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: IVY PARK AT SAN RAMON
FACILITY NUMBER: 079201116
VISIT DATE: 07/21/2026
NARRATIVE
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Continued from lIC9099

Investigation Findings: It was reported to the department that a resident cannot regularly attend dining services due to an elevator being out of service. The resident also reports that when meal delivery is requested, the meals are often not delivered. As a result, the resident has gone without meals paid for. R1 and R2 stated that they prefer to get meals delivered instead of using another elevator farther from their room. R1 does not require assistance with feeding and uses the free meal service provided by the facility instead of going to the dining room as a preference. R1 has not been restricted from ordering food or going to the dining room on R1’s own. R2 uses the meal service as R2 prefers to eat alone in R2’s room. R3 informed LPA that R3 prefers to eat in the dining room and uses the stairs. S1 and S2 informed LPA that due to an elevator being temporarily out of service, the facility is offering residents on the third floor affected by the elevator being out of service a meal delivery service. Residents can either call down to the front desk or send a ticket to the kitchen to place an order. Caregivers on the third floor then pick up and deliver the orders. LPA reviewed files for four residents on the affected floor, none require assistance with meals or feeding. LPA observed dinning room to be fully functioning, staffed, and accessible to all residents. Based on interviews conducted and file review, the above allegation is UNSUBSTANTIATED.

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.

Exit interview conducted and a copy of this report provided.

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: David Doidge
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 15-AS-20260629220357
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: IVY PARK AT SAN RAMON
FACILITY NUMBER: 079201116
VISIT DATE: 07/21/2026
NARRATIVE
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Continued from LIC9099

Investigation Findings: It was reported to the department that the primary elevator serving a resident’s apartment has been out of service for longer than eight weeks. Based on observation and interviews with staff and residents, the main elevator (Elevator two) has been out of service since May 21st. Despite efforts made by management to get the elevator repaired, it remains nonoperational, therefore the allegation above is SUBSTANTIATED.

The preponderance of evidence is met, therefore, the allegation is substantiated.

Deficiency is cited from Title 22 California Code of Regulations and listed on 809-D. Failure to submit proof of correction by plan of correction due date and any repeat violation within 12 month period may result in a civil penalty.

Deficiency plan and proof of correction were discussed with Executive Director Gilbert Castro.

Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: David Doidge
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 15-AS-20260629220357
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: IVY PARK AT SAN RAMON
FACILITY NUMBER: 079201116
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/21/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
08/04/2026
Section Cited
CCR
87303(a)
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Maintenance and Operation. (a) The facility shall be clean, safe, sanitary and in good repair at all times... This requirement is not met as evidence by:
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Executive Director (ED) has agreed to obtain a written detail plan on the repair process with a clearer estimated time of repair with completion dates for each step of the process. ED will submit the plan to CCLD by POC date.
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Based on observation and record review, licensee did not comply with the section cited above by having the main elevator (Elevator two) in disrepair which poses a potential health and safety risk to the persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Bennett Fong
LICENSING EVALUATOR NAME: David Doidge
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5