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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006402
Report Date: 08/09/2024
Date Signed: 08/09/2024 02:57:35 PM


Document Has Been Signed on 08/09/2024 02:57 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868



FACILITY NAME:IVY PARK AT SEAL BEACHFACILITY NUMBER:
306006402
ADMINISTRATOR:TURGEON, JENNIFERFACILITY TYPE:
740
ADDRESS:3850 AND 3840 LAMPSON AVETELEPHONE:
(562) 594-5788
CITY:SEAL BEACHSTATE: CAZIP CODE:
90740
CAPACITY:261CENSUS: 169DATE:
08/09/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Jennifer TurgeonTIME COMPLETED:
03:15 PM
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An unannounced case management visit was conducted on this day by Licensing Program Analyst (LPA) Claudia Gutierrez regarding an incident report received by Community Care Licensing on July 30, 2024. LPA met with Executive Director (ED) Jennifer Turgeon and explained the purpose of the inspection.

Per incident report, on July 25, 2024, Resident 1’s (R1’s) representative reported that Staff 1 (S1) text them a video and photographs of R1. Video depicted R1 engaged in a verbal altercation with Staff 2 (S2), whom had “previously been investigated” and “was counseled.” Photographs depicted S2 assisting R1 with changing clothes. S1 resigned their position on July 25, 2024.

During today’s visit, interviews were conducted with staff and residents. LPA obtained a copy of resident roster and staff roster. ED refused to provided LPA with any documentation pertaining to their “internal investigation”, including staff statements and disciplinary action taken against staff. ED provided LPA with a summary regarding "internal investigation." Due to insufficient information available at this time, this incident requires further investigation. LPA informed ED that subsequent visits and document requests will be required and ED stated they understood.

An exit interview was conducted a copy of this report was provided at the end of the inspection.

SUPERVISOR'S NAME: Armando J LuceroTELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Claudia GutierrezTELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:
DATE: 08/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/09/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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