Vista Terrace of Belmont

On January 28, 2026, Licensing Program Analyst (LPA) Komal Curley conducted an unannounced case management visit in relation to an incident that occurred on 1/19/26. LPA met with Administrator, Jim Sidoti and explained the purpose of the visit. The Licensee reported on 1/19/26, the concierge reported an alleged theft of $40.00 cash from Resident 1's (R1's) purse located in R1's room. R1 stated that he/she saw the housekeeper (S1) take the money out of his/her purse. R1 confirmed it was $40. Police department, ombudsman, and R1's responsible party was notified. During the visit, LPA discussed the incident with the administrator and business office manager and obtained S1's personnel records. According to Administrator, S1 is an agency staff who has only worked at the facility once. Administrator indicated when he was on his way to the facility to have a conversation with S1 regarding the incident, S1 clocked out and left. The agency was notified about the incident. Records reviewed showed that S1 is fingerprint cleared. LPA was unable to interview R1 during the visit as R1 was out of the community. No citations are being issued during the visit today. Further investigation is required. Report is reviewed with administrator and a copy is provided.

On December 4, 2025, Licensing Program Analyst (LPA) Komal Curley conducted an unannounced case management visit in relation to an incident that occurred on 11/26/25. LPA met with Administrator, Jim Sidoti and explained the purpose of the visit. The Licensee reported on 11/26/25, Resident 1 (R1) and R1's responsible party reported to the administrator that there were items missing from R1's room. Belmont Police Department and LTCO was notified. During the visit today, LPA reviewed R1's file and interviewed R1. According to R1, he/she wanted to wear his/her earrings for Thanksgiving, however when R1's responsible party went to get them, R1's responsible party observed all of R1's jewelry missing. R1 remembers talking to a staff member and showing a staff member the jewelry, however does not remember when and who it was. R1 indicated he/she did not notify staff about bringing his/her jewelry into the facility. Based on R1's personal property and valuables log signed by R1's daughter, R1 declined to record any items on the log. No citations are issued during the visit. Report is reviewed with Administrator and a copy is provided.

On November 13, 2025, Licensing Program Analyst (LPA) Komal Curley conducted an unannounced case-management visit. LPA met with Administrator, Jim Sidoti and explained the purpose of the visit. The purpose of today's visit is to deliver an immediate exclusion letter to exclude a Staff 1 (S1) from the facility. The letter was given to the Administrator. This report is reviewed and discussed with the Administrator and a copy is provided.

On November 13, 2025, Licensing Program Analyst (LPA) Komal Curley conducted an unannounced case management visit in relation to an incident that occurred on 11/4/25. LPA met with Administrator, Jim Sidoti and explained the purpose of the visit. The Licensee reported on, 11/4/25 at 7:45pm, Resident 1 (R1) eloped from the facility. According to the Licensee, prior to the elopement, R1 became verbally and physically aggressive towards his/her one-on-one caregiver, instructing the caregiver not to enter his/her room. The one-on-one caregiver left R1's room, leaving R1 alone. R1 then exited the facility without authorization. Police department was immediately notified. R1 was located on the street in front of the community and was escorted back to the facility. During the visit, LPA interviewed the administrator, staff and reviewed R1's file. According to staff interviewed, R1 left through the third floor exit doors and was found outside around the bushes by the first floor entrance. According to staff interviewed, at around 8:15pm, the one-on-one caregiver noticed R1 was not in his/her room and notified the med-tech on shift. Based on file reviewed, R1 has a Parkinson's Disease, is unable to leave the facility unsupervised, has unsafe wandering behaviors, and is at risk for elopement, therefore, the facility worked with the family and the family decided to hire a private caregiver through a third party agency. According to Health and Wellness Director, when a private caregiver starts working with residents at the facility, the Health and Wellness provide orientation and let the private caregivers know that if there is an incident that occurs while assisting a resident, to notify the med-tech on shift. According to the staff interviewed, the one-on-one caregiver did not endorse or notify the facility med-tech that R1 and the caregiver got into an argument and was not with R1 until the one-on-one caregiver noticed R1 was missing. No citations are issued during the visit. Report is reviewed with Administrator and a copy is provided.

