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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320431
Report Date: 10/02/2026
Date Signed: 10/02/2026 02:46:35 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/10/2026 and conducted by Evaluator Socorro Leandro
COMPLAINT CONTROL NUMBER: 11-AS-20260310143052
FACILITY NAME:IVY PARK AT PALOS VERDESFACILITY NUMBER:
198320431
ADMINISTRATOR:JOE SALDANAFACILITY TYPE:
740
ADDRESS:25535 HAWTHORNE BLVD.TELEPHONE:
(310) 377-7425
CITY:TORRANCESTATE: CAZIP CODE:
90505
CAPACITY:115CENSUS: 84DATE:
10/02/2026
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Executive Director - Brenda MyersTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff are inappropriately charging residents for care
Untrained staff providing care to residents
INVESTIGATION FINDINGS:
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On 10/02/2026, Licensing Program Analyst (LPA) Socorro Leandro conducted an unannounced complaint investigation visit regarding the allegations listed above. LPA met with the Executive Director, Brenda Myers, and the purpose of the visit was explained. LPA was granted entry to the facility.

Investigation consisted of the following:

On 03/11/2026, records were gathered. On 09/18/2026, medications were reviewed alongside Medication Administration Records (MARs). On 10/02/2026, interviews were conducted and records were reviewed. Interviews consisted of Resident 2 (R2) to Resident 9 (R9) and Staff 1 (S1) to Staff 7 (S7). Records reviewed consisted of caregiver staff trainings and Resident 1’s (R1) records.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2026
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 3
Control Number 11-AS-20260310143052
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: IVY PARK AT PALOS VERDES
FACILITY NUMBER: 198320431
VISIT DATE: 10/02/2026
NARRATIVE
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Investigation revealed the following:

Allegation: “Staff are inappropriately charging residents for care”, it is being alleged that the facility is inappropriately charging residents for care services.

Interviews conducted with R2 to R9 revealed the following: 8 out of 8 residents denied the allegation, furthermore, residents indicated that they receive quality care services and/or they pay for the care services they receive.

Interviews conducted with S1 to S7 revealed the following: 7 out of 7 staff denied the allegation.

R1’s records reviewed revealed the following:

Preplacement Appraisal Information dated 12/11/2024 stated that R1 used hearing aids, mobility has taken a sharp decline, diagnosed with dementia, had three falls within the last month, required assistance with bathing and personal hygiene, had a mobility device, and was non-ambulatory.

UCLA Medical Records dated 12/15/2024 indicated that R1 had more than eighteen medications prescribed to them and had several comorbidities which included but not limited to dementia, cancer, high cholesterol, etc. Moreover, R1 had a history of mechanical falls.

Admission Agreement signed and dated 12/19/2024 indicated that R1’s “Monthly Fee includes: Fee for General Services for Resident One: $5,295” and “Fee for Care Services: $6,610.” According to the Admission Agreement R1 was at a “Level 5 (356 – 450 points) $6,610 per month.” Fees for General Services for Residents include but not limited to: Living Accommodations – apartment, utilities, furnishings, maintenance; Laundry; Housekeeping; Meals; Planned Activities; Transportation; Security, Emergency Response and Fire Protection; Assistance with Access to Outside Services; Observation and Consultation; Personal Assistance and Care; Community Fee; etc.

Resident Assessment signed and dated 12/19/2024 stated that R1’s assessment totaled at “384” billable points. Billable points included areas of assistance that R1 required such as, grooming, bathing, dressing, dietary, medications, special medications, toileting, transfer ability, escorting, fall management, assistive devices, vital signs, wandering, etc.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 11-AS-20260310143052
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: IVY PARK AT PALOS VERDES
FACILITY NUMBER: 198320431
VISIT DATE: 10/02/2026
NARRATIVE
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Diet Clarification Request dated 12/19/2024 revealed that R1 required an altered texture of “mechanical soft ground texture.”

Unsubstantiated: 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.



Allegation: “Untrained staff providing care to residents”, it is being alleged that caregivers are not trained.

Interviews conducted with R2 to R9 revealed the following: 8 out of 8 residents denied the allegation, furthermore, residents indicated that they receive quality care services.

Interviews conducted with S1 to S7 revealed the following: 7 out of 7 staff denied the allegation. (6 out of the 7 staff interviewed were caregivers).

Caregiver trainings reviewed revealed the following: S2 to S7 completed mandatory caregiver trainings, such as, resident personal rights, providing care to residents with dementia/Alzheimer’s, fall prevention, hospice services, activities of daily living, commonly used mobility devices, etc. S2 to S7 training hours range from more than 43 hours to more than 119 hours.

Unsubstantiated: 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.

An exit interview was conducted, and a copy of this report was left with the Executive Director, Brenda Myers.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3