Burlingame Senior Living.
Burlingame Senior Living is Ranked in the bottom 5% of California memory care with 32 CDSS citations on record; last inspected Apr 2026.
A large home, reviewed on public record.
Compared to 56 California facilities with a similar number of beds.
RCFE memory care · 36-month window. Higher percentile = better performance on inspection record. Source: California Dept. of Social Services · Community Care Licensing.
Rankings based on 36-month CDSS inspection data. Severity and frequency: fewer citations = higher percentile. Repeat rate: lower repeat citation share = higher percentile.
FACILITY WATCH · BETA
Burlingame Senior Living has 32 citations on record. Know the moment anything changes.
New findings, complaint investigations, or status changes — emailed to you free.
Citation history, plotted month by month.
32 deficiencies on record. Each bar is a month with a citation.
Finding distribution
32 total · 36 monthsScope × Severity (CMS A–L)
The rules that apply to this facility.
State requirements with the exact regulation citation, plain-language explanation, and a question to ask on tour. Rules this facility has been cited for appear first.
Plain language
Because a facility markets dementia or Alzheimer's care, state law mandates higher training standards: 12 hours of initial dementia training (6 hours before a staff member works independently with residents, 6 more within the first 4 weeks), 8 hours of annual dementia in-service every year thereafter, and an administrator must include 8 hours of dementia-specific continuing education in every 2-year recertification cycle. Training must cover individualized care plans, behavioral expressions, appropriate supervision, and the facility's dementia care philosophy.
Ask on tour
“Can you show me each direct-care staffer's most recent dementia training certificate, and tell me when their next refresher is due?”
Questions to ask before you visit.
A short pre-tour checklist tailored to Burlingame Senior Living's record and state requirements.
The facility has 24 serious citations on file across all inspections — can you provide your corrective-action plan for each cited item, and show families any documentation of remediation steps taken?
Ask the operator on tour. Take notes and compare answers across facilities you visit.
10 complaints are on file with CDSS — were any substantiated, and what remediation did the facility take in response to substantiated findings?
Ask the operator on tour. Take notes and compare answers across facilities you visit.
The facility is cited under §87705 or §87706 for dementia care — can you provide the written dementia-care program required by §87705, and explain what corrective action was taken to address the cited deficiency?
Ask the operator on tour. Take notes and compare answers across facilities you visit.
Every inspection visit, verbatim.
26 inspections in the public record, most recent first. Click any row to expand — cited rows open automatically.
2026-04-30Other VisitNo findings
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On April 30, 2026, Licensing Program Analyst (LPA) Murial Han conducted an unannounced Case Management - Incident visit. LPA met with Administrator and the Resident Care Director, Hola Finau and LPA explained the purpose of today's visit. On April 17, 2026, the facility reported an incident that happened on April 14. 2026 in which R1 was observed by staff #1 (S1) in bed, yelling due to severe pain. S1 assessed R1 and it was noted that R1 could not stand and both legs were swollen which resulted in staff calling 911. The incident report indicated that R1 was diagnosed with hip fracture and received left hip surgery and returned to the facility. The incident report did not include the cause of the hospitalization. During today's visit, LPA interviewed the Resident Service Director and R1. According to the Resident Service Director, on 4/13/2026, R1 was pushing the wheelchair while walking with the private caregiver and R1 lost balance and fell. The private caregiver reported it to the medication technician (med tech) who assessed R1 and did not notice any injuries at the time. However, on the next day, 4/14/2026, R1 had a change in health/physical condition that resulted in hospitalization. LPA interviewed R1 who remembered the fall and the hospital stay but no other details. Based on documents provided, LPA observed R1's Needs and Service Plan was updated interventions to reduce fall. No deficient is cited today. This report is reviewed and discussed with the administrator and a copy is provided.
2026-03-25Other VisitNo findings
Plain-language summary
On March 25, 2026, the facility received a visit to discuss changes to penalties from an earlier inspection. The facility was originally assessed three civil penalties; one penalty was removed, while two penalties remained in place for issues with personnel records and criminal record clearance procedures, with the fine reduced from $850 to $600.
