<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602608
Report Date: 07/03/2025
Date Signed: 07/03/2025 03:07:17 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/26/2025 and conducted by Evaluator Noemi Galarza
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250626151034
FACILITY NAME:IVY PARK AT CERRITOSFACILITY NUMBER:
198602608
ADMINISTRATOR:LAURA RODRIGUEZFACILITY TYPE:
740
ADDRESS:11000 NEW FALCON WAYTELEPHONE:
(562) 865-9500
CITY:CERRITOSSTATE: CAZIP CODE:
90703
CAPACITY:163CENSUS: 136DATE:
07/03/2025
UNANNOUNCEDTIME BEGAN:
09:08 AM
MET WITH:Dina Davis, Interim Executive DirectorTIME COMPLETED:
03:05 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff retaliates against resident.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Galarza conducted an initial 10-day complaint investigation visit regarding the above allegation. LPA discussed the purpose of the visit with Interim Executive Director Dina Davis.

The investigation consisted of: A physical plant tour of the interior and exterior, record review, and interviews with residents (R1- R11), and staff (S1- S8) was completed. Copies of resident (R1's) Identification and Emegency Information, Admission Agreement, Eviction Notice (6/25/25), Physician's Report (2/8/2022), Health and Service Evaluation, Resident Assessment, House Rules, LIC 500 Personnel Report, and resident roster were obtained.

*See next page for narrative.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2025
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 28-AS-20250626151034
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: IVY PARK AT CERRITOS
FACILITY NUMBER: 198602608
VISIT DATE: 07/03/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Allegation: Staff retaliates against resident. It is alleged that on June 25, 2025 resident (R1) received a 30-day eviction notice because they expressed concerns regarding the facility to the city council about facility safety. It is also alleged that the licensee has not been responsive to safety concerns such as, unlocked empty rooms and main entrance doors kept unlocked by staff late at night. According to information obtained, when their was a change in ownership the licensee told residents that town hall meetings would be ongoing, and their concerns would be addressed. One (1) out of 11 residents stated administration staff retaliates if residents complain. The majority of the residents had no knowledge of the eviction notice issued to resident (R1). Staff interviews revealed that the eviction notice was issued on June 25, 2025, because in recent months there have been numerous incidents where R1 has become aggressive towards other residents and staff. According to staff, resident (R1) has exhibited unsafe behaviors and broken facility House Rules. Staff denied the allegation. Based on record review, the findings indicate that from April 202 5- to present there have been five incidents of aggressive behavior towards resident and staff. Per House Rules, "Disruptive or abusive behavior by employees, residents, and resident's families or guests is not acceptable or permitted." Therefore, there is insufficient evidence to corroborate the allegation.

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.

An exit interview was conducted and a copy of this report was discussed and provided to Interim Executive Director Dina Davis.


SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2