Senior Care Records.

Facility Evaluation Report

Ivy Park at Wood Ranch, Simi Valley09/05/2024Licence 565850424

Capacity100
Census77
Date signed09/05/2024 02:10:22 PM
The inspector’s account

Licensing Program Analyst (LPA) Brian Balisi conducted an unannounced Case Management – Incident visit at 12:30 p.m. for the purpose of investigating self reported incident reports. Upon arrival, LPA met Interim Executive Director Kathleen Olson and explained the reason for the visit.

On 08/23/2024, the Department received an incident reports stating on 08/15/2024 at approx 8am, Staff #1 (S1) was observed to be handling Resident #1(R1) in a firm manner while R1 attempted to swing their arms in an agitated manner, resulting in discoloration / bruising on R1's forearms. R1 did not indicate any discomfort or additional injuries.

At approx 12:30pm, LPA conducted physical plant interviewed staff and reviewed and obtained copies of pertinent documentation relevant to the investigation. LPA has determine further investigation is needed and will return at a later date to complete the investigation if warranted.

Exit interview conducted. A copy of the report was issued.

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