On November 4, 2025, Licensing Program Analyst (LPA) Komal Curley conducted an unannounced case-management visit. LPA met withMaintenance Director, Alan Harris and explained the purpose of the visit. The purpose of today's visit is to deliver an immediate exclusion letter to exclude a Staff 1 (S1) from the facility. The letter was given to the Maintenance Director. This report is reviewed and discussed with the Maintenance Director and a copy is provided.

On May 6, 2025, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual inspection. LPA met with Administrator, Jose Acumabig and explained the purpose of the visit. LPA toured the facility inside and outside including but not limited to; a random sample of resident rooms, communal bathrooms, activity room, common areas & kitchen. The indoor and outdoor passageways were free of obstruction. No accessible bodies of water of fire safety hazards observed. This is a three story facility. LPA toured main dining room and kitchen on the first floor. LPA observed 2 days perishables and 7 days non-perishables. LPA observed medication room on the first floor to be locked and inaccessible to residents. Communal bathrooms on the first floor were clean and in good repair. Communal areas and activity rooms were observed clean and free from tripping hazards. All resident rooms have a full bathroom. According to the administrator, residents bring their own furniture and linens. There is a laundry room on each floor, no chemicals were observed. Chemicals, medications, and sharps were locked and inaccessible to residents. Hot water temperature throughout the facility was within regulatory requirements. Carbon monoxide detectors are working properly. All fire extinguishers were observed to be charged. Emergency drills are logged and done quarterly. Temperature throughout the facility is comfortable and lighting is sufficient for comfort. LPA reviewed 5 resident records and 5 staff records. Resident records are updated, complete and signed. Staff records are complete, with training logs that have met the basic requirement. Medication review was done, and all medications are accounted for, and centrally stored medication records are updated. No citations are issued during this visit. Report is reviewed with the administrator and a copy is provided.

During the investigation, LPA interviewed residents and toured the dining. The dining room temperature was observed to be at 74 degrees F. LPA interviewed 5 residents, according to 4/5 residents interviewed, all 4 residents indicated that the dining room was at a comfortable temperature and they felt warm. Based on observations and interviews conducted, the department has determined that although the above allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED. Report is reviewed with Administrator and a copy is provided.

On March 19, 2024, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual inspection. LPA met with Administrator, Kaitlyn Clarey and explained the purpose of the visit. LPA toured the facility inside and outside including but not limited to; resident rooms, communal bathroom, common areas & kitchen. The indoor and outdoor passageways were free of obstruction. No accessible bodies of water of fire safety hazards observed. This is a three story facility. LPA toured main dining room and kitchen on the first floor. Residents were observed eating lunch. LPA observed 2 days perishables and 7 days non-perishables. LPA observed medication room to be locked and inaccessible to residents. Communal bathrooms on the first floor were clean and in good repair. Communal area on the third floor was observed clean and free from tripping hazards. Chemicals, medications, and sharps were locked and inaccessible to residents. Hot water temperature throughout the facility was between 113-115 degrees. Carbon monoxide detectors are working properly. All fire extinguishers have been checked and current as of October 2023. Emergency drills are logged and done monthly. Extra linen and first aid kit was observed present. Temperature throughout the facility is comfortable and lighting is sufficient for comfort. LPA reviewed 5 resident records and 5 staff records. Resident records are updated, complete and signed. Staff records are complete, with training logs that have met the basic requirement. Medication review was done, and all medications are accounted for, and centrally stored medication records are updated. No citations are issued during the visit. Report is reviewed with the administrator and a copy is provided.

On January 4, 2024, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced health and safety check. LPA met with Interim Administrator, Kaitlyn Clarey and explained the purpose of the visit. During the visit, LPA observed two residents in the dining room eating lunch, one resident unpacking their belongings in his/her room. LPA observed 7-day non-perishable and 2-day perishable. According to Kaitlyn, there is one resident who requires assistance with medication. Medications were observed locked and inaccessible to residents. Residents interviewed indicated they were content to be back. A total of 5 residents have returned back to the facility, a few more residents are to return this weekend, and will continue till next week. No citations are issued during the visit. Report is reviewed with Kaitlyn and a copy is provided.