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On March 25, 2026, Licensing Program Analyst (LPA) Murial Han conducted a case management visit to deliver the amended report dated 1/28/2026. LPA met with administrator and explained the purpose of today's visit. During the visit, LPA explained that the civil penalty that was assessed during the annual inspection on 1/28/2026 for 87411(f) will be removed and the remaining two civil penalties will stand: Personnel Records 87412(a)(13)(B) and Criminal Record Clearance in the amount of $600 instead of $850. This report is reviewed and discussed with administrator. A copy of this report was provided.
2026-03-25Annual Compliance VisitNo findings
Plain-language summary
On March 25, 2026, inspectors visited the facility to confirm that two staff members named in a previous exclusion order were no longer employed there. The administrator confirmed both staff members had left and that they understood the exclusion order. No violations were found during this follow-up visit.
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On March 25, 2026, Licensing Program Analyst(LPA) Murial Han arrived at the facility to follow up on a Decision and Order(exclusion) of staff #1 (S1) and staff #2 (S2). LPA met with administrator and explained the purpose of the visit. According to the Administrator, S1 and S2 are no longer working at the facility and the administrator acknowledged that they have received the Decision and Order. No deficiencies cited during today. This report is reviewed and discussed with the administrator. A copy is provided.
2026-01-28Other VisitType A · 9 findings
Plain-language summary
During a routine annual inspection on January 28, 2026, inspectors found the kitchen floor dirty and greasy with black particles, a dusty ice machine, and grease buildup on the stove, and also discovered that one staff member did not have a completed criminal background clearance and was asked to leave the facility. The facility received an $850 civil penalty for these violations and must correct the kitchen sanitation issues. The facility has proper emergency call systems, secure medication storage, and appropriate water temperature controls.
“87755 Inspection Authority of the Licensing Agency (c) The licensing agency shall have the authority to inspect, audit, and copy resident or facility records upon demand during normal business hours. Deficient Practice Statement 1 2 3 4 Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as during the inspection, the administrator was not able to locate Staff #5 (S5)'s personnel file which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 02/06/2026 Plan of Correction 1 2 3 4 The administrator will develop a plan to ensure compliance and will submit the plan of correction by 2/6/2026”
“Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA observed the kitchen floor was dirty, dusty, greasy, and full of dark black partials which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/29/2026 Plan of Correction 1 2 3 4 The administrator will develop a plan of correction to ensure the kitchen is clean and safe at all times. The plan of correction shall indicate the date (no later than 2/6/2026) that the facility will complete the cleaning of the kitchen and will provide photos to proof of completion. The administrator will provide a copy of the plan to CCL by 1/29/2026.”
“Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as during the annual inspection, LPA observed S1 was working in the kitchen without a criminal background clearance which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/29/2026 Plan of Correction 1 2 3 4 S1 was asked to leave the facility during the inspection. The administrator will develop a plan of correction to ensure all the staff members have completed the criminal background clearance process prior to work. The administrator will provide a copy of the plan of correction to CCL by 1/29/2025. A civil penalty of $500 is being assessed today.”
“Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as during the annual inspection, LPA observed S2 not associated with the facility which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/29/2026 Plan of Correction 1 2 3 4 The administrator will Associate S2 by the end of the day and the administrator will develop a plan to ensure all staff members are associated with the facility prior to work and will provide a copy of plan to CCL by 1/29/2026. A civil penalty of $100 is being assessed today.”
“Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA observed S2 did not complete the on-the-job training which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/29/2026 Plan of Correction 1 2 3 4 The administrator will develop a plan to ensure all staff members received on-the-job training and will provide a copy of the plan to CCL by 1/29/2026.”
“Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA observed the last drill was completed on 4/17/2025 which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/29/2026 Plan of Correction 1 2 3 4 The administrator will develop a plan to ensure emergency drills are conducted accordingly and the plan shall indicate that the facility will conduct a drill no later than 1/30/2025. The administrator will provide a copy of the plan of correction to CCL by 1/29/2026.”
“Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as during the tour of the kitchen with the resident service director and the kitchen manager, LPA observed the ice machine has a layer of dust on the top, the green garage can has white, light brown and gray 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 addition, the stove was observed to have yellow and brown grease which poses an immediate health, safety or personal rights risk to persons in care which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 02/06/2026 Plan of Correction 1 2 3 4 The administrator will develop a plan of correction to ensure the kitchen is clean and safe at all times. The plan of correction shall indicate the date (no later than 2/6/2026) that the facility will complete the cleaning of the kitchen and will provide photos to proof of completion. The administrator will provide a copy of the plan of correction to CCL by 2/6/2026.”
“Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA observed the Emergency and Disaster Plan Annual Review was blank which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 02/06/2026 Plan of Correction 1 2 3 4 The administrator will develop a plan to ensure the Emergency and Disaster Plan is being reviewed annually. The administrator will provide a copy of the plan of correction to CCL by 2/6/2026.”
“87411 Personnel Requirements - General Deficient Practice Statement 1 2 3 4 Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA observed S5 did not have a TB status which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/29/2026 Plan of Correction 1 2 3 4 The administrator will develop a plan to ensure all facility staff members complete the TB requirement prior to work and will provide a copy of the plan to CCL by 1/29/2026. The plan shall indicate the date that S5 will complete the TB test and the date shall be no later than 2/4/2026. A civil penalty of $250 is being accessed for repeat violation.”
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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.
2025-11-13Other VisitNo findings
Plain-language summary
On November 13, 2025, the state conducted an unannounced visit and delivered immediate exclusion letters for two staff members, meaning they are prohibited from working at this facility. The administrator confirmed that both staff members are no longer employed there. The facility received copies of the exclusion letters.
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On 11/13/2025, Licensing Program Analyst (LPA) Murial Han conducted an unannounced Case Management-Other visit. LPA met administrator, Brian Raimundo and explained the purpose of today's visit. LPA delivered an immediate exclusion letter for staff #1 (S1) and staff #2 (S2) who are currently associated in the facility. The administrator confirmed that S1 and S2 are no longer working at the facility. The exclusion letters were provided to the administrator. This report is reviewed and discussed, and a copy is provided.
2025-10-15Other VisitNo findings
Plain-language summary
On October 15, 2025, a state licensing representative conducted an unannounced follow-up visit after the facility reported an incident on October 9 in which staff members were seen holding a resident's arm in bed and forcing them to take medicine. The representative toured the memory care unit, interviewed the resident and staff, and found no violations, though the facility was asked to submit documentation about the incident and to provide information about a new administrator. The facility's previous administrator is no longer employed there.
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On 10/15/2025, Licensing Program Analyst (LPA) Murial Han conducted an unannounced case management visit to follow up on an incident that was reported by the facility. Upon entry, LPA was informed by the receptionist that the administrator is no longer working at the facility and LPA met with the Sales Director and LPA 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 arm in bed and forcing R1 to take medicine. During today's visit, LPA toured the Memory Care Unit, interviewed R1, and staff members. LPA requested for documents to be submitted to CCL by 10/17/2025: R1's LIC 602, appraisal service needs and plan, and documents related to the incident. In addition, LPA requested the Licensee to submit documents for an administrator to CCL by 11/6/2025. No deficient is cited today. This report is reviewed and discussed with the Sales Director and a copy is provided.
2025-08-20Complaint InvestigationUnsubstantiatedNo findings
Plain-language summary
The facility received a complaint about a resident's hand injury involving a mattress pump device. After investigating interviews with staff and the resident, reviewing hospital records, and consulting a police report that found the injury appeared accidental, the complaint was not substantiated—there was no evidence of abuse or neglect. The facility has since moved the mattress pump away from the bedside to prevent similar incidents.
