Inspection Reports for The Ivy at Golden Gate
1601 19th Avenue San Francisco, CA 94122, CA, 94122
Back to Facility ProfileInspection Report Summary
Most inspections found no deficiencies, with the facility generally clean, well-maintained, and compliant with regulations. Several complaint investigations were unsubstantiated, including concerns about medication administration, resident care, and refunds. However, the facility was cited for failing to provide adequate supervision to a resident with dementia who eloped, as noted in the most recent complaint investigation on October 8, 2025. There was also a substantiated complaint in December 2024 regarding a delayed refund to a resident beyond the agreed timeframe. The facility’s record shows mostly compliance with isolated issues, with the latest annual inspection on August 22, 2025, reporting no deficiencies.
Deficiencies (last 3 years)
Deficiencies (over 3 years)
0.7 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
83% better than California average
California average: 4 deficiencies/yearDeficiencies per year
4
3
2
1
0
Census
Latest occupancy rate
71% occupied
Based on a October 2025 inspection.
This facility has shown a steady increase in demand based on occupancy rates.
Census over time
Inspection Report
Complaint Investigation
Census: 120
Capacity: 168
Deficiencies: 1
Oct 8, 2025
Visit Reason
An unannounced case management visit was conducted to follow up on an incident report submitted on 2025-10-03 regarding a resident who eloped from the facility without supervision.
Findings
The facility failed to provide adequate care and supervision to a resident diagnosed with Alzheimer's dementia, who was able to leave the facility unassisted. This deficiency was cited under California Code of Regulations, Title 22.
Complaint Details
The visit was triggered by a complaint incident report regarding Resident R1 eloping from the facility without assistance. The complaint was substantiated as the facility failed to provide adequate supervision.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to provide care and supervision to resident R1 diagnosed with Dementia, who eloped from the facility without supervision. | Type A |
Report Facts
Deficiencies cited: 1
Plan of Correction Due Date: Oct 9, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Yi Sam Jian | Licensing Program Analyst | Conducted the unannounced case management visit |
| Daisy Dizon | Memory Care Director | Met with Licensing Program Analyst during the visit |
| Caroline Frangieh | Regional Operations Specialist | Met with Licensing Program Analyst during the visit |
| Katherine Raukhman | Administrator/Director | Facility Administrator named in report header |
| Brenda Chan | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Annual Inspection
Capacity: 168
Deficiencies: 0
Aug 22, 2025
Visit Reason
An unannounced annual inspection visit was conducted to evaluate the facility's compliance with licensing requirements.
Findings
The facility was found to be clean, well-maintained, and compliant with all regulations. No deficiencies were cited during the inspection.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Grace Donato | Licensing Program Analyst | Conducted the unannounced annual inspection visit. |
| Chris Schuster | Regional Operations Specialist | Met with Licensing Program Analyst during the inspection. |
| Sayma Arnautovich | Director of Housekeeping | Accompanied the Licensing Program Analyst during the facility tour. |
| Katherine Raukman | Administrator/Director | Named as facility administrator/director. |
| Brenda Chan | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Complaint Investigation
Capacity: 168
Deficiencies: 0
Jun 5, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to a complaint received on 2025-03-14 alleging that a client's care needs were not being met by staff.
Findings
The investigation found that the client's wounds were pre-existing and being appropriately treated by the facility along with outside medical care. Interviews and record reviews indicated the facility was providing appropriate care and meeting resident needs. The complaint allegation was determined to be unsubstantiated with no deficiencies cited.
Complaint Details
Complaint alleged that client R1's care needs were not met by staff, with observations of poor condition. The allegation was unsubstantiated after investigation, meaning there was insufficient evidence to prove the alleged violation occurred.
