IVY PARK AT WOOD RANCH

Official classification

Type B

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

(2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degrees C) and not more than 120 degree F (49 degrees C). This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above as four out of eight resident faucets delivered hot water between 120.6 and 128.7 degrees Fahrenheit, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/14/2026 Plan of Correction The hot water temperature was adjusted at the time of the visit. POC has been cleared.

Official classification

Type B

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above as three disenfectant bottles were observed in AL 2 unlocked and accessible to residents in care, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/14/2026 Plan of Correction The cleaning supplies were locked at the time of the visit. POC has been met.

Official classification

Type B

Official code

87468.1(a)(3)

Regulation authority

CCR

What the official deficiency says

To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination. This requirement is not met as evidenced by: Based on interviews and records review, the licensee did not comply with the section cited above, as staff intentionally placed ketchup on R1's body and personal belongings to encourage a clothing change, which posed a potential health, safety, and personal rights risk to residents in care.

Official plan of correction

Licensee representative stated that staff had been suspended and written up, then returned to work after internal investigation had completed. Additionaly Licensee rep agreed to review section cited and provide a written plan to ensure future compliance then send to LPA via email by COB POC date.

Deadline recorded: Jun 19, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(a)(4)

Regulation authority

CCR

What the official deficiency says

87465(a)(4) Incidental Medical & Dental Care. (a) A plan for incidental medical and dental care shall be developed by each facility… (4) The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Based on interviews and records review, the licensee did not comply with the section cited above, as staff continued to administer a medication to R1 that was discontinued by R1’s PCP which posed an immediate health and safety risk to residents in care.

Official plan of correction

Licensee agreed to conduct medication inservice review section cited and create a written plan to ensure future compliance then send to LPA via email by COB POC date.

Deadline recorded: Apr 10, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)(1)

Regulation authority

CCR

What the official deficiency says

A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days... and disposition of the case. This requirement was not met as evidenced by: Based on interviews and records review, the licensee did not comply with the section cited above as incident reports (LIC 624) for multiple falls for R1 were not sent to the RO in a timely manner which posed a potential health and safety risk to residents in care.

Official plan of correction

Licensee agreed to review reg cited and submit a written plan on how they will ensure future compliance then submit to CCL via email by POC date.

Deadline recorded: Apr 17, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87463(i)

Regulation authority

CCR

What the official deficiency says

When there is significant change in condition, as defined in Section 87101, Definitions, or once every 12 months, whichever occurs first...as specified in Section 87467, Resident Participation in Decision Making.This requirement was not met as evidenced by: Based on interviews and records review, the licensee did not comply with the section cited above as no updated reappraisals were observed in R1’s file after R1 experienced multiple falls, which posed a potential health and safety risk to residents in care.

Official plan of correction

Licensee agreed to review reg cited and submit a written plan on how they will ensure future compliance then submit to CCL via email by POC date.

Deadline recorded: Apr 17, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87469(c)(3)

Regulation authority

CCR

What the official deficiency says

(c) If a resident who has an advance directive and/or request regarding resuscitative measures… experiences a medical emergency… (3) Specifically for a terminally ill resident that is receiving hospice services... For emergencies not directly related to the expected course of the resident’s terminal illness, the facility staff shall immediately telephone emergency response (9-1-1). This requirement was not met as evidenced by: Based on interviews and record review, the Licensee did not comply with the above cited section in facility staff did not seek medical attention for R1 in a timely manner which poses/posed an immediate health, safety, and person rights risk to persons in care.

Official plan of correction

The Licensee will conduct an in-service training with all staff to address Hospice and CCLD procedures and will provide CCLD proof by POC due date.

Deadline recorded: Feb 13, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87464(f)(1)

Regulation authority

CCR

What the official deficiency says

(f) Basic services shall at minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement was not met as evidenced by: Based on interviews and record review, the Licensee did not comply with the above cited section in that R1 did not receive adequate care and supervision resulting in bodily injuries which poses/posed an immediate health, safety, and personal rights risk to persons in care.

Official plan of correction

The Licensee will conduct in-service training with all care staff on care and supervision as well as ensuring Appraisals are current/maintained and will provide CCLD proof by POC due date.

Deadline recorded: Feb 13, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)(1)

Regulation authority

CCR

What the official deficiency says

(a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D)… This requirement was not met as evidenced by: Based on interview and record review, the Licensee did not comply with the above cited section in CCLD and R1's family were not adequately notified of R1's incidents in a timely manner which poses/posed a potential health, safety, and personal rights risk to persons in care.

Official plan of correction

The Licensee will review reporting requirements with all Directors and submit a signed statement of understanding and provide it to CCLD by POC due date.

Deadline recorded: Feb 13, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87468.2(a)(8)

Regulation authority

CCR

What the official deficiency says

87468.2(a)(8) To be free from neglect, financial, exploitation, involuntary seclusion, punishment, humiliation, intimidation, and verbal, mental, physical, or sexual abuse. This requirement was not met as evidenced by: Based on interviews and record review the Licensee did not comply with the regulation cited above as S1 handled resident in a rough manner and caused bruising, which poses an immediate health and safety risk to residents in care.

Official plan of correction

Licensee agreed to hold a training on all Personal Rights, Mandated Reporting and Abuse for all staff, provide proof of training with staff signatures to CCL via email by COB 10/29/2024.

Deadline recorded: Oct 29, 2024. A deadline is not proof that correction was completed.