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According to the administrator, on the day of the incident, staff #1 (S1) was conducting morning routine rounds to check on the residents, and when S1 opened R1’s door, S1 witnessed R1 sitting by the end of the bed and holding the mattress pump (a device that keeps the mattress inflated). S1 proceeded to check on R1 and observed a wound on the left hand that was bleeding so S1 removed the device and called for assistance. Staff #2/med tech (S2) responded and arrived to assist. The administrator stated that after S2 saw the wound, they decided to call 911. R1 was transferred to the hospital and returned within 24 hours. The administrator stated that the mattress pump was placed by the foot board of the bed but no one knew how R1 got hold of it. The administrator stated that since the incident, they have removed the mattress pump from the foot of the bed and place it on the floor to prevent this from happening again. LPA interviewed R1 who stated that he/she can’t remember what happened to the hand, but maybe hit it on the door. LPA interviewed S1 who denied pulling R1’s hand and stated that when she saw R1 was holding the mattress pump, R1’s left hand was bleeding so she removed the mattress pump, provided a pad to cover the wound and called for assistance. LPA interviewed S2 stated that he did not pulling R1’s hand. S2 stated that when S1 called for assistance, he went to the room immediately and saw R1’s hand was bleeding, and it was covered with a pad. Therefore, they decided to call 911. Both S1 and S2 stayed with R1 until the paramedics arrived and they did not witness anyone pulled R1's hand/arm. LPA interviewed R1’s responsible party who stated that no one witnessed exactly what caused the skin tear and they are happy with the overall care that the facility is providing to R1 but the communication can improve at times. During LPA’s visit on 7/3/2025, LPA observed R1 to be calm and left hand was wrapped with gauze. LPA observed the mattress pump was placed away from the foot of the bed. 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 police report, it indicated that R1's injury appeared to have been accidental, and there is no merit to any elder abuse or neglect. Based on interview, observation and record review during the course of the investigation, this allegation is deemed to be unsubstantiated. Although the above investigations 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 reviewed and discussed with the administrator; a copy is provided.
2025-07-08Other VisitNo findings
Plain-language summary
On July 8, 2025, a licensing analyst visited the facility to follow up on a fall that occurred on July 1st, during which a resident hit their head in the bathroom and was taken to the hospital. The resident has recovered, is not in pain, and the facility has put measures in place including checking on the resident every two hours and arranging physical therapy to help prevent future falls. No violations were found.
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On July 8, 2025, Licensing Program Analyst (LPA) Murial Han conducted an unannounced Case Management visit to follow-up on an incident that was reported by the facility. LPA met with the interim administrator, Rowena Cancino and explained the purpose of today's visit. On 7/1/2025, the facility reported resident #1 (R1) had an unwitnessed fall in the bathroom and sustained a laceration of scalp. R1 was sent to the hospital and returned a few hours later. The interim administrator stated that R1's family member was in the room during the fall and alerted staff of the fall. During today's visit, LPA observed R1 in the room, appeared to be comfortable and pleasant. R1 did not remember the fall and stated that she was not in pain. According to the interim administrator, as part of the fall management program, the facility has implemented status checks for R1 every 2 hours, R1 is receiving Physical Therapy from a home health agency and R1 has not sustained any further falls. The interim administrator stated that the facility will conduct another fall assessment for R1 in a few weeks. No deficient is cited today. This report is reviewed and discussed with the interim administrator. A copy of the report is provided.
2025-07-08Complaint InvestigationMixedType A · 3 findings
Plain-language summary
This complaint investigation found violations in four areas: a resident was placed in a room with a broken heater (later fixed with a portable heater), the facility van broke down on the day of a resident's medical appointment requiring use of a personal vehicle, the interim administrator lacked required qualifications and this was not reported to the state, and both facility elevators broke down on one occasion with one elevator non-functional for nearly two years, leaving several residents waiting hours in the dining area (the facility was previously cited for elevator maintenance failures and is being assessed an additional $250 penalty). The complaint about a resident's hygiene and incontinence care was not substantiated, as the resident began accepting help with showering and personal care after staff encouragement.