Report Facts
Facility capacity: 168
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Dominic Tobola | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Alan Fox | Regional Operations Specialist | Met with Licensing Program Analyst during the investigation |
| Katherine Raukman | Administrator | Facility administrator mentioned in the report |
| April Cowan | Licensing Program Manager | Named as Licensing Program Manager overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 126
Capacity: 168
Deficiencies: 0
May 2, 2025
Visit Reason
The visit was an unannounced complaint investigation triggered by allegations received on 2025-02-12 regarding medication distribution, resident record maintenance, and communication with a resident's responsible party.
Findings
The investigation found no evidence to substantiate the allegations. Medication administration records and resident records were maintained properly, and documented communication with the responsible party was confirmed. The allegations were deemed unsubstantiated due to lack of preponderance of evidence.
Complaint Details
The complaint alleged that staff did not distribute resident's medication as prescribed, did not maintain current resident records, and failed to communicate with the responsible party regarding resident's care service. These allegations were found unsubstantiated.
Report Facts
Complaint Control Number: 14-AS-20250212155932
Capacity: 168
Census: 126
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Dominic Tobola | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Katherine Raukhman | Executive Director | Facility representative interviewed during investigation |
| April Cowan | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Complaint Investigation
Census: 126
Capacity: 168
Deficiencies: 0
May 2, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 2025-02-21 regarding medication administration and timely prescription refills at the facility.
Findings
The investigation found no corroborating evidence to support the allegations that staff did not ensure medication was dispensed as prescribed or that prescriptions were not refilled timely. Staff interviews and record reviews indicated medication was administered appropriately, and delays in physician orders were documented. The allegations were determined to be unsubstantiated.
Complaint Details
The complaint alleged staff failed to dispense medication as prescribed and did not refill prescriptions timely. The investigation included interviews with staff and review of resident medication and hospice records. The findings were unsubstantiated due to lack of sufficient evidence.
Report Facts
Facility capacity: 168
Census: 126
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Dominic Tobola | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Katherine Raukhman | Executive Director | Facility representative interviewed during investigation |
| April Cowan | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Complaint Investigation
Census: 125
Capacity: 168
Deficiencies: 0
Dec 10, 2024
Visit Reason
The inspection was an unannounced complaint investigation visit conducted to address allegations that the facility did not issue a refund to residents R1 and R2.
Findings
The investigation found that residents R1 and R2 had signed an admissions agreement effective 7/31/2024 and had voluntarily refused to move their belongings into the facility. The facility provided the appropriate pro-rated community fees refund. The complaint was determined to be unfounded with no deficiencies cited.
Complaint Details
Complaint alleged the facility did not issue a refund to residents R1 and R2. The allegation was found to be unfounded after review of admissions agreements, interviews, and documentation.
Report Facts
Facility capacity: 168
Census: 125
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Dominic Tobola | Licensing Program Analyst | Conducted the complaint investigation visit and authored the report |
| Andrea Medlin | Licensing Program Manager | Named in the report as Licensing Program Manager |
| Katherine Raukhman | Executive Director | Facility representative met during the investigation |
Inspection Report
Complaint Investigation
Census: 125
Capacity: 168
Deficiencies: 1
Dec 4, 2024
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint alleging that the facility did not issue a refund to a resident.
Findings
The complaint was substantiated as the facility had delayed refunding the monthly fees to the resident beyond the agreed 21-day period after the resident vacated and removed personal property. The level of care fees were refunded timely, but the monthly fees were not fully refunded until over two months later, violating the admissions agreement.
Complaint Details
The complaint alleged that the facility did not issue a refund to resident R1. The allegation was substantiated based on evidence that the refund of monthly fees was delayed beyond the agreed timeframe, violating the admissions agreement and state regulations.
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to refund any fees paid in advance covering the time after the resident’s personal property has been removed from the facility within 15 days as required by H&S 1569.625(c). | Type B |
Report Facts
Census: 125
Total Capacity: 168
Days delayed refund: 74
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Katherine Raukhman | Executive Director | Met with Licensing Program Analyst during the investigation and involved in findings. |
| Dominic Tobola | Licensing Program Analyst | Conducted the complaint investigation and authored the report. |
| Andrea Medlin | Licensing Program Manager | Oversaw the complaint investigation and signed the report. |
Inspection Report
Complaint Investigation
Census: 126
Capacity: 168
Deficiencies: 0
Sep 6, 2024
Visit Reason
The inspection visit was conducted as an unannounced complaint investigation following a complaint received on 2024-01-29 regarding multiple allegations about facility care and services.
