Senior Care Records.

Facility Evaluation Report

Ivy Park at San Tomas, San Jose07/17/2025Licence 435202874

Capacity82
Census27
Date signed07/17/2025 03:16:06 PM
Name of licensing program analystMarcella Tarin
Name of licensing program managerJin Jackie
The inspector’s account

Licensing Program Analyst (LPA) Marcella Tarin arrived unannounced to conduct a Plan of Correction (POC) visit for deficiencies issued on 7/8/2025. LPA met with Regional Operations Specialist Jessica Pryor. LPA stated the purpose of the visit.

On 7/8/2025, during a Complaint Investigation visit for Complaint 26-AS-20241024102358, LPAs Monter and Tarin conducted a random audit of 4 Residents medications. During audit, LPAs observed medication discrepancies for R8. A POC was developed with the facility. The POC was submitted by POC due date of 7/9/2025.

During today's visit, LPA Tarin reviewed staff medication training on 7/11/2025, to include topics such as medication administration,

A Letter of Deficiencies Citations Cleared provided during visit.

No deficiencies cited during this visit per California Code of Regulations, Title 22. An exit interview was conducted with Regional Operations Specialist Jessica Pryor and a copy of this report was provided.

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