On December 6, 2023, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced case-management visit to follow up on a visit conducted on 11/28/2023. LPA met with Maintenance Director, German Briones and explained the purpose of the visit. LPA also spoke to Administrator, Dave Peper via phone and explained the purpose of the visit. On 11/28/2023, LPA Charitra conducted a health and safety visit as a result of facility being closed since April 2023 due to electrical disrepair. During the visit, LPA toured the facility to ensure facility is ready, safe, and comfortable for residents to move back. LPA observed the facility's water temperature to be fluctuating throughout the facility; not within regulatory requirements. In addition, LPA observed the faucet in the beauty salon to be leaking and in disrepair. On 12/6/2023, LPA made a follow up visit to ensure water temperature was within regulatory requirements and to ensure the leaking faucet in the beauty salon was fixed. During the visit today, LPA checked water temperature in 9 resident apartments (3 apartments per floor), 2 communal bathrooms, and the beauty salon. Water temperature measured between 105-120 degrees F. LPA observed faucet in the beauty salon to be repaired and in good working condition. No deficiencies are cited during the visit. LPA reviewed report with Maintenance Director and a copy is provided.

On November 28, 2023, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced case-management health and safety visit at the facility as a result of facility being closed since April 2023 due to electrical disrepair. LPA met with Administrator, Joan Johnson, Regional Vice President of Operation with Integral Senior Living, Debi Witt, Vice President of Operation with Cogir Management, Dave Peper and Executive Vice President of with American Health Care, Ray Oborn. LPA toured the facility inside and outside including all three of the facility floors, resident rooms, common areas & kitchen. The indoor and outdoor passageways were free of obstruction. No residents were present at the facility due to facility closure. While touring the facility it was observed that the room temperature was at 71F. Hot water throughout the facility measured between 121-125 degrees F. Carbon monoxide monitor is working properly. All fire extinguishers have been checked and current as of October 2023. Resident apartments and bathrooms were observed to be in good repair, bathrooms equipped with grab bars and non-skid mats. Due to the emergency relocation, most residents took their personal belongings to the facilities they've been relocated to. Beauty salon faucet was observed to be leaking and in disrepair. 7-day non-perishable was present, however 2-day perishables was not present as facility is still closed. Facility will purchase 2-day perishables the day before facility reopens and provide LPA a photo of receipt of perishables purchased. Medication room and medication cabinet were both observed to be locked. Required postings were observed to be present on the 1st floor. Facility is overall clean, however LPA to make a follow up visit to ensure facility water temperature is within regulatory requirements and faucet in the beauty salon has been repaired. Report is reviewed with Administrator, Joan Johnson and Regional Vice President of Operation, Debi Witt.

Regarding the allegation that staff are discriminating against resident, according to the reporting party, Resident 1 (R1) is being discriminated against for standing up and eating and was told she can’t be in there if he/she is standing. During the investigation, LPA interviewed staff. Administrator denied this allegation and indicated that no staff has told R1 that he/she can't eat in the dining room if he/she is standing. Based on staff interviews, residents addressed to administrator that they were uncomfortable eating because R1 would be standing and eating in the dining room with his/her back towards residents, and would wear a garbage bag. Regarding the allegation that staff did not ensure resident's room was free of pests, according to the reporting party, the facility failed to ensure pests/flies were not in Resident 1's (R1's) room as R1 has OCD and is germaphobic. During the investigation, LPA was unable to tour and observe R1's room due to facility closure, however LPA interviewed staff. According to 3/3 staff interviewed, R1 has OCD, is germaphobic and hoards items in his/her room. Staff interviewed indicated that R1 would not allow any staff to come into his/her room, including housekeepers due to his/her phobias. In addition, according to interviewed staff, when R1 addressed the flies/pests issue to management, ECO-Lab was notified immediately and they came on a regular basis to inspect the facility. Due to R1's phobias, R1 did not let anyone in his/her apartment to inspect or treat the alleged pests. Based on the interviews conducted, record review, and information collected, the allegations above are UNSUBSTANTIATED, meaning that although the allegation may have happened or is valid, there is no preponderance of evidence to prove that the alleged violation occurred. Report is reviewed with Administrator, Joan Johnson and a copy is provided.