Findings
The investigation found no preponderance of evidence to substantiate the allegations, including issues related to accommodations, meal service during isolation, medication administration, staff conduct, and COVID-19 room cleaning. The allegations were therefore unsubstantiated.
Complaint Details
The complaint included allegations that facility staff failed to provide safe, healthful, and comfortable accommodations; failed to provide tray service when a resident was ill; failed to provide medication according to physician's directions; failed to accord dignity in personal relationships; and did not clean and disinfect a COVID-positive resident's room. The investigation concluded these allegations were unsubstantiated.
Report Facts
Capacity: 168
Census: 126
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| John Calandra | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Katherine Raukhman | Executive Director | Facility representative met during the investigation and exit interview |
| Andrea Medlin | Licensing Program Manager | Named in the report as Licensing Program Manager |
Inspection Report
Annual Inspection
Census: 127
Capacity: 168
Deficiencies: 0
Aug 21, 2024
Visit Reason
An unannounced Annual Required – 1 year inspection was conducted to evaluate the facility's compliance with regulatory standards.
Findings
The facility was found to be clean, well-maintained, and compliant with safety and care regulations. No deficiencies were cited during the visit, and all reviewed resident and staff files, as well as medication records, were in order.
Report Facts
Residents receiving hospice services: 6
Sample file review: 10
Staff file spot check: 5
Fire extinguisher last charged date: Nov 8, 2023
Water temperature range: 105.3-114.4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Katherine Raukhman | Executive Director | Met with Licensing Program Analyst during inspection and named in report |
| Dominic Tobola | Licensing Program Analyst | Conducted the inspection |
| Andrea Medlin | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Census: 110
Capacity: 168
Deficiencies: 0
May 23, 2024
Visit Reason
An unannounced visit was conducted by Licensing Program Analyst John Calandra to deliver an immediate exclusion letter to exclude a private companion who previously worked in the facility and is not allowed to work there.
Findings
The immediate exclusion letter was delivered and reviewed with the Executive Director, Katherine Raukhman, who was advised that the excluded private companion is not allowed to work in the facility. The report was reviewed, discussed, and a copy was provided.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| John Calandra | Licensing Program Analyst | Conducted the unannounced visit and delivered the immediate exclusion letter. |
| Katherine Raukhman | Executive Director | Met with Licensing Program Analyst and received the immediate exclusion letter. |
Inspection Report
Original Licensing
Census: 105
Capacity: 168
Deficiencies: 0
Aug 2, 2023
Visit Reason
An unannounced Pre-Licensing visit was conducted to evaluate the facility for licensing approval.
Findings
The facility was found to be clean, in good repair, and in compliance with Title 22 regulations. No safety hazards were observed, and required records and postings were maintained.
Report Facts
Water temperature: 112
Water temperature: 113
Facility capacity: 168
Census: 105
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Katherine Raukhman | Executive Director | Met with Licensing Program Analyst during the inspection |
| Komal Charitra | Licensing Program Analyst | Conducted the unannounced Pre-Licensing visit |
| Cara Smith | Licensing Program Manager | Named in report signature section |
Inspection Report
Capacity: 168
Deficiencies: 0
May 5, 2023
Visit Reason
The visit was an office type evaluation involving a telephone interview with the administrator as part of a Change of Ownership (CHOW) application process.
Findings
The applicant/administrator demonstrated understanding of community care facility licensing laws, including facility operation, admission policies, staffing requirements, restrictive health conditions, and general provisions. Identification was verified and required documentation was obtained.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Katherine Raukman | Administrator | Participated in COMP II telephone interview and confirmed understanding of licensing laws. |
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