“R1 room's carpet was dirty, the heater was not working in, both elevators and the facility van were broken which poses an immediate health and safety risks to residents in care.”
“qualified administrator since March 2025 which poses an immediate health and safety risks to residents in care.”
“the heater was malfunctioned which poses a potential health and safety risk to resident in care.”
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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
2025-04-21Other VisitNo findings
Plain-language summary
On April 21, 2025, state licensing conducted an unannounced follow-up visit after the facility reported that a resident had left the premises on April 10 and had not returned. The resident, who is fully independent and does not need assistance, returned to the facility on April 20 and explained that he or she had stayed at a hotel for a few days; the facility is in the process of discharging this resident due to non-payment. No violations were found.
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On April 21, 2025, Licensing Program Analyst (LPA) Murial Han conducted an unannounced Case Management visit to follow up on an incident that was reported by the facility. Upon entry, LPA met with the Business Office Manager, Batool Alsmabi and LPA explained the purpose of today's visit. The interim Executive Director, Rowena Cancino arrived shortly thereafter and assisted with the visit. On 4/17/2025, the facility reported that resident #1 (R1) left the facility and R1 was last seen at the facility on 4/10/2025 during lunch time. According to the Interim Executive Director, R1 has always been leaving and returning his/her own as R1 is fully independent and does not require any services. The Interim Executive Director stated that the facility has issued a 30-day eviction notification to R1 due to non-payment and is currently working on discharge planning. Based on documents provided by the facility, R1 is able to leave the facility unassisted and is independent with all the Activities of Daily Living. On 4/20/2025, LPA was informed by the Interim Executive Director that R1 has returned to the facility. During today's visit, LPA interviewed R1 who is aware of the 30-day eviction and stated that he/she went to a hotel for a few days and returned yesterday. R1 is aware that the facility is assisting with discharge planning. No deficiency cited today. This report is review and discuss with the Interim Executive Director and a copy is provided.
2025-04-04Other VisitNo findings
Plain-language summary
I don't have substantive inspection findings to summarize from this document. The text contains only administrative notes about where original signatures are filed and does not describe what was inspected, what was found, or any conditions at the facility. I cannot write a meaningful summary without the actual inspection details.
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**** NOTE ORIGINAL SIGNATURE IS ON FILE WITH THE PACIFICA SENIOR LIVING UNION CITY FACILITY***** 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 **** NOTE ORIGINAL SIGNATURE IS ON FILE WITH THE PACIFICA SENIOR LIVING UNION CITY FACILITY*****
2025-03-11Complaint InvestigationSubstantiatedType A · 1 finding
Plain-language summary
An investigation found that one elevator at the facility was broken for over a year, and when the other elevator also went down (including on Christmas Eve), residents, staff, and paramedics had to use stairs and experienced long delays. The facility did not provide documentation showing that repairs were in progress during this time. The facility has since approved replacement of the broken elevator.
“This requirement is not met as evidenced by one of the two facility elevators has been malfunctioned for more than a year and the facility was not able to provide documents to proof that the repair or replacement of the elevator is in progress which poses an immediately health and safety risk to residents in care.”
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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
2025-01-15Other VisitNo findings
Plain-language summary
On January 15, 2025, the state conducted a follow-up visit to check on a resident who had an unlawful detainer order (a court order for discharge due to non-payment). The resident refused to leave the facility that day and declined the discharge location the facility had arranged, so the placement agency was given five more days to find an alternative safe location. No violations were found during this visit.
