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Inspection visit

Routine inspection

IVY PARK AT SAN JUAN CAPISTRANOLicense 3060062031 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

On 12/7/2024, Licensing Program Analyst (LPA) Alfonso Iniguez conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with David Alvarado /Executive Director. LPA explained the purpose of today’s visit. The facility is licensed to serve (120) elderly adults ages 60 and above, of which (120) can be non-ambulatory and (4) Bed-ridden. The facility has an approved hospice waiver for (15). The facility is a two-story building with 54 resident rooms on the first floor and 43 resident rooms on the second floor. The first floor has two large living rooms, dining room, activity room and an outdoor garden courtyard with a fountain. The fountain is raised and does not present a hazard to residents. Outside of the dining room there is an outdoor promenade with tables and chairs for residents to sit outside. LPA Iniguez and the Executive Director toured the physical plant. LPA inspected a total of (6) bedrooms and (6) bathrooms. The beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the residents’ personal belongings was observed. The bathrooms were found to be within Title 22 regulations and were operational. Smoke and carbon monoxide detectors were in operable condition. The water temperature ranged from 115.5°F to 116.2°F, and the room temperature ranged from 76°F to 78°F. The evaluation Report continues on the next page, LIC 809-C , providing further details of the inspection findings. During the visit, LPA Iniguez observed that the facility was clean, sanitary, and appropriately furnished. Storage areas for personal hygiene were in place. The kitchen was inspected, and there was sufficient perishable and non-perishable food available, which was adequately maintained. All fire extinguishers were charged and operable. The last Fire/Disaster Drills were conducted on 10/22/24. A review of (5) residents' service files and (4) staff personnel files was done. LPA reviewed (3) Medication Administration Records (MARs) and found no discrepancies. LPA observed the facility's infection control practices. All mandated inspection control posters were displayed throughout the facility. A copy of liability insurance was given to LPA . Facility Annual Fees are not current since 11/30/24. LPA Iniguez provided current amount balance to administrator and PIN number. Per ED payment was sent to CCLD on 10/26/24. Deficiency cited under California Code of Regulations, Title 22, Division 6, Chapter 8. See details below: -See D page for details. Note: *Citations not cleared by the due date will be a $100 fine assessed for each citation until it is cleared. Civil penalties will continue to accrue until Proof of Corrections (POC) is cleared. * An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to David Alvarado / Executive Director.

Citations

1 citation recorded*CCLD

What does Type A vs Type B mean?

Type A. Serious citation. Imminent or substantial risk to children. The regulator requires corrective action immediately and may impose a civil penalty.

Type B. Lower-severity citation. Corrective action required, no imminent risk. The regulator monitors compliance on the next visit.

  • 87412(a)(13)(B)Type A

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in not having a criminal record clearance on file for 4 staff members which poses an immediate health, safety or personal rights risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the December 7, 2024 inspection of IVY PARK AT SAN JUAN CAPISTRANO?

This was a inspection inspection of IVY PARK AT SAN JUAN CAPISTRANO on December 7, 2024. 1 citation were issued: 1 Type A (serious).

Were any citations issued to IVY PARK AT SAN JUAN CAPISTRANO on December 7, 2024?

Yes, 1 citation was issued (1 Type A, 0 Type B). The first citation was for: "Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in not ha..."

What type of inspection was this?

This was a inspection inspection. inspection inspections are conducted by CCLD as part of their licensing oversight.

SourceView on CCLDView original report

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Data from CCLD public records. Last updated . If you believe any information is inaccurate, report it here.