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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157209257
Report Date: 03/06/2023
Date Signed: 03/06/2023 01:11:37 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/28/2023 and conducted by Evaluator Mai Yang
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20230228141933
FACILITY NAME:IVY PARK AT SEVEN OAKSFACILITY NUMBER:
157209257
ADMINISTRATOR:BRADLEY, PAMELAFACILITY TYPE:
740
ADDRESS:4301 AND 4225 BUENA VISTA ROADTELEPHONE:
(661) 837-1337
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY:164CENSUS: 68DATE:
03/06/2023
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Administrator/ Executive Director Pamela BradleyTIME COMPLETED:
01:10 PM
ALLEGATION(S):
1
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9
Facility failed to notify residents that pendant alarms were not working
INVESTIGATION FINDINGS:
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2
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9
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On 3/6/23, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an initial 10-day inspection. LPA introduced self, stated the purpose of the visit and met with Administrator/ Executive Director Pamela Bradley.

During the course of the investigation, LPA received copy of records, toured the facility and conducted interviews. Facility pendant alarm were not working on 02/23/23. Facility notified alarm vender and supervisors immediately. The residents were notified the same day of the alarm system not working on 2/23/23. A written notification was sent to the residents’ responsible party and residents on 2/27/23.

Based on the observation, records reviewed, and interviews that were conducted the above allegation is founded to be UNSUBSTANTIATED due to facility has notified the resident within 24 hours of the alarm system not working and took the proper measure to ensure the safety of the residents. An exit interview was conducted, a copy of this report was provided via email to Administrator. Report signed on-site.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: See MouaTELEPHONE: (559) -65-7912
LICENSING EVALUATOR NAME: Mai YangTELEPHONE: 559-772-7402
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2023
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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