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On 1/15/2025, Licensing Program Analyst (LPA) Murial Han conduced an unannounced Case Management visit to follow - up on an Unlawful Detainer order. LPA met with the administrator and explained the purpose of today's visit. Facility was granted an unlawful detainer order for residents #1 (R1) due to non-payment and according to the order, R1 was supposed to be discharged today. Upon entrance, LPA observed the administrator, 3 sheriffs, 2 Ombudsman, representative from the placement agency and a administrator and a resident service coordinator from another facility assisting R1 with discharge planning. After a few hours of working with R1, the administrator reported that the sheriffs did not remove R1 from the facility as R1 refused to leave and go to a destination that was arranged by the facility. Therefore, R1 will be staying for 5 more days while the placement agency is seeking for a safe discharge destination. No deficiency cite today. This report is reviewed and discussed with the administrator. A copy is provided.
2025-01-15Annual Compliance VisitType A · 4 findings
Plain-language summary
A continuation inspection visit was conducted on January 15, 2025, following up on an earlier annual inspection. The facility's records for five residents and five staff members were reviewed, and one deficiency was cited related to state regulations. The administrator was notified of the findings and given information about appeal rights.
“Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as 1 out of 5 staff was not associated with this facility which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/16/2025 Plan of Correction 1 2 3 4 The administrator associated the staff identified during the visit. However, the administrator/licensee still needs to develop a plan in writing to ensure compliance prior to staff working at the facility. The administrator/licensee will provide a copy of the plan to CCL by 1/16/2025.”
“Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as 3 out of 5 staff did not have training records indicating that their required annual training was completed in 2024 which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/16/2025 Plan of Correction 1 2 3 4 The administrator/licensee will develop a plan to ensure all required annual training is completed for facility staff and the plan shall indicate the date that the training will be completed for the 3 facility staff who were identified during the inspection. The administrator will provide a copy of the plan to CCL by 1/16/2025.”
“Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as 4 out of 5 staff did not have the criminal record clearances in their personnel files which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 01/22/2025 Plan of Correction 1 2 3 4 The administrator/licensee will develop a plan in writing to ensure compliance and will provide a copy of the plan to CCL by 1/22/2025.”
“Based on observation, interview, record reviews 3 out of 5 staff files did not have a copy of their TB and Health Screen results. Deficient Practice Statement 1 2 3 4 Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as 2 out of 5 staff files did not have a copy of their TB and Health Screen results which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/16/2025 Plan of Correction 1 2 3 4 The administrator/licensee will develop a plan to ensure compliance and the plan shall indicate when the staff will complete their health screening process and TB. The administrator/licensee will submit a copy of the plan to CCL by 1/16/2025.”
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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.
2024-12-30Annual Compliance VisitNo findings
Plain-language summary
This was a routine annual inspection on January 30, 2024, where inspectors toured the 69-unit facility and found the memory care unit properly secured with keypad access, emergency call systems in bathrooms, and staff equipped with alert devices. The inspector observed that medications, sharps, and chemicals were locked and inaccessible to residents, water temperatures were safe, and fire extinguishers were current. The inspection was not yet complete at the time of this report.
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On January 30, 2024, Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. LPA met with the administrator, Ignacio Lopez and explained the purpose of today's visit. 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, and all of the room have a private bathroom. On the ground floor, there are resident rooms, 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 elevators and the unit has 30 second egress exit doors. In addition, there is a dining room, a small kitchen, and common rooms on the 2nd floor. There is a laundry rooms on the 2nd, 3rd and 4th floors. 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 3/26/2024 and water temperatures were measured at 105 - 109 degrees F through-out the facility. LPA observed medications, sharps, and chemicals are locked and inaccessible to residents in care. A review of (4) staff files was conducted and noted on the LIC 859 LPA will return on another day to complete the inspection. This report is review and discussed with the administrator. A copy is provided.
2024-11-26Complaint InvestigationSubstantiatedType B · 1 finding
Plain-language summary
A complaint investigation found that the facility's van had been broken for more than eight weeks, and while staff said they were offering to pay for Uber or taxi rides as alternatives, residents reported they were not aware of this option and had cancelled or stopped scheduling medical appointments because they had no transportation. At least one resident missed a medical appointment that the administrator had promised to arrange. The facility was cited for failing to ensure residents had access to transportation for necessary appointments.