Regarding the allegation, facility failed to notify family members of emergency situation and relocation, according to the reporting party, the facility did not notify the family members about the power outage when it occurred and the facility did not notify family members about the relocation in a timely manner. During the investigation, LPA interviewed the Administrator, Resident Care Director, and family members. Both the administrator and resident care director denied this allegation and indicated that as soon as they found out about the relocation, both the administrator and the Resident Care Director started calling family members to notify them of the relocation. According to 4/4 of the families interviewed, the facility notified them immediately after being aware of the relocation. Regarding the allegation, facility failed to have an adequate emergency preparedness plan, according to the reporting party, the facility did not have a sufficient amount of lanterns and they administrator had to go out and buy lanterns. During the investigation, LPA interviewed the administrator, resident care director and reviewed facility's emergency preparedness plan. The administrator and resident care director denied this allegation and indicated that the facility had an emergency disaster plan that was kept and adhered to. In addition, it was stated that there were a sufficient amount of lanterns and flashlights for residents, however additional lanterns were purchased to provide residents with additional lighting. Families interviewed indicated that facility tried to ensure residents received necessary supplies to be comfortable at the facility during the power outage. Therefore, based on the interviews conducted and information collected, the allegations above are UNSUBSTANTIATED, meaning that although the allegation may have happened or is valid, there is no preponderance of evidence to prove that the alleged violation occurred. Report is reviewed with Resident Care Director and a copy is provided.

On May 11, 2023, San Bruno Regional Office conducted a Microsoft Teams meeting with Integral Senior Living (ISL) Management along with the Santa Rosa and Oakland Regional Office. During this meeting, ISL discussed the status of the electrical issues, options that will be provided to families and residents due to the delay in reopening, how to coordinate and track residents if they plan to move to other communities or need belongings from Vista Terrace of Belmont. Present in this meeting was Assistant Program Administrator, Stacy Barlow, Regional Manager, Vivien Helbling, Licensing Program Manager, Cara Smith, Licensing Program Analyst, Komal Charitra from the San Bruno Regional Office, Regional Manager, Issac Taggart, Licensing Program Manager, Yvonne Flores from the Oakland Regional Office, Licensing Program Manager, Bethany Moellers from the Santa Rosa Regional Office, and San Mateo Long Term Care Ombudsman, Tom Barrett. In addition, present in this meeting from ISL was Senior VP of Operations, Mike Zeug, Senior VP of Sales/Marketing, Jeffrey Smith, VP of Human Resources, Cathy Battles, , Director of Operational Services, Cossondra Blair, Director of Project Management, Tara Weitor, Executive Director at Vista Terrace of Belmont, Joan Johnson and additional representatives from ISL. In addition, attorney Joel Goldman from Hanson Bridgett was present. During this meeting the following was discussed; 4-6 month timeline for facility electrical repairs, communication with family members regarding delay in repair and the options residents and families will receive, coordinating moving the rest of the residents' belongings from Vista Terrace to their new location, and ongoing status updates that will be provided to CCL, residents and families regarding the electrical repairs. --Licensee to submit the following requested items to CCL; copies of electrical reports/repairs from January 2023 and a copy of electrical report from April 2023 with timelines of required repairs.

