Dementia care
Cited in 2 reports, with 2 deficiencies in total.
IVY PARK AT SAN TOMAS
3930 WILLIAMS RD, San Jose CA 95117
82 bedsLatest official report Aug 21, 2026Licensed
Additional info
- Telephone
- (669) 201-2015
- Licensee
- WEST VALLEY MC,LLC; OAKMONT MANAGEMENT GROUP LLC
- Administrator
- NICKOLAI, KAREN
- Contact
- NICKOLAI, KAREN
- License first date
- Jun 6, 2023
- License effective date
- Jun 6, 2023
- District office
- SAN JOSE RO · (408) 324-2112
- Regional office
- 26
- Clients served
- 983 - RCFE / DEMENTIA
Summary
The available records show 9 Type A and 6 Type B deficiencies for this facility.
- Most recent inspection
- Aug 21, 2026
- Most recent deficiency
- Aug 12, 2026
1 later report, on Aug 21, 2026, recorded no deficiencies, though the records do not say whether they were follow-ups.
What Type A and Type B mean
- Type A
- Violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
- Type B
- Violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care.
Both classifications are published by California CDSS and are shown as published. SeniorLivingFacts does not rename them or add a severity level of its own.
At a glance
Counts cover the five-year public record. Typical figures are the median for the 41 Santa Clara County facilities licensed for 50 or more beds.
In the available public five-year record, CCLD published 36 reports for this facility: 16 inspections, 18 complaint investigations, and 2 licensing or administrative records.
Those records contain 9 Type A and 6 Type B deficiencies.
0 deficiencies have explicit official correction or clearance evidence in the loaded records.
- Official inspections
- 16
- Recorded deficiencies
- 15
- Type A deficiencies
- 9
- Type B deficiencies
- 6
- Substantiated complaints
- 4
- Repeated topics
- 4
More than the typical 10
9 in the last 12 months
Well above the typical 4
7 in the last 12 months
Well above the typical 2
2 in the last 12 months
Well above the typical 1
5 in the last 12 months
Most this size have none
2 in the last 12 months
Last 36 months
Repeated topics
Topics cited in more than one report during the last 36 months. A repeat may show a pattern worth asking about. Each date opens its report below.
Hazardous items and storage
Cited in 2 reports, with 2 deficiencies in total.
Medication handling and storage
Cited in 2 reports, with 2 deficiencies in total.
Staffing, personnel, and training
Cited in 2 reports, with 2 deficiencies in total.
Official report history
All preserved reports from the most recent to the oldest, sortable by report type.
Complaint
Allegations1 substantiated · 0 unsubstantiated · 2 unfounded · 1 cited
Dementia careType A
- Official classification
- Type A
- Official code
- 87705(e)(3)
- Regulation authority
- CCR
What the official deficiency says
Care of Persons with Dementia (e) Licensees that use delayed egress devices on exterior doors and perimeter fence gates shall meet the following initial and continuing requirements: (3) Facility staff shall attempt to redirect a resident at risk for elopement who may be attempting to leave the facility without violating Section 87468.1, Personal Rights of Residents in All Facilities. This requirement was not met as evidenced by: Licensee did not ensure that facility staff redirected R1 as he/she left the facility, posing an immediate safety risk to residents in care.
Official plan of correction
Licensee agrees to submit a Plan of Correction by 05/29/2026 stating how the licensee will conduct in-service training with staff on ensuring that staff redirect a resident at risk for elopement who may be attempting to leave the facility. Once training is complete, the licensee agrees to submit training records that include name of staff trained, training dates, training topics, and names and qualifications of trainers.
