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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 365530195
Report Date: 03/16/2026
Date Signed: 03/16/2026 03:35:35 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, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/12/2026 and conducted by Evaluator Javier Prieto
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20260312161551
FACILITY NAME:IVY PARK AT ALTA LOMAFACILITY NUMBER:
365530195
ADMINISTRATOR:SANCHEZ, JENNIFERFACILITY TYPE:
740
ADDRESS:9519 BASELINE ROADTELEPHONE:
(909) 941-3001
CITY:RANCHO CUCAMONGASTATE: CAZIP CODE:
91730
CAPACITY:77CENSUS: 66DATE:
03/16/2026
UNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Olympia Ramirez, Executive Director TIME COMPLETED:
04:00 PM
ALLEGATION(S):
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9
Staff do not answer residents calls for assistance timely
Staff do not ensure residents bathroom is cleaned timely
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to conduct a complaint investigation regarding the above allegations. LPA Prieto met with Executive Director Ramirez and explained the elements of the complaint.

Allegations #1 - LPA Prieto spoke with Executive Director Ramirez (S1) who states the they reviewed call records and no calls were made from resident #1 (R1) in question. S1 adds that staff is called 5 minutes after a call is made for a response. R1 was interviewed who stated that her calls are being responded to when made.

Allegation #2 - Health Services Director (S2) states that R1 is on medication management and is visited at least four times a day. S2 adds that R1 has not made any concerns related the cleanliness of her bathroom. R1 was interviewed by LPA and she states there is no concerns with her bathroom not being cleaned.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2026
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 56-AS-20260312161551
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME: IVY PARK AT ALTA LOMA
FACILITY NUMBER: 365530195
VISIT DATE: 03/16/2026
NARRATIVE
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Based on the information obtained there is not enough evidence to support the allegations made in this complaint. Therefore, the allegations are deemed UNSUBSTANTIATED at this time. This report was signed by LPA Prieto and Executive Director Ramirez and a copy was left with the facility.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2