197609362-9-14-2026-31-AS-MGFS-DYCVPL-20260928163651

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609362
Report Date: 09/14/2026
Date Signed: 09/14/2026 05:19:30 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/22/2025 and conducted by Evaluator Nadia Shahbazian

COMPLAINT CONTROL NUMBER: 31-AS-20251222083633

FACILITY NAME:	IVY PARK AT BURBANK		FACILITY NUMBER:	197609362
ADMINISTRATOR:	ANGELA SMITH		FACILITY TYPE:	740
ADDRESS:	2721 WILLOW STREET		TELEPHONE:	(818) 954-9500
CITY:	BURBANK	STATE: CA	ZIP CODE:	91505
CAPACITY:	130	CENSUS: 101	DATE:	09/14/2026
		UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Angela Smith-Executive Director		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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Staff does not ensure resident's hygiene needs are being met.
Staff does not answer resident's calls in a timely manner.
Staff does not ensure facility garbage are properly disposed.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Nadia Shahbazian and Licensing Program Manager (LPM) Mary Flores conducted an unannounced subsequent complaint investigation visit regarding the above allegations. LPA/LPM met with Angela Smith Executive Director and explained the reason for the visit.

On 12/23/25 LPA Shahbazian conducted an initial complaint investigation visit and requested copies of staff roster, resident roster and relevant documentation regarding the investigation. From 11:10am to 12:05pm LPA interviewed the Administrator. At 12:30pm, LPA conducted a physical plant tour of the facility. On 5/18/26 LPA interviewed 4 staff and 4 residents. On 9/14/26 LPA and LPM interviewed 6 residents, 3 staff, and observed 6 residents’ rooms and requested additional resident records for 10 residents.

Regarding allegation: Staff does not ensure resident's hygiene needs are being met. It is alleged staff do not provide proper hygiene services.
(CONTINUED ON LIC 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Nadia Shahbazian
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2026

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 31-AS-20251222083633

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: IVY PARK AT BURBANK	FACILITY NUMBER: 197609362
	VISIT DATE: 09/14/2026

NARRATIVE

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Interviews conducted with residents revealed 5 out of 10 residents stated they do require assistance with some activities of daily living(ADLs), are receive assistance from the staff, and have no concerns regarding the services being provided. 4 out of 10 residents are independent and/or do not require assistance with hygiene needs; such as showering, toileting, grooming, or dressing. 1 out of 10 residents were unable to be interviewed due to cognitive skills. Interviews with staff revealed most residents are scheduled 2 showers per week; some may be schedule for daily showers. Staff also stated when a resident refuses to shower they attempt at least three additional times and noted on their records if they do refuse for the day. Document review revealed 4 out of 10 residents’ care plans noted they required some assistance with hygiene care; such as standby assistance or assistance with showers 2x per week.

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.

Regarding allegation: Staff does not answer resident's calls in a timely manner. It is alleged staff leave residents unattended for extended periods of time upon calling. Interviews with residents 5 out of 10 residents stated not to need call button assistance or that have use the call button for assistance. 3 out of 10 residents revealed they have been assisted in a timely manner when they use the call button. 2 out of 10 residents were unable to respond due to cognitive skills. Interviews with staff revealed staff should be responding within 15 minutes. Health Services Director stated that has noticed that the staff forget to clear the pendant button, as they have observed two residents that were in activities that had accidentally pressed the button and were not cleared by staff that were with them when they press it. One staff stated that it has happened that residents had to wait for up to 30 minutes in the past. During the tour conducted on 9/14/26 LPA/LPM tested a pendant call button at 10:34am and caregiver responded at 10:47am. Others were not tested as residents were in the dining room and/or in the memory care unit where staff were supervising the residents. Facility maintains a pendant call log it was observed that at least 1 time per month residents waited over 20 minutes. They were the residents described by the Health Service Director.

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.

(CONTINUED ON LIC 9099C)

SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Nadia Shahbazian
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2026

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20251222083633

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: IVY PARK AT BURBANK	FACILITY NUMBER: 197609362
	VISIT DATE: 09/14/2026

NARRATIVE

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Regarding allegation: Staff does not ensure facility garbage are properly disposed. It is alleged that trash is left out in hallways and not picked up. Interview with Executive Director revealed sometimes residents may leave trash out to be disposed of by staff. Staff stated that residents that leave the trash out do it to prevent staff coming into their rooms. Staff indicated that if they observed trash in the hallways they immediately pick it up. Interview with residents revealed 8 out of 10 residents stated the trash is picked up by the staff and it has never overflowed in their trash cans or been left outside. One resident stated that they put the trash outside the door for staff to take during the night. 2 out of 10 residents were unable to answer due to cognitive skills. During facility’s tour conducted on 12/23/25, 5/18/26, and 9/14/26 LPA/LPM did not see trash bags or trash in the hallways, trash cans were observed not overflowing with trash. Document review revealed Care Assignment NOC shift not dated notes trash pick-up.

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 was conducted with Angela Smith Executive Director and a copy of this report was provided.

SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Nadia Shahbazian
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2026

LIC9099 (FAS) - (06/04)

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