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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701234
Report Date: 02/04/2025
Date Signed: 02/04/2025 03:13:20 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/25/2024 and conducted by Evaluator Pang Lee
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20241125080927
FACILITY NAME:IVY RIDGE ASSISTED LIVINGFACILITY NUMBER:
342701234
ADMINISTRATOR:HONG TRINH (ZOE)FACILITY TYPE:
740
ADDRESS:2030 23RD STTELEPHONE:
(916) 600-3309
CITY:SACRAMENTOSTATE: CAZIP CODE:
95818
CAPACITY:36CENSUS: 33DATE:
02/04/2025
UNANNOUNCEDTIME BEGAN:
02:38 PM
MET WITH:Lezel BelloTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Facility staff do not provide a safe environment for residents.
Facility staff do not provide a comfortable environment for residents.
Facility does not have sufficient number of bathrooms to meet residents need.
Facility shower is in disrepair.
Facility does not provide comfortable temperature for residents.
INVESTIGATION FINDINGS:
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On 02/04/25 at 2:38 PM, Licensing Program Analyst (LPA) Pang Lee arrived unannounced to this facility to conduct a complaint visit. LPA met with assistant administrator Lezel Bello and explained the purpose of the visit. The purpose of this visit is to deliver complaint findings for the allegations above. The current census is 33.

It was alleged that the facility staff did not provide a safe environment for residents. The investigation included interviews with staff, residents, and an outside agency, as well as observations. Of the residents interviewed, 6 out of 7 reported no concerns about the facility’s safety. These 6 residents expressed that they feel safe living in the facility. Additionally, 6 out of 7 of the residents interviewed reported not seeing other residents enter another resident’s room without permission. Four facility staff members denied the allegations, stating that they communicate daily about residents' needs. The outside agency also found no concerns regarding the safety of the facility.
Continue LIC 9099-C

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Pang Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2025
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 3
Control Number 27-AS-20241125080927
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: IVY RIDGE ASSISTED LIVING
FACILITY NUMBER: 342701234
VISIT DATE: 02/04/2025
NARRATIVE
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Based on observations made on 11/27/24 and 12/24/24, LPA Lee did not find any evidence that the facility staff was providing an unsafe environment for residents in care. During the investigation, it was learned that the facility had accommodated resident 1 (R1) by installing a new doorknob at R1’s request. Furthermore, the facility made an effort to accommodate (R1) by offering a move to the front of the main building. However, R1 would need to share the room with (R2), as R2’s room was the only available space. R1 declined the offer, expressing a preference for a private room, similar to the one R1 is currently occupying in the Terrace Hall.

It was alleged that the facility does not provide a comfortable environment and comfortable temperature for residents. The investigation included interviews with staff, residents, and outside agency as well as on site observations. Based on the interviews, 6 out of 7 residents expressed no concerns regarding the comfort of the environment or temperature in the facility. In fact, these residents stated they were content living in the facility. 4 facility staff members denied the allegations, stating that they communicate regularly regarding residents' needs. Staff also reported they frequently accommodate (R1) by providing room service such as ice, towels, meals, and a specific butter R1 requested. Additionally, staff stated that R1 is not charged for room delivery and that they make efforts to ensure R1 feels comfortable in the facility. Based on R1's admission agreement, there is no contract stating that the facility will provide room delivery, and R1 is not being charged for room delivery. Staff further denied allegation of uncomfortable temperatures, stating that the temperature is typically set between 70°F and 78°F. The outside agency also stated that the facility makes efforts to accommodate R1. During an observation on 11/27/24, LPA Lee observed residents appeared comfortable. A tour of the facility showed that the temperature in the main building downstairs was 72°F, while the temperature in the wall building measured 74°F. The temperature in the Terrace Hall downstairs was 78°F, and upstairs it was 72°F. The temperature in R1’s room was recorded at 69°F which is within the regulation of 68* F to 85* F. LPA Lee observed multiple residents room measured at 78* F. LPA Lee also confirmed there was no feces or potting soil in any of the resident bathroom toilets or sinks. During a follow-up visit on 12/24/24, LPA Lee observed 12 residents in the dining room and 4 in a smaller dining room, all having lunch and appearing comfortable. R1's room was measured at 73°F, and the bathrooms in the Terrace Hall were clean, sanitary, and free of feces or potting soil.

It was alleged that the facility does not have sufficient number of bathrooms to meet residents' needs and that the facility’s shower is in disrepair.

Continued LIC 9099-C

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Pang Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 27-AS-20241125080927
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: IVY RIDGE ASSISTED LIVING
FACILITY NUMBER: 342701234
VISIT DATE: 02/04/2025
NARRATIVE
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The investigation included interviews with staff and residents. According to interviews, 6 out of 7 residents reported no concerns regarding the number of bathrooms and the shower not in good repair. 4 facility staff members denied the allegations, confirming that there are a total of 7 bathrooms in the facility. During a visit on 11/27/24, LPA Lee observed that the facility does indeed have 7 bathrooms. The main building has 2 bathrooms upstairs and 1 downstairs. The Terrace Hall has 2 bathrooms downstairs and 2 bathrooms upstairs. Both facility visits on 11/27/24 and 12/24/24, LPA Lee also observed that all showers in the facility were in good repair.

Based on statements obtained, records review and observations during the investigation process, LPA was unable to corroborate the allegations. The investigation revealed the preponderance of evidence standards have not been met; therefore, the above allegations are found to be UNSUBSTANTIATED. A finding that the complaint allegations are UNSUBSTANTIATED means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation(s)occurred.

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Pang Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3