198602608-9-11-2026-28-AS-FFIS-DYDLRH-20260929085908

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602608
Report Date: 09/11/2026
Date Signed: 09/11/2026 05:18:17 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 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
07/07/2026 and conducted by Evaluator Cynthia D Chan

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20260707124535

FACILITY NAME:	IVY PARK AT CERRITOS		FACILITY NUMBER:	198602608
ADMINISTRATOR:	MARK PADILLA		FACILITY TYPE:	740
ADDRESS:	11000 NEW FALCON WAY		TELEPHONE:	(562) 865-9500
CITY:	CERRITOS	STATE: CA	ZIP CODE:	90703
CAPACITY:	163	CENSUS: 155	DATE:	09/11/2026
		UNANNOUNCED	TIME BEGAN:	11:35 AM
MET WITH:	Mark Padilla, Executive Director		TIME COMPLETED:	03:50 PM

ALLEGATION(S):

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Facility is retaining a resident who requires a higher level of care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Cynthia Chan conducted a subsequent visit to continue the investigation. LPA met with Administrator Mark Padilla and explained the purpose of the visit.

On 7/9/26, LPA Chan conducted the initial visit. LPA obtained a copy of the resident roster, staff roster, and documents for Resident #1. LPA interviewed six (6) Staff. During the visit today, LPA interviewed ten (10) residents and another staff member.

Allegation - Facility is retaining a resident who requires a higher level of care. It is alleged that Resident #1 (R1) has a dementia diagnosis and has been physically aggressive. LPA interviewed seven (7) Staff. Staff stated that R1 was recently diagnosed with dementia. The family takes R1 to medical appointments and has not mentioned to the facility that R1 requires a higher level of care.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Cynthia D Chan
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2026

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 28-AS-20260707124535

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: IVY PARK AT CERRITOS	FACILITY NUMBER: 198602608
	VISIT DATE: 09/11/2026

NARRATIVE

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According to the medical assessment dated 6/24/26, R1 has a diagnosis of dementia. Staff stated that R1 needs assistance with showering, brushing teeth, medication management, and escorting. Staff revealed that R1 has been reluctant to shower and brush teeth and needs lots of encouragement as well as reminders to keep up with good hygiene. Staff do not force the resident to complete the activities of daily living. Staff stated that R1’s responsible party and the primary physician are aware of R1’s self-neglect. Staff have not observed R1 being physically aggressive or having any medical condition that requires a higher level of care. In addition, the facility has a dementia care plan and can accept or retain residents with dementia. LPA verified with a health professional that R1 does not need a higher level of care but needs increased supervision. Based on the information gathered, R1's behavior and care are manageable but may need additional care services in the future while residing at the facility.
LPA interviewed ten (10) residents, and all the residents stated that staff assist them as part of their care plan or when they press their pendants. Residents are content with the care and supervision provided.

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 with the Executive Director. A copy of this report, along with the appeal rights, was provided.

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Cynthia D Chan
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2026

LIC9099 (FAS) - (06/04)

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