On May 1, 2023, San Bruno Regional Office conducted a Microsoft Teams meeting with Integral Senior Living (ISL) Management along with the Santa Rosa and Oakland Regional Office. During this meeting, the offices discussed the emergency evacuation that occurred on 4/28/2023 due to a power outage that was reported on 4/25/2023. Residents were relocated back home with their families or to the sister facilities; Windsong of Sonoma located in Petaluma or The Point at Rockridge located in Oakland. Present in this meeting was Assistant Program Administrator, Pam Gill, Regional Manager, Vivien Helbling, Licensing Program Manager, Cara Smith, Licensing Program Analyst, Komal Charitra from the San Bruno Regional Office, Regional Manager, Issac Taggart, Licensing Program Manager, Yvonne Flores from the Oakland Regional Office, Licensing Program Manager, Bethany Moellers from the Santa Rosa Regional Office, Long Term Care Ombudsman, Tom Barrett and Nikki Manske (San Mateo County) and Kiev Harris (Alameda County). In addition, present in this meeting was Director of Operations, Cossandra Blair, Senior Vice President of Operations, Mike Zeug, Interim Administrator, Joan Johnson and additional representatives from ISL. During this meeting, the following was discussed; reassessment of residents after relocation (transfer trauma/injuries), communication between facilities, families and residents, maintenance and repair time-frame, medical transportation, admission agreement addendum, staffing, updated plan of operation for all three facilities in regards to the emergency relocation of residents. --Licensee/Administrator to submit an updated LIC500 (staff schedule) for Windsong of Sonoma and The Point at Rockridge -- Licensee/Administrator to provide LPA with a copy of the electricians report from 4/29/23. --Licensee/Administrator to provide LPA with an updated plan of operation for all three facilities

On April 28, 2023, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced Health and Safety case management visit as a result of an emergency evacuation due to a power outage that was reported on 4/25/23. LPA met with Interim Administrator, Joan Johnson and explained the purpose of the visit. On 4/24/23, the facility had a power outage. During the time, the facility did have two back up generators, sufficient food supply, 30-day supply of resident medications, and hot water. Residents were provided with lanterns for their rooms at night and extra blankets if they were cold. On 4/27/23, the facility notified CCL that all residents will be relocated due to the main breaker switch being in disrepair. According to the Interim Administrator, it may take weeks to months to repair it as the facility needs a city permit and PG&E's approval. All residents will be relocated to the facility's sister facilities, The Point at Rockridge located in Oakland, and Windsong of Sonoma located in Petaluma. According to the Interim-Administrator, as of now 12 residents will be relocated to the facility in Oakland, 21 will be relocated to the facility in Petaluma, and 3 will be moved back home with family. During the visit, LPA toured the facility, observed sufficient staffing present, observed movers packing resident furniture, facility staff assisting with talking to residents and helping other facility staff and residents pack up their belongings. LPA observed another back-up generator being installed. For residents going back home with family, their responsible parties will sign off on the medications and take it home and for the residents who are going to sister facilities, the staff will take the medications and all resident files with them. The facility's goal is to move out all residents by this evening. Staff will be accompanying residents to their new facility. The facility has scheduled an electric testing company to come to the facility tomorrow morning to evaluate current systems. LPA will continue monitoring the facility. Facility to send LPA a copy of LIC9020- Resident Roster as soon as possible. No citations issued during this visit. LPA reviewed report with Joan Johnson and a copy is provided

On January 12, 2023, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced Health and Safety visit as a result of the Department receiving notice from Emergency Services of San Mateo and the Long-Term Care Ombudsman regarding the power outage at the facility due to the storm. LPA met with Resident Care Director, Ed Dewitt and Administrator, Siobhan Surraco and explained the purpose of the visit. During the visit, LPA toured all three floors of facility. LPA observed 2 day perishable and 7 day non-perishable present. Residents were observed socializing on the third floor and dining on the first floor dining room. A comfortable temperature of 68-69 degrees F is maintained on all floors. Facility has a backup generator and is able to provide sufficient lighting in the hallways of the facility. Bedrooms were observed to have no power, however residents were given flashlights and lanterns for their rooms. According to the Administrator, the facility has restored hot water to partial areas of the facility for residents to take shower. In addition, a larger generator will be arriving tomorrow. Proof of generator will be submitted to CCL tomorrow with a copy of plan of operation for this emergency. Report reviewed with Administrator and a copy is provided. No citations issued during this time.

On June 28, 2022, Licensing Program Analyst (LPA) Komal Charitra, conducted an unannounced case management visit to follow-up on a visit that LPA conducted on 4/20/2022 concerning an incident that occurred on 4/11/2022. The Department referred this incident to the Investigation Branch. An investigation regarding Resident #1 (R1) was conducted by Investigation Branch and based on the information collected, there was no deficiencies found and this incident does not require any additional investigation. This investigation is closed. Report is reviewed with Interim Executive Director, Ryan Mussato and a copy is provided.