Deadline recorded: May 29, 2026. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline May 29, 2026
Correction not verified in available records
Complaint
Allegations0 substantiated · 1 unsubstantiated · 0 unfounded
No deficiencies recorded in this reportComplaint
Allegations0 substantiated · 1 unsubstantiated · 1 unfounded
No deficiencies recorded in this reportComplaint
Allegations0 substantiated · 3 unsubstantiated · 0 unfounded
No deficiencies recorded in this reportComplaint
Allegations0 substantiated · 5 unsubstantiated · 0 unfounded
No deficiencies recorded in this reportComplaint
Allegations0 substantiated · 0 unsubstantiated · 2 unfounded
No deficiencies recorded in this reportComplaint
Allegations0 substantiated · 0 unsubstantiated · 2 unfounded
No deficiencies recorded in this reportComplaint
Allegations0 substantiated · 0 unsubstantiated · 1 unfounded
No deficiencies recorded in this reportComplaint
Allegations3 substantiated · 9 unsubstantiated · 1 unfounded · 3 cited · investigated over 2 visits
Basic services and supervisionType B
- Official classification
- Type B
- Official code
- 87464(f)(4)
- Regulation authority
- CCR
What the official deficiency says
87464(f)(4) Basic services shall at a minimum include:(4)Personal assistance and care as needed by the resident and as indicated in the pre-admission appraisal... activities of daily living such as dressing, eating, bathing and assistance... this requirement was not met as evidenced by: Based on interview and photo, S1, S2 stated the facility was short staffed and the R1s laundry did not get washed. S1 stated R1 had to wear dirty clothing. RP provided photo R1 had soiled clothing on two seperate occasions 09/20/24, and 09/22/24. This posed a potential risk to the health and safety of residents in care.
Official plan of correction
Administrator stated she will provide a letter of understanding of regulation and has hired more staff. ADM will submit to LPA Yanez by POC due date 01/09/25 via email.
Deadline recorded: Jan 9, 2026. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Jan 9, 2026
Correction not verified in available records
Complaint
Part of the complaint whose outcome is recorded on Dec 30, 2025 · Control 26-AS-20240923130821
Medical and dental careType A
- Official classification
- Type A
- Official code
- 87465(g)
- Regulation authority
- CCR
What the official deficiency says
87465(g) Incidental Medical and Dental Care: (g)The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health including…apparent life-threatening medical crisis…This requirement is not met as evidenced by: Based on interview and record review, facility staff did not seek timely medical care for R1. On 08/05/24 R1s were recorded calling for help from 0400 to 0730 hrs. Staff were recorded coming into the R1s room at 0730 hrs. and 911 was called. S3 stated he/she was alerted
Official plan of correction
The ROS stated that the facility will conduct In-Service training with staff on wellness checks and will provide proof of training by POC due date 08/28/25 *cont'd: by staff when his/her shift started at approximately 0630 hrs. S4 stated R1 probably waited for four hours to get help because staff is probably attending to another resident emergency need. Which pose/poses an immediate health, safety and personal-rights risk to person in care
Deadline recorded: Aug 28, 2025. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Aug 28, 2025
Correction not verified in available records
Resident rightsType A
- Official classification
- Type A
- Official code
- 87468.2(a)(4)
- Regulation authority
- CCR
What the official deficiency says
87468.2(a)(4) Additional Personal Rights of Residents in Privately Operated Facilities (a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities…shall have all the following personal rights: (4) To care, supervision, and services that meet their individual needs and are delivered by staff… This requirement is not met as evidenced by: Based on interview staff did not provide care to R1 in a timely manner. On 08/05/24, R1 was recorded screaming for help from 0400 to 0730 hrs. S1 stated R1 waited for hours because “someone is not caring for R1.” S2 stated R1 was possibly waiting for hours to be helped
Official plan of correction
The ROS stated that the facillity will conduct In-Service training for staff to ensure residents rights are protected by POC due date 08/28/25 *cont'd :because there are 2 staff for all residents at the time of the incident. S3 stated he/she was alerted by staff when S3 arrived at 0630 hrs. that R1 had fallen in the bathroom. Which pose/poses an immediate health, safety and personal risk to person in care.
