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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079201317
Report Date: 04/30/2024
Date Signed: 04/30/2024 04:13:09 PM

Unsubstantiated


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
04/29/2024 and conducted by Evaluator James Sampair
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20240429144934
FACILITY NAME:IVY PARK AT WALNUT CREEKFACILITY NUMBER:
079201317
ADMINISTRATOR:CASTRO, GILBERTFACILITY TYPE:
740
ADDRESS:2175 YGNACIO VALLEY ROADTELEPHONE:
(925) 932-3500
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94598
CAPACITY:86CENSUS: 67DATE:
04/30/2024
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Executive Director Gilbert CastroTIME COMPLETED:
04:45 PM
ALLEGATION(S):
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Staff do not ensure the residents have hot water while in care
INVESTIGATION FINDINGS:
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On 4/30/2024 at 3:00 PM, Licensing Program Analysts (LPAs) J. Sampair and A. Gharachorloo arrived at the facility unannounced to conduct the initial 10-day complaint investigation of the allegation above. Upon entry, the LPAs informed Executive Director (ED) Gilbert Castro the purpose of the visit.

The complaint alleges that staff do not ensure the residents have hot water while in care.

The LPAs interviewed the ED who stated that he had been informed of the plumbing problem wiith the hot water on 4/25/2024. He provided written proof that the plumbers were notified and inspected the affected apartments on the same day, 4/25/2024. The repairs were approved the following day, 4/26/2024, and the repairs were completed as soon as the parts arrived. In the meantime, the residents were given access to and made use of alternative locations to safely shower. Additionally, the residents were given credit of approximately $100 for the inconvenience for each resident.

Report Continued on LIC9099-C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Harpreet HumpalTELEPHONE: (510) 529-9416
LICENSING EVALUATOR NAME: James SampairTELEPHONE: (510) 286-4201
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2024
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 2
Control Number 15-AS-20240429144934
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 WALNUT CREEK
FACILITY NUMBER: 079201317
VISIT DATE: 04/30/2024
NARRATIVE
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...Report Continued from LIC9099

Although the allegations may have happened, or are valid, there is not a preponderance of evidence to prove them; therefore, the allegations are UNSUBSTANTIATED.

Exit interview conducted with ED Castro. Appeal Rights and a copy of this report provided.
SUPERVISOR'S NAME: Harpreet HumpalTELEPHONE: (510) 529-9416
LICENSING EVALUATOR NAME: James SampairTELEPHONE: (510) 286-4201
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2