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Inspection visit

Follow-up on corrections

IVY PARK AT SIMI VALLEYLicense 5658502991 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Martha Arroyo conducted a Case Management - Deficiencies visit in conjunction with a complaint visit (Complaint Control # 29-AS-20250825094140). The purpose of the visit is to issue a citation for a deficiency observed during the initial complaint investigation. During the course of the investigation, it was revealed that Resident #1 (R1) was not feeling well and had stomach issues. Per family’s request, R1 was sent out to the hospital to be evaluated and treated. Record review revealed that a written Unusual Incident/Injury Report (LIC 624) was not submitted to Community Care Licensing (CCL) within seven (7) days of the occurrence, as required by reporting regulations, for R1’s hospital visit. The following deficiencies were observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview was conducted. A copy of the report and appeal rights were provided.

Citations

2 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.

  • 87211(a)(1)(D)Type B

    Each licensee shall furnish to the licensing agency such reports as the Department may require, including: Any incident which threatens the welfare, safety or health of any resident… This requirement has not been met as evidenced by: Based on record review, the licensee did not comply with the section cited above as the facility did not submit LIC 624 within seven (7) days of occurrence for R1’s hospital visit, which poses a potential health and safety risk to residents in care.

  • 87468.1(a)(1Type B

    Residents shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. (3) To be free from abuse or other actions of a punitive nature. This requirement has not been met as evidenced by: Based on the investigation, the Licensee did not comply with the section cited above as R2 was observed speaking inappropriately to R1 on several occasions, which poses a potential health, safety, and/or personal rights risks to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the January 23, 2026 inspection of IVY PARK AT SIMI VALLEY?

This was a other inspection of IVY PARK AT SIMI VALLEY on January 23, 2026. 1 citation were issued: 1 Type B.

Were any citations issued to IVY PARK AT SIMI VALLEY on January 23, 2026?

Yes, 1 citation was issued (0 Type A, 1 Type B). The first citation was for: "Each licensee shall furnish to the licensing agency such reports as the Department may require, including: Any incident ..."

What type of inspection was this?

This was a 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.