435202744-8-6-2026-26-AS-RMAO-DXJ7F6-20260901213658

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435202744
Report Date: 08/06/2026
Date Signed: 08/06/2026 03:59:02 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
03/10/2026 and conducted by Evaluator Manuel Monter

COMPLAINT CONTROL NUMBER: 26-AS-20260310091638

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:	08/06/2026
		UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Administrator Meghian Geul		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Resident sustained multiple falls and bruises due to staff neglect

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 March 10, 2026, the Department received a complaint alleging Resident sustained multiple falls and bruises due to staff neglect.

On March 18, 2026, Licensing Program Analyst Steve Chang Interviewed Administrator Meghian Geul, referred to as ADM. ADM stated on 3/9/26, at 8:00AM, staff S6 went to R1's room to get R1's breakfast order and found R1 on the floor of the bathroom. ADM stated R1 was trying to get shower and fell. The S6, contacted staff S1, who checked R1 and called 911 immediately. Emergency services arrived and R1 was sent to hospital. ADM stated the incident is an unwitnessed fall.

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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 26-AS-20260310091638

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: 08/06/2026

NARRATIVE

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ADM stated facility cannot 100% prevent residents fall. ADM stated R1 is independent, with only escort care, wherein staff escort R1 to go to dining room and activity room, and escort R1 to return to his/her room. ADM stated R1 can walk inside his/her room.

On March 18, 2026, LPA Steve Chang interviewed Staff S1-S5. S1 stated on 3/9/2026, at 8:00AM, S6 called him/her because R1 was found on the floor in the bathroom. S1 stated S6 was taking R1’s breakfast order to R1’s room and R1 was on the floor in the bathroom. S1 stated she went to R1's bedroom and observed R1’s left foot was bleeding. S1 stated he/she was trying to stop R1's bleeding and asked his/her coworker to call 911. S1 stated emergency responders came in about 3 minutes and R1 was sent to regional hospital.

S2 stated R1 has standby assist for dressing and escort care. Staff S3 stated R1’s care was only escort care with some assistance with dressing. S3 stated R1 did not need assistance with showers or toileting. Staff S4 stated R1 is independent and is only on escort care. S5 stated he/she heard the incident is that R1 wanted to take a shower and slipped/fell at the bathroom. S4 stated R1 does not need assistance to transfer to and from bed. S5 stated R1 is not on status check care.

On May 22, 2026, Licensing Program Analyst Manuel Monter and Steve Chang interviewed residents R2-R5. 4 Out of 4 Residents (R2-R5) stated they do not know R1. 4 Out of 4 Residents (R2-R5) stated they are not aware of any instance where a resident’s escorting or transferring needs were neglected.

On May 22, 2026, Licensing Program Analysts Manuel Monter and Steve Chang interviewed staff members S7 through S11. S7 stated he/she does not remember how many falls R1 experienced. S7 and S8 reported that R1 is independent and does not require assistance with walking, escorting, or transfers. S8 stated that R1 has had three falls in the facility. S9 also reported that R1 sustained three falls, noting that the most recent fall resulted in R1 being sent to the hospital. S9 stated that R1 is independent and does not need assistance with walking, escorting, or transfers. S10 and S11 stated they do not know R1 and have not worked with R1.

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SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2026

LIC9099 (FAS) - (06/04)

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Control Number 26-AS-20260310091638

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: 08/06/2026

NARRATIVE

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On July 23, 2026, Licensing Program Analyst Manuel Monter interviewed R1. R1 stated he/she remembers faintly the fall he/she had back in March 2026. R1 stated that day he/she was walking near his/her bathroom when he/she tripped and fell. R1 stated he/she was rushing to answer his/her phone. R1 stated he/she didn’t press his/her pendant before he/she fell. R1 stated he/she didn’t think he/she needed help or predict that he/she would need the help. R1 stated prior to his/her fall in March 2026, the facility wouldn’t check on him, unless he/she pressed his/her pendant.

The Department Reviewed resident R1’s Progress Notes.
Progress Note Dated November 22, 2025: at 5:15pm, care giver called the medtech, noting that R1 had fallen. R1 had slipped on the floor and hit his/her buttocks. R1 denied hitting his/her head.

Progress Note Dated December 14, 2025: at 4:30pm, R1 pushed his/her pendant and the care giver found R1 sitting on his/her buttocks, in his/her apartment closest. R1 claims he did not hit his/her head and did not have pain.

Progress Note Dated December 16, 2025: Per R1, he/she stated he/she had a fall last night at 4:00am. R1 denies hitting his/her head and pain. R1 appeared confused and stated that his/her belongings are missing.

Progress Note Dated December 20, 2025: At 2:49am, R1 reported to care giver that he/she had a fall besides his/her chair. R1 was assisted back to his/her chair. No complaints of pain or discomfort. Staff noted skin tear about 2 inches wide on his/her right elbow. Cleaned wound and applied bandage.

Progress Note Dated December 23, 2025: At 10:27am, Care giver called for help, because he/she found R1 sitting on the floor. R1 denied hitting his/her head. Staff observed old skin tear on his/her right elbow bleeding.

Progress Note Dated January 31, 2026: Around 9:20pm, R1’s Family member called asking to help R1. Staff went to R1’s room to check on R1. R1 stated he/she had lost his/her balance and fell on the floor. R1 denies hitting his/her head. Staff noticed bruise on his/her left arm. R1 stated he/she had it for a long time, refused to call 911.

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SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2026

LIC9099 (FAS) - (06/04)

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Control Number 26-AS-20260310091638

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: 08/06/2026

NARRATIVE

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Progress Note Dated February 24, 2026: at 11:20am, R1 was found lying on the floor. R1 stated that he/she had a fall while reaching his/her computer table. R1 denied hitting his/her head. R1 refused to call 911 and to be sent out to the hospital.

Progress Note Dated March 9, 2026, states: at 8:30am, R1 was found lying on the floor in the bathroom, with visible bleeding. Resident was responsive but noted to have active bleeding from injury site (Left foot.) 911 was contacted.

The Department reviewed R1’s Physician’s Report, dated March 8, 2025. R1 has auditory and visual impairment. R1 is non ambulatory and uses a walker. R1 is able to bath, dress him/herself. R1 is able to care for his/her own toileting needs. R1 is able to store and administer his/her own medications.

The Department reviewed R1’s Service Plan, dated November 21, 2025. Based on a review, the service plan states R1 requires assistance with dressing in the morning, before breakfast daily. R1 requires escorting and or physical assistance to attend meals and or activities. R1 is at moderate risk for falling. Facility staff is to monitor for the use of glasses. Place pendant within reach of resident. Monitor and report changes in ambulation. The care team will monitor for changes in condition and conduct a reappraisal as appropriate.

Based on investigation, records reviewed, and interviews conducted, R1 was generally independent with his/her ADLs with limited assistance; however, R1 had mobility limitations and was identified as being at risk for falls which resulted R1 sustaining injuries from falls. The Department was unable to establish whether the alleged neglect due to lack of care and supervision did nor did not contribute to R1’s injuries. 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: 08/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2026

LIC9099 (FAS) - (06/04)

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