435202929-7-9-2026-26-AS-ACON-DVZUDL-20260715152941

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435202929
Report Date: 07/09/2026
Date Signed: 07/09/2026 03:03:07 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/29/2026 and conducted by Evaluator Yi Sam Jian

COMPLAINT CONTROL NUMBER: 26-AS-20260429103707

FACILITY NAME:	IVY PARK AT PALO ALTO		FACILITY NUMBER:	435202929
ADMINISTRATOR:	BRICE, STEPHANIE		FACILITY TYPE:	740
ADDRESS:	2701 EL CAMINO ROAD		TELEPHONE:	(650) 326-1108
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94306
CAPACITY:	97	CENSUS: 85	DATE:	07/09/2026
		UNANNOUNCED	TIME BEGAN:	09:37 AM
MET WITH:	Stephanie Brice		TIME COMPLETED:	03:18 PM

ALLEGATION(S):

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-Staff are not changing the resident's linens.
-Staff are not providing laundry services to a resident in care.
-Staff did not respond to resident's call button.
-Staff are not disposing of the resident's trash.
-Facility did not ensure that staff are properly trained.
-Staff did not administer medication as prescribed.

INVESTIGATION FINDINGS:

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On 07/09/2026, Licensing Program analyst (LPA) Yi Sam Jian conducted an unannounced complaint investigation visit. LPA met with the Executive Director, Stephanie Brice, and disclosed the purpose of the visit.

Regarding the allegation that staffs are not changing resident’s linens, interviews conducted during the investigation indicated that the facility maintained a routine schedule for linen changes and that services were provided to residents on an ongoing basis. The investigation did not identify sufficient evidence demonstrating that the facility failed to provide linen services.
Regarding the allegation that staffs are not providing laundry services, information obtained during the investigation indicated that laundry services were routinely provided by the facility and that residents also retained the ability to complete laundry independently if desired.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Yi Sam Jian
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2026

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 26-AS-20260429103707

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: IVY PARK AT PALO ALTO	FACILITY NUMBER: 435202929
	VISIT DATE: 07/09/2026

NARRATIVE

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Regarding the allegation that staffs did not respond to resident call lights, interviews conducted during the investigation did not identify sufficient evidence demonstrating that staff did not respond to resident requests for assistance.
Regarding the allegation that staff did not dispose of resident’s trash, information obtained during the investigation indicated that the facility maintained routine housekeeping practices, including regular trash removal.
Regarding the allegation that the facility did not ensure that staff were properly trained, documentation obtained during the investigation indicated that the facility maintained records of training for the staff.
Regarding the allegation that staff did not administer medications as prescribed, documentation obtained during the investigation indicated that the facility maintained medication administration procedures and safeguards.

Although the above 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. No deficiencies cited during today's visit. An exit interview was conducted and a copy of the report provided to facility representatives.

SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Yi Sam Jian
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2026

LIC9099 (FAS) - (06/04)

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