On June 16, 2022, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual infection control inspection. LPA met with Resident Care Director (RCD), Ed Dewitt and explained the purpose of the visit. LPA was screened at entry point and RCD was able to provide screening log documentation for staff, visitors, and residents. LPA toured facility and grounds. No accessible bodies of water or fire safety hazards observed. This is a 3 story building with rooms on each floor. LPA observed the laundry room on each floor to be fully functioning and in good repair. LPA observed 4 residents maintaining social distancing in the activities room on the 2nd floor. 30-day PPE supply was observed on the second floor storage room. LPA toured the 1st floor and observed the dining room to have tables 6ft apart to maintain social distancing. Communal bathrooms were equipped with liquid soap and paper towels; LPA advised to cover trash cans with lids in all bathrooms. The Wellness center room on the 1st floor was observed to be locked with resident files and medication. LPA observed the dining hall to have tables 6ft apart to maintain social distancing. Infection control practices are reviewed: entry procedures, staff training and policies, resident/ visitors/ and staff daily monitoring records, and 30-day PPE supply. LPA advised to put social distancing and masking sign on the elevator door. Toxins and sharps are stored appropriately and inaccessible to residents, and a comfortable temperature is maintained. Lighting is sufficient for comfort. First aid kit was observed to be completed. LPA requests the following documents to be submitted to CCLD by June 23, 2022: LIC309 Administrative Organization LIC308 Designation of Administrative Responsibility LIC500 Personnel Report Administrator Certificate LIC610E Emergency Disaster Plan Report is reviewed with Resident Care Director, ED Dewitt and a copy is provided.

On April 20, 2022, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced case management visit to follow up on an incident that occurred on 4/11/2022. LPA met with Interim Executive Director, Ryan Mussato and explained the purpose of the visit. During the visit, LPA reviewed resident's (R1's) file and received documents in relation to the incident. LPA Charitra interviewed the Interim Administrator. An updated care plan was submitted to LPA by email. During this time, R1 was at the hospital for a routine check up. This incident requires further investigation. This report is discussed and reviewed with Interim Executive Director, Ryan Mussato. A copy is provided.

On March 10, 2022 Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced Case Management visit regarding an incident that occurred around February 26, 2022. LPA Charitra was greeted by Front Desk Receptionist, Amina Lmamoune and the Director of Sales, Tina Morrill joined shortly thereafter. LPA explained the purpose of the visit. During today's visit, LPA interviewed the resident regarding the incident. LPA Charitra requested copies of pertinent documents to be sent to LPA via email by 3/14/22 from the Administrator. This incident requires further investigation. This report is discussed and reviewed with the Director of Sales and a copy is provided.

On June 29, 2021 Licensing Program Analyst (LPA) Chris Hopkins conducted an unannounced annual required inspection. LPA met with Business Director Arturo Lock and Executive Director Michael Li and stated the purpose of the visit. LPA toured the indoor and outdoor premises of the facility. The indoor and outdoor passageways were free of obstruction. LPA observed the resident bathroom, and it is equipped with non-skid mats and grab bars. Bathroom is sanitary and odorless. The hot water temperature was measured in residents room #301 bathroom at 117 degrees Fahrenheit and residents room #213 at 118 degrees Fahrenheit. The facility is observed to be clean, odorless, and well maintained. Residents bedrooms were observed to be well organized and fully furnished with adequate lighting. Toxic materials were observed locked in the Janitorial closet and inaccessible to residents. Food supply in kitchen was observed with an adequate two day perishable and seven day non-perishable food supply. Carbon monoxide, smoke detectors, and fire extinguisher were present at the facility. Centrally stored medication was locked in the Medication cart located on the 1st floor Medication room and inaccessible by residents. All medication was labeled and sorted by resident name. Staff records were reviewed. Staff have criminal record and fingerprint clearances on file. Resident records were reviewed and were observed to be complete with documents such as Admission Agreements, Medical Assessments, and Personal Rights. No deficiencies observed today. Facility is operating in compliance with Title 22 regulations. This report was discussed with Business Director Arturo Lock , and a copy of this report was provided via email.