Senior Care Records.

Facility Evaluation Report

Ivy Park at San Jose, San Jose06/17/2022Licence 435202847

Capacity140
Census98
Date signed06/17/2022 03:28:43 PM
The inspector’s account

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced Case Management visit ,and met with Memory Care Director (MCD) Jayden Bettencourt.

On 6/3/2022, the Department received an Unusual Incident Report from facility regarding a resident (R1) eloped from facility. The Department conducted an interview on 6/3/2022 and requested the resident's physician report.

On 6/6/2022, the Department received resident's physician report.

Based on the record reviewed on 6/6/2022, and the interview conducted on 6/3/2022, the resident is not allowed to leave unassisted.

A deficiency was cited today. See LIC809-D. Exit interview was conducted with MCD This report and LIC809-D were provided to MCD for record.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction