Burlingame Senior Living

On January 28, 2026 Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. LPA met with administrator, Brian Raimundo and LPA explained the purpose of today's visit. LPA toured facility and grounds of this 4-story facility with the administrator. There are two elevators and 3 stairwells, and 69 apartments--small studios, large studios, and one bedroom units, all have a private bathroom. On the ground floor, there are offices, kitchen, living and main dining rooms. The second floor is the memory care unit, and can only be accessed by a keypad for the elevator. There is a dining room, kitchen, and common rooms on the 2nd floor. There are laundry rooms on the 2nd, 3rd and 4th floors. There is an underground parking garage. LPA observed an emergency call system installed in each bathroom and all assisted living clients have pendants that transmit audible and visual signal to the centrally monitoring system and pagers carried by care staff and med techs. LPA observed fire extinguishers were last serviced on 3/4/2025 and water temperatures were measured at 105 - 116 degrees F. LPA observed medications, toxins, sharps and disinfectants were locked and inaccessible to residents in care. During the tour of the kitchen with the resident service director and the kitchen manager, LPA observed the overall of the kitchen floor to be dirty, dusty, greasy, and full of dark black partials. In addition, the ice machine was observed to be dusty, the green garage can have white, gray and brown spots on it, there was a gray tray stored on one of the carts that was filled with black dirt, and a piece of dirty black metal device in it. Furthermore, the stove/flat top was observed to have yellow and brown grease on it 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 A review of (6) resident files was conducted and noted on the LIC 858. A review of (4) staff files was conducted and noted on the LIC 859. LPA requested for 6 staff files but the facility was able to provide 5 out of 6 files as the facility was not able to locate the file for S6. During the file review, LPA observed S1 did not have a criminal background clearance. The administrator stated that S1 has completed the process but result is still pending. S1 was asked to leave until criminal background clearance process is completed. In addition, LPA observed S2 was not associate with the facility. A civil penalty is being assessed for $850 today ( $500 for S1, $100 for S2 and $250 for repeat violation of 87411(f)). Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in additional civil penalties. This report is reviewed and discussed with administrator. A copy of this report and the appeal rights were provided.

On 11/13/2025, Licensing Program Analyst (LPA) Murial Han conducted an unannounced case management visit to deliver the finding of an incident that was reported by the facility. LPA met with administrator, Brian Raimundo and explained the purpose of today's visit. On 10/9/2025, the facility reported that staff #1 (S1) witnessed staff #2 (S2) and staff #3 (S3) holding resident #1 (R1)'s arms down in bed while forcing R1 to take medicine. LPA attempted to interview R1 and R1 did not remember the incident and was not able to answer LPA's questions due to R1's diagnosis. LPA interviewed S1 who stated that on the day of the incident, she was working on the Assisting Living Unit and was called to assist the Memory Care Unit. When she got off the elevator, she heard R1 screaming in the room and when she got to the room, she witnessed S2 and S3 were holding R1's arms while forcing R1 to take the medicine. LPA interviewed S2 who stated that on the day of the incident, R1 did not want to take the medicine and R1 was attempting to hit S3 while S3 was trying to give the medicine so S2 assisted S3 by holding down R1's arms while R1 was in bed. S2 stated that R1 needed to take the medicine so R1 would not hit other people. LPA requested to interview S3 but S3 did not return call. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 LPA interviewed the memory care director who stated that she was not at the facility when the incident happened but when she was informed on the next day, she reported it to the Regional Director of Operations and both staff were placed on administrative leave. LPA interviewed the current administrator who stated that he was not the administrator when the incident happened but he was informed by the Regional staff that S2 and S3 were terminated. Based on training records, the facility provided an in-service on 10/8/2025 on Medication Pass and the training material indicated that resident shall not be forced to take medication, but the staff sign-in record did not indicate that S3 attended the in-service. After the investigation, this incident is substantiated as R1 has the Right to receive or reject medical care or other services. Based on interviews, observation, and record reviews during the investigation, the preponderance of evidence standard has been met. Therefore, this allegation was determined to be substantiated. Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC9099-D. Failure to correct the deficiencies may result in civil penalties. Report was discussed with administrator and a copy is provided with Appeal Rights.

Regarding to the allegation of - staff do not ensure that facility is maintained a comfortable temperature, the reporting party stated, R1 was being placed in a temporary room, while the facility replaced the carpet but the heater was broken. According to the sales manager and the interim administrator, the temporary room was vacant for a long time and no one checked the heater prior to R1's move-in as R1 was not supposed to move in to that room, therefore, the facility was not aware that the heater was not working. The interim administrator stated that they called a couple of companies to fix it but they couldn't so they provided a portable heater for R1. LPA interviewed R1 who stated that the temperature of the room was comfortable after the portable heater was provided and LPA observed the room temperature was measured at 73 degrees Fahrenheit. After the investigation, this allegation is deemed to be substantiated. Regarding to the allegation of- staff do not ensure facility vehicle is in good repair, the reporting party stated the facility van has been broken for months and on 4/9/2025, R1 had a medical appointment and R1 had to be transported by the maintenance guy in a personal truck that required R1 to climb into. According to the interim administrator, the facility van was broken on the day of R1's appointment but it has been fixed. The interim administrator stated that the facility provides transportation for residents on Tuesdays and Thursdays, and R1's appointment was on a Wednesday and since the van was broken, the maintenance manager took the resident to the appointment in a private vehicle. The interim administrator stated that she/he was not aware that R1 had to climb into the private vehicle until after the appointment. The interim administrator acknowledged that the facility van breaks down from time to time and when that happens, the facility offers other means of transportation such as vouchers to transportation companies. LPA has completed and substantiated a complaint investigation in November 2024 (reference number 14- AS- 20241121125035) regarding to residents were missing their medical appointments because the facility van was broken. After the investigation, this allegation is deemed to be substantiated. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Regarding to the allegation of- director does not have the required qualifications, the reporting party stated that the interim director/administrator doesn't have the qualifications to be in the position. According to the interim administrator who used to be the Health Services Director stated that when the Administrator resigned in February 2025, she was appointed by the Licensee to be the interim administrator. Based on observation and record review, the licensee did not provided any documentation to CCL to update the facility administrator. After the investigation, this allegation is deemed to be substantiated. Regarding to the allegation of- staff do not ensure elevators are in good repair, the reporting party stated that on 5/5/2025, both facility elevators were broken and residents waited downstairs for over 3 hours until one of them was fixed. As part of the investigation, LPA interviewed the sales manager and the interim administrator who acknowledged that both elevators were down on 5/5/2025 and the elevator on the right side has been down for almost 2 years. The sales manager was present on 5/5/2025 and stated that when they learned that the only working elevator was malfunctioned, they contacted management immediately, and call the elevator repair company. The sales manager acknowledged that there were a few residents who were not able to take the stairs so they waited for hours in the dining until the elevator was fixed. LPA completed and substantiated a complaint investigation on 3/11/2025 (complaint reference number 14-AS-20250110144222) regarding to Licensee did not ensure facility elevators were maintained in good repair. After the investigation, this allegation is deemed to be substantiated and a civil penalty of $250 is being assessed for repeat violation. Based on interviews, observation, and record reviews during the investigation, the preponderance of evidence standard has been met. Therefore, this allegation was determined to be substantiated. Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC9099-D. Failure to correct the deficiencies may result in additional civil penalties. Report was discussed with the interim administrator; a copy is provided with Appeal Rights. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Regarding to the allegation of - staff do not ensure resident's showering needs are being met and staff do not ensure resident's incontinence needs are being met, the reporting party stated that there is a resident on the first floor near the elevator that doesn't shower, and smells like urine. The reporting party stated that everyone knows who this resident is, and staff just say this resident doesn't like to shower. As part of the investigation, LPA interviewed the interim administrator who stated that resident #2 (R2) has a history of refusing shower and did not allow facility staff to assist with incontinence care and cleaning the room but R2 is no longer refusing after many conversation of encouragement. The interim administrator reported that the odor is not as strong since R2 has been showering weekly, allowing staff to assist ADLs, and weekly housekeeping and laundry service. LPA attempted to interview R2 but was not successful. LPA interviewed staff #1 (S1) and staff #2 (S2) and both of them reported that R1 is no longer refusing care, R2 has been showering weekly, managing his/her own incontinence care, and allowing staff to assist with laundry and housekeeping services. During LPA's visits on 5/14/2025, 7/3/2025 and 7/8/2025, LPA did not observed any odor by the entrance, by R2's room and the lobby area. This observation was reported to CCL in 2024 and at the time, the facility has provided documentation to proof that the facility implemented different interventions to encourage R2 to participate in care. After the investigation, this allegation is deemed to be unsubstantiated. Based on observation, interviews and records review, these allegations are deemed to be unsubstantiated. 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. This report is review with the interim administrator and a copy is provided

According to the previous Administrator and the Resident Service Director, one of the elevators has been broken for more than a year and it was repaired but continued to break. The former Administrator denied the allegation that the paramedics were waiting for 25 minutes while responding to an emergency call and stated that if both elevators were down, the staff would direct the paramedics to use the stairs. The Resident Service Director stated that there was one time when both elevators were down, and the paramedics had to transport a resident to the room using the stairs. The former Administrator and the Resident Service Director stated that the most recent visit from an elevator company informed them that the elevator needed to be replaced and the Senior Vice President has already approved it. LPA interviewed staff #1 (S1) and staff #2 (S2) and both stated that one of the elevators has been broken for almost a year. They stated that the only working elevator would be down from time to time due to over usage. They stated that they were informed by other staff members that during Christmas Eve, the only working elevator was also down and residents, family members, and paramedics had to wait for a long time. After the investigation, this allegation is deemed to be substantiated as the former administrator, the resident service director, and the facility staff reported that the elevator has been malfunctioned for over a year and the facility was not able to provide documents to proof that repairs were in progress. In addition, facility staff reported that when the only working elevator became malfunctioned, it created a big problem for the residents, facility staff, family members, medical visitors, etc. Based on interviews, observation, and record reviews during the investigation, the preponderance of evidence standard has been met. Therefore, this allegation was determined to be substantiated. Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC9099-D. Failure to correct the deficiencies may result in civil penalties. Report was discussed with the interim Administrator; a copy is provided with Appeal Rights provided

On January 15, 2025, Licensing Program Analyst (LPA) Murial Han conducted an unannounced continuation visit for an annual inspection that was conducted on 12/30/2024. LPA met with the administrator and the resident service director and LPA explained the purpose of today's visit. During today's visit: A review of (5) resident files was conducted and noted on the LIC 858. A review of (5) staff files was conducted and noted on the LIC 859. Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. This report is reviewed and discussed with administrator. A copy of this report and the appeal rights were provided.

LPA interviewed staff #1 (S1) who stated that the door alarm went off and they responded to the alarm, however, they did not see R1 at the door. S1 also stated that they did not know R1 left the unit because the unit has 2 delayed egress doors and the elevator doors. Therefore, they did not know which exit R1 used to leave the unit. Based on the Pre-placement Appraisal Information, the facility was aware that R1 has wandering behaviors as it was indicated on the Appraisal. During the visit on 11/7/2024, LPA and the Resident Service Director tested the delayed egress doors and both doors were working properly and one of the doors lead to the courtyard in front of the facility where R1 was seen by the Memory Care Director. After the investigation, this allegation is substantiated as R1 left a secured unit unattended and the facility did not know how R1 got out. Based on interviews, observation, and record reviews during the investigation, the preponderance of evidence standard has been met. Therefore, these allegations were determined to be substantiated. Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC9099-D. Failure to correct the deficiencies may result in civil penalties. Report was discussed with the Operation Specialists, a copy is provided with Appeal Rights provided 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Based on the Needs and Services Plan, R1 did not have hearing aids. Based on observation, interviews and records review, this allegations is deemed to be unsubstantiated. 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. This report is review with the administrator and a copy is provided

On April 4, 2024, Licensing Program Analyst (LPA) Murial Han conducted an unannounced case management visit to follow-up on an incident that was report to CCL by the facility. LPA met with Resident Service Director, Rowena Cancino and Administrator, Glenda Bertccui. LPA explained the purpose of today's visit. On March 28, 2024, facility reported that facility received a call from the post office reporting that one of the residents was there. Subsequently, facility director went to the post office to pick up the resident(R1). However, someone had already called 911 and resident was transferred to the hospital for further evaluation. During today's visit, LPA interviewed the Resident Service Director and the Administrator who stated that R1 usually gets transported by the facility van when R1 wanted to leave the facility; 2 days prior to the incident, R1 was informed by facility staff that the van would be out of service and if R1 could hold off on conducting outings. During the day of the incident, R1 was persistent with leaving the facility to conduct some personal business. As R1 was signing out at the front desk, the receptionist reminded R1 that R1 was not to leave the facility unassisted. However R1 left by him/herself without further actions performed by facility to ensure R1's safety. Based on R1's Physician's Order (LIC 602), R1 was not able to leave the facility unassisted. Therefore, deficient is cited under California Code of Regulations, Title 22 as the facility did not ensure care and supervisor was provided while R1 was out of the facility. Civil penalty of $250 will be assessed today for repeat violation as this deficiency was cited on 7/20/2023. Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. This report is reviewed and discussed the administrator; a copy is provided with the appeal rights.

On January 30, 2024, Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. LPA met with resident service director, Rowena and explained the purpose of the visit. The administrator arrived shortly thereafter and assisted with the inspection. LPA toured facility and grounds of this 4-story facility. There are two elevators and 3 stairwells, and 69 apartments--small studios, large studios, and one bedroom units, all have a private bathroom. On the ground floor, there are offices, kitchen, living and main dining rooms. The second floor is the memory care unit, and can only be accessed by a keypad for the elevator. There is a dining room, kitchen, and common rooms on the 2nd floor. There are laundry rooms on the 2nd, 3rd and 4th floors. There is an underground parking garage. LPA observed an emergency call system installed in each bathroom and all assisted living clients have pendants that transmit audible and visual signal to the centrally monitoring system and pagers carried by care staff and med techs. LPA observed fire extinguishers were last serviced on 2/1/2023 and water temperatures were measured at 105 - 116 degrees F. LPA observed medications are secured in medication rooms on 1st and 2nd floors and toxins are secured in locked maintenance rooms on 2nd, 3rd and 4th floors. LPA reviewed documentation for emergency drills. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 During the kitchen tour, LPA observed perishable and non-perishable foods are adequate. The walk-in refrigerator and freezer floors were dirty, the mental shelves in the walk-in refrigerator was observed to have black partials hanging on the metal bars, the metal tray to hold clean cups was dirty, etc. LPA reviewed 5 resident records and all of them contained admission agreement, medical assessment- LIC 602 (Physician Order), Appraisal Needs and Service Plan, Resident Identification information, Pre-appraisal assessment, etc. LPA reviewed 3 staff files and all of them contained personnel records, health screening, COVID-19 vaccination information, Job Description, Abuse Statement, fingerprint cleared and associated to the facility and First Aid/CPR documentation was not adequate. Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. This report is reviewed and discussed with administrator. A copy of this report and the appeal rights were provided.

On July 20, 2023, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced case-management visit in relation to complaint investigation (complaint number: 14-AS-20230714123226). LPA met with Operation Specialist, Kathleen Calobeer and explained the purpose of the visit. During the complaint investigation visit, LPA found that the facility failed to submit the incident report for the incident that occurred on July 12, 2023 where Resident 1 (R1) signed out and left the facility unassisted. According to the Resident Care Coordinator, Rowena Cancino, it was acknowledged an incident report was not submitted to CCL. 87211 Reporting Requirements- A civil penalty of $250 is assessed on 7/20/2023 for a repeat violation within 12 months. This violation was cited on 6/29/2023. During the visit, LPA observed Staff 1 (S1) to not be fingerprint cleared. Based on personnel record review with facility, LPA observed S1 to not be fingerprint cleared and association status to be pending. Operations specialists immediately notified S1 and S1 left the facility during LPAs visit and will not return until fingerprints are cleared. This violation results in a civil penalty of $100 per day x 1 day = $100 Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC809-D. Failure to correct the deficiencies may result in additional civil penalties. Report is reviewed with Operations Specialist and a copy is provided with civil penalties and appeal rights.

On June 29, 2023, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced case management visit to follow up on an incident that occurred on June 7, 2023. LPA met with Executive Director, Emaude (Alex) Tayebi and explained the purpose of the visit. The Licensee reported Resident 1 (R1) had an unwitnessed fall in his/her room. R1 was transported to the hospital and head injuries were noted. During the visit, LPA reviewed R1's file and interviewed the Administrator and Resident Services Director, Rowena Cancino. According to staff interviewed, R1 has had a total of three falls the past month (5/1/2023, 5/23/2023, and 6/7/2023). During record review, LPA discovered that incident reports for the incidents that occurred on 5/1/2023 and 5/23/2023 were not reported to CCLD. According to file reviewed, R1 has a diagnosis of Alzheimer's Dementia with behavioral disturbances. Based on R1's service plan, R1 is fall risk and has a wandering behavior. The service plan was dated 5/3/2023 after R1 had an unwitnessed fall and was taken to the hospital on 5/1/2023. R1 had two additional falls after the service plan was updated, however the facility failed to reassess R1 after the falls that occurred on 5/23/2023 and 6/7/2023. In addition, during record review, LPA observed the service plan to be incomplete as it was not be signed by R1's responsible party. During the record review, LPA observed Staff 1 (S1) and S2 to not be associated at the facility. LPA reviewed facility personnel records and observed S1 and S2 to have fingerprint clearance, however was not associated to the facility. Continue to 809C. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 LPA did not observed S1's and S2's criminal record clearance documentation in personnel files. Executive Director was able to provide LPA with proof from Guardian indicating staff are fingerprint cleared but not associated to the facility. A civil penalty of $200 is being assessed for S1 and S2 for not being associated to the facility. 87463(a) Reappraisal- A civil penalty of $250 is assessed on 6/29/2023 for a repeat violation within 12 months. This violation was cited on 6/6/2023. Deficiency of the Residential Care Elderly California Code of Regulations, Title 22, Division 6 is observed and cited on a LIC809D. Failure to correct the deficiencies may result in civil penalties. This report is reviewed and discussed with Executive Director; a copy of the report is provided with appeal rights. Copy of civil penalty is provided.