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Inspection visit

Follow-up on corrections

IVY PARK AT SAN TOMASLicense 4352028741 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Marcella Tarin conducted an unannounced Case Management to address a deficiency observed during complaint 26-AS-20250411110434. LPA met with Executive Director (ED) Karen Nickolai. LPA stated the purpose of the visit. On 1/22/2026, 1/27/2026, 3/6/2026, 4/2/2026 and 4/9/2026 the Department requested via email additional documentation for a resident, referred to as R1, from Executive Director (ED) Karen Nickolai. LPA Tarin spoke with ED via phone call on 4/3/2026 and 4/9/2026. ED stated R1 was a resident ‘before her time’ and R1’s documentation was not at the facility, and possibly off-site in storage. On 4/22/2026, ED states she was unable to locate documentation for R1 in storage. A deficiency is being cited per California Code of Regulations, Title 22. See LIC809D for more information. An exit interview was conducted with ED, a copy of this report and appeal rights were provided.

Citations

3 citations 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.

  • 87506(e)87506(e)Type B

    87506 Resident Records (e) Original records or photographic reproductions shall be retained for a minimum of three (3) years following termination of service to the resident.This was not met as evidenced by: Based on interview and records reviews, on 1/22/2026, 1/27/2026, 3/6/2026, 4/2/2026 and 4/9/2026 the Department requested additional documentation for R1 from Executive Director (ED) Karen Nickolai. On 4/22/2026 the ED stated she is unable to locate R1s documentation in storage.

  • 87465(h)(6)(A-F)Type B
  • 87211(a)(1)(D)Type B

FAQ · About this visit

Common questions about this visit

What happened during the April 22, 2026 inspection of IVY PARK AT SAN TOMAS?

This was an other inspection of IVY PARK AT SAN TOMAS on April 22, 2026. 1 citation were issued: 1 Type B.

Were any citations issued to IVY PARK AT SAN TOMAS on April 22, 2026?

Yes, 1 citation was issued (0 Type A, 1 Type B). The first citation was for: "87506 Resident Records (e) Original records or photographic reproductions shall be retained for a minimum of three (3) y..."

What type of inspection was this?

This was an other inspection. other 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.