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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 277209411
Report Date: 05/27/2026
Date Signed: 06/01/2026 02:29:59 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 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
05/26/2026 and conducted by Evaluator Vadim Gorban
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20260526121858
FACILITY NAME:IVY PARK OF MONTEREYFACILITY NUMBER:
277209411
ADMINISTRATOR:ANDREA RAMIREZFACILITY TYPE:
740
ADDRESS:1110 CASS STREETTELEPHONE:
(818) 643-2400
CITY:MONTEREYSTATE: CAZIP CODE:
93940
CAPACITY:112CENSUS: 106DATE:
05/27/2026
UNANNOUNCEDTIME BEGAN:
08:51 AM
MET WITH:Administrator Andrea RamirezTIME COMPLETED:
11:00 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff do not prevent resident(s) from smoking in the non-smoking areas of the facility.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 05/27/2026 Licensing Program Analyst (LPA) Gorban unannounced visited the facility to commence complaint investigation and deliver findings. LPA introduced self and met with administrator Andrea Ramirez and was allowed entry.

During this complaint investigation LPA toured the facility conducting health and safety checks, reviewed facility records, and interviewed administrator, staff, and resident.
Allegation: Facility staff do not prevent resident(s) from smoking in the non-smoking areas of the facility. Based on observation during investigation, R1 smoke across from facility parking lot by the walk way, the facility approved smoking area. Based on interviews, staff accompany and ensure R1 to smokes in designated spot. Although the alleged violation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation occur, therefore the allegation is Unsubstantiated.

Exit interview conducted, report signed and copy of this report provided to health services director for facility records.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Shawna Doucette
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2026
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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