435202744-8-26-2026-26-AS-RMAO-DXZNZU-20260917105455

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435202744
Report Date: 08/26/2026
Date Signed: 08/26/2026 04:49:17 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
07/30/2026 and conducted by Evaluator Manuel Monter

COMPLAINT CONTROL NUMBER: 26-AS-20260730160400

FACILITY NAME:	IVY PARK AT MILPITAS		FACILITY NUMBER:	435202744
ADMINISTRATOR:	MEGHIAN GEUL		FACILITY TYPE:	740
ADDRESS:	80 CEDAR WAY		TELEPHONE:	(408) 770-9575
CITY:	MILPITAS	STATE: CA	ZIP CODE:	95035
CAPACITY:	225	CENSUS:	DATE:	08/26/2026
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Administrator Meghian Geul		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Staff are mismanaging resident's medication

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced complaint inspection to deliver the findings on the above allegation. LPA met with Administrator Meghian Geul

On July 30, 2026, the Department received a complaint alleging Staff are mismanaging resident 's medication. Its been alleged the facility received 30 medication tablets of medication M1 on July 7, 2026, and the facility had ran out of Medication M1 on July 26, 2026.

On July 31, 2026, Licensing Program Analyst Manuel Monter interviewed Resident Care Coordinator, Shristi Pasad, referred to as RCC. RCC described the facility’s protocol for receiving medications. RCC stated that when medications arrive, staff centrally log them, check that the medications are correct, by cross referencing the doctors orders and ensuring they are the correct medication for the correct resident, and endorse the information to the next shift. Page 1 Out of 4.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2026

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 4

Control Number 26-AS-20260730160400

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 MILPITAS	FACILITY NUMBER: 435202744
	VISIT DATE: 08/26/2026

NARRATIVE

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RCC stated staff count the medications, confirm the order is present, and verify that the order matches the medication received. RCC stated that if the medications received differ from the order, the facility has 48 hours to have the pharmacy correct the issue.

On August 6, 2026, Licensing Program Analyst Manuel Monter interviewed Administrator Meghian Geul. ADM stated it’s the facility’s policy when receiving medications, that the medtech or other qualified staff member, needs to log said medication on the Centrally stored medication record check that the medications are correct, by cross referencing the doctors orders. ADM stated that staff member also needs to count the medication and verify that the order matches the medication received. ADM stated if a discrepancy is noted, they need to notify their supervisor.

On August 6, 2026, Licensing Program Analyst Manuel Monter interviewed Health Services Director Cathy Lourdes Platon, referred to as HSD. HSD stated the facility policy regarding receiving medications is as follows. HSD stated staff are supposed to read over the medication order. If it’s a narcotic, they count how many medications tablets it contains. HSD stated then its entered on the narcotics log and the Centrally stored medication record.

LPA asked HSD that if the facility receives a medication from the pharmacy and it is observed that the number of medication tablets inside the container does not match the tablet count indicated on the medication label, what steps staff are supposed to take in that situation. HSD stated staff are supposed to report it to the supervisor or to HSD if there is a discrepancy in the count. HSD stated this discrepancy, for resident R1's M1 was not reported to her.

HSD stated they only found out about this discrepancy on July 24th when it was observed there was only 2 medication tablets left. HSD stated when it was discovered, they immediately tried to refill, but the pharmacy had stated it was too early and that they had delivered 30 tablets. HSD stated they also contacted the doctors office as well, but the doctor didn’t initially approve the replacement for 10 tablets. HSD stated she got in contact again with resident R1’s Doctor on July 27, 2026, and informed them that 10 additional tablets were needed. HSD stated they R1’s medication M1 arrived Friday July 31, 2026.

Page 2 Out of 4.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 26-AS-20260730160400

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 MILPITAS	FACILITY NUMBER: 435202744
	VISIT DATE: 08/26/2026

NARRATIVE

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On August 11, 2026, Licensing Program Analyst Manuel Monter interviewed Witness W1. W1 stated on July 7, 2026, the pharmacy filled 30 tablets of medication M1. W1 stated on July 23, 2026, the facility called the pharmacy stating they only received 20 tablets and they needed an additional 10 tablets. W1 stated the facility still had several medication tablets to administer at the time of the call. W1 stated the facility got a new prescription for the additional 10 medication tablets on July 28, 2026.

The Department reviewed R1’s Centrally Stored Medication Record (CSMR). The CSMR indicates that Medication M1, with a fill date of July 6, 2026, also has a strength of 0.25 mg and contains 20 tablets. The instructions for this supply state: take 1 tablet and allow it to dissolve every night at bedtime.

The Department Reviewed FAX Communication regarding R1’s Medication Orders. The fax communication states, Medication M1’s order was last written on June 15 , 2026. With 2 refills noted, and 30 tablets.

The Department reviewed Resident R1’s Controlled Drug Administration Record, which states the amount of tablets received for Medication M1, is 20 tablets on July 7, 2026.

The Department Reviewed Resident R1’s medication M1 label, which has a fill date of July 6, 2026 and a tablet count of 30.

The Department reviewed an email communication from Health Services Director Cathy Platon date July 27, 2026, which stated the following, "During preparation for resident R1's M1’s refill, we identified a discrepancy between the quantity documented as received and the quantity dispensed by the pharmacy. The pharmacy label indicates that 30 tablets were dispensed; however, the initial narcotic inventory entry reflects receipt of 20 tablets. This discrepancy was not identified at the time the medication was received and was only discovered when the current supply was exhausted and a refill was needed. The R1's last available dose was administered yesterday. Upon discovering the discrepancy, we contacted the Pharmacy and the prescribing provider to request an interim supply of 10 tablets"

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SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2026

LIC9099 (FAS) - (06/04)

Page: 4 of 4

Control Number 26-AS-20260730160400

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 MILPITAS	FACILITY NUMBER: 435202744
	VISIT DATE: 08/26/2026

NARRATIVE

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Based on investigation and interviews conducted, resident R1’s medication M1 was noted to contain 20 tablets, which conflicted with what the medication M1’s label noted, which was 30 tablets. RCC, HSD and ADM stated its Ivy Park Milpitas protocol when medications arrive, that staff is supposed to log the medications on the Centrally Stored Log, count the medications and ensure it matches with the doctors order. RCC, HSD and ADM stated discrepancies must be brought to the attention of the supervisor or HSD.

Although it is a fact that the facility staff did not respond to the discrepancy noted in a timely manner, the facility’s program does not explicitly state that the facility will count medication tablets when a new medication is received. Furthermore, under title 22, there is no specific regulation that requires the facility to count medication as it arrives. Based on investigation, once the discrepancy was noted, HSD contacted R1’s Doctor and Pharmacy on July 24, 2026.

Therefore, the Department found that the above allegation is UNSUBSTANTIATED. An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegations did or did not occur.

Exit interview was conducted with Administrator, Meghian Geul and a copy of the report was provided.

Page 4 Out of 4. End of Report.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2026

LIC9099 (FAS) - (06/04)

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