<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 486803921
Report Date: 06/18/2026
Date Signed: 06/18/2026 03:10:06 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/17/2026 and conducted by Evaluator Elias Magdaleno
COMPLAINT CONTROL NUMBER: 21-AS-20260417124451
FACILITY NAME:IVY PARK AT GLEN COVEFACILITY NUMBER:
486803921
ADMINISTRATOR:MOSES, CANDICEFACILITY TYPE:
740
ADDRESS:140 GLEN COVE MARINA ROADTELEPHONE:
(707) 653-4728
CITY:VALLEJOSTATE: CAZIP CODE:
94591
CAPACITY:155CENSUS: 133DATE:
06/18/2026
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Candice Moses, AdministratorTIME COMPLETED:
02:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not providing adequate food service for residents
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
At approximately 12:30PM, Licensing Program Analyst (LPA) Magdaleno arrived unannounced to deliver findings regarding the above allegation and met with Adminsitrator Candice Moses.

Staff are not providing adequate food service for residents – Reporting Party (RP) alleges that meals are often not enough or dishes are missing parts. During the course of this investigation, LPA made observations and conducted interviews. Interviews with eight (8) of eight (8) residents indicated that facility meals are of adequate size and facility has not run out of food. Further interviews indicated that six (6) of eight (8) residents often are not able to finish their entire meals. Two (2) of eight (8) residents indicated a desire for more food variety. Interviews with three (3) of three (3) staff indicated that they have not witnessed facility food levels running low and, upon resident request, will bring more food out until residents are full. Interviews with management indicated that if there is ever a missed shipment of food from supplier, staff will go to nearby grocery stores and purchase the supplies needed.
Continued LIC9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Elias Magdaleno
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2026
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 21-AS-20260417124451
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: IVY PARK AT GLEN COVE
FACILITY NUMBER: 486803921
VISIT DATE: 06/18/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Continued from LIC9099...

Further interviews with management indicated that facility follows a dietician created food plan and menu in order to meet the needs of all residents. LPA observed residents eating snacks between meals times as well as being served full meals outside of mealtimes upon request. LPA toured facility kitchen and observed fresh and frozen food levels to meet requirements. LPA also observed facility holds informational seminars held by a registered dietician to inform residents of healthy food choices. Although the 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. Exit interview conducted with Administrator, whose signature on form confirms receipt.

SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Elias Magdaleno
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2