Deadline recorded: Aug 28, 2025. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Aug 28, 2025
Correction not verified in available records
Complaint
Allegations1 substantiated · 2 unsubstantiated · 0 unfounded · 2 cited · investigated over 2 visits
Staffing, personnel, and trainingType A
- Official classification
- Type A
- Official code
- 87411(a)
- Regulation authority
- CCR
What the official deficiency says
87411 Personnel Requirements - General (a) Facility personnel shall at all times be...competent to provide the services necessary to meet resident needs This requirement was not met as evidenced by Based on investigation, R8 requires assistance with medication administration. Resident medication M1 was not administered on 7/8/2025. HSD stated " I don't know " regarding the discrepancy, which poses an immediate health, safety and personal rights risk to residents in care.
Official plan of correction
Licensee states the facility will conduct additional medication administration training by 7/15/2025. Licensee will submit the Plan of Correction (POC) by POC due date 7/9/2025, and submit completion of training to the Department.
Deadline recorded: Jul 9, 2025. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Jul 9, 2025
Correction not verified in available records
Medication handling and storageType B
- Official classification
- Type B
- Official code
- 87465(h)(6)(A-F)
- Regulation authority
- CCR
What the official deficiency says
87465 Incidental Medical and Dental Care (h)(6)(A-F) The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained for at least one year... This requirement was not met as evidenced by Based on investigation, R7 to R10, LPAs noted that each resident has medications that were not listed on the Centrally Stored Medication log. HSD stated, " I don't know " regarding the discrepancies, which poses an immediate health, safety and personal rights risk to residents in care.
Official plan of correction
Licensee states the facility will conduct additional medication administration training by 7/15/2025. Licensee will submit the Plan of Correction (POC) by POC due date 7/9/2025, and submit completion of training to the Department
Deadline recorded: Jul 15, 2025. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Jul 15, 2025
Correction not verified in available records
Complaint
Part of the complaint whose outcome is recorded on Jul 8, 2025 · Control 26-AS-20241024102358
No deficiencies recorded in this reportComplaint
Allegations0 substantiated · 1 unsubstantiated · 2 unfounded
No deficiencies recorded in this reportComplaint
Allegations0 substantiated · 5 unsubstantiated · 0 unfounded
No deficiencies recorded in this reportComplaint
Allegations0 substantiated · 4 unsubstantiated · 0 unfounded
No deficiencies recorded in this reportComplaint
Allegations1 substantiated · 0 unsubstantiated · 0 unfounded · 1 cited
Staffing, personnel, and trainingType A
- Official classification
- Type A
- Official code
- 87411(a)
- Regulation authority
- CCR
What the official deficiency says
Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. In facilities licensed for sixteen or more, sufficient support staff shall be employed to ensure provision of personal assistance and care as required in Section 87608, Postural Supports. Additional staff shall be employed as necessary to perform office work, cooking, house cleaning, laundering, and maintenance of buildings, equipment and grounds. The licensing agency may require any facility to provide additional staff whenever it determines through documentation that the needs of the particular residents, the extent of services provided, or the physical arrangements of the facility require such additional staff for the provision of adequate services. This facility was found to be deficient as evidenced by a review of the facility forms and documents revealing that a resident required more one on one care and supervision, with redirection, which posed an immediate threat to the Health, Safety, and Personal Rights of the residents in care.
Official plan of correction
The facility designated representative stated that the personnel requirements and scheduling will be updated to show that the proper level of staffing is being maintained at all times. A statement of correction, along with a copy of the most current staffing schedule for 24 hours/7 days a week coverage, will be completed and submitted into CCL by the due date.
Deadline recorded: Dec 16, 2024. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Dec 16, 2024
Correction not verified in available records
Complaint
Allegations0 substantiated · 2 unsubstantiated · 0 unfounded
No deficiencies recorded in this reportComplaint
Allegations0 substantiated · 0 unsubstantiated · 1 unfounded
No deficiencies recorded in this reportSource and limits
California Department of Social Services, Community Care Licensing Division. Public facility history is described by the source as a five-year window. Older records and previous-licensee history may require a regional-office request. Type 741 RCFE-CCRCs, nursing homes, and other care settings are excluded from this page.
Read the data methodology