“This requirement is not met as evidenced by based on interviews and observations, residents are missing their appointments and not scheduling new appointments as the facility van is broken and they were not aware of the other means of transportation which poses a potential health risks to residents in care.”
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The resident service director stated that the facility van has been broken for many weeks and the facility is offering to pay for the transportation while the van is being fixed. LPA interviewed resident #1(R1) who stated that the administrator was going to make transportation arrangement for his/her recent medical appointment but the resident service director was not aware of it, and called R1's family member and the family member took R1 to the medical appointment. LPA interviewed 2 other residents and they report that the van has been broken for more than eight weeks and they were not aware that the facility was providing other means of transportation such as an Uber or a Taxi. In addition, one of them stated that he/she had to cancel the medical appointments as he/she did not have any transportation arrangements. Furthermore, he/she stated that the residents were not scheduling any appointments as there was no transportation arrangements. After the investigation, this allegation is deemed to be substantiated as the residents reported that they were missing their appointments and they were not scheduling new appointments as there was no other means of transportation that was provided by the facility. In addition, they were not aware that the facility was offering Uber/ Taxi rides. Based on interviews, and observations 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 administrator; a copy is provided with Appeal Rights provided
2024-11-15Complaint InvestigationMixedType A · 1 finding
Plain-language summary
A complaint investigation found that a resident with known wandering behaviors left a secured memory care unit without staff knowing how they exited, even though staff heard a door alarm and responded. The facility's delayed egress doors were tested and found to be working properly, and the resident was located in the courtyard outside the building. A separate allegation about hearing aids was found to be unsubstantiated.
“This requirement is not met as evidence by: based on interviews, observations and record reviews, R1 left the unit/facility unattended and was found by the courtyard in front of the facility and staff did not know how R1 got out which poses an immediate health and safety risks to residents in care.”
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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
2024-07-30Complaint InvestigationSubstantiatedType B · 1 finding
Plain-language summary
A complaint investigation found that the facility shared a resident's personal information with relatives without the resident's permission, violating the resident's right to privacy. Three other allegations—about interference with contacting the Ombudsman, bullying by staff, and financial abuse—were investigated and found to be unfounded.
“This requirement is not met as evidenced by based on record reviews and interviews, the facility shared R1's personal information with R1's relatives without R1's permission which poses a potential health risks to residents in care.”
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After the investigation, this allegation is substantiated as the facility provided R1's personal information to R1's relatives without R1's permission which violated R1's Rights as the facility did not remain R1's information confidential. Based on interviews 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 As part of the investigation, LPA interviewed the facility director who denied the allegation and stated that R1 was inquiring about where the Ombudsman's contact information was posted and it was provided to R1. The facility director did not know that R1 was asking for assistance with the call. According to R1, staff did not prevent him/her from contacting the Ombudsman's office. R1 stated that the Resident Service Director provided the Ombudsman's contact information to R1 but R1 thought the Resident Service Director acted like he/she did not want to assist with the phone call, therefore, R1 traveled to the Ombudsman's office. After the investigation, this allegation is deemed to be unfounded. Based on records review, and interviews the department has determined that the allegations were false, could not have happened and/or is without a reasonable basis, therefore the allegations are UNFOUNDED. Report is discussed and reviewed with the Operation Specialists and a copy is 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 After the investigation, this allegation is deemed to be unfounded as R1 stated that the medical device that was attached to his/her body part was causing the pain while he/she was being wheeled into the shower on a shower chair. Regarding to the allegation of- staff are bullying resident in care, the reporting party stated that there was much bullying at the facility and no other details was provided. As part of the investigation LPA interviewed the Administrator and the Resident Service Director who denied the allegation. LPA interviewed R1 who denied the allegation and stated that there was a lady raised her finger while talking to R1 but this lady did not work at the facility. After the investigation, this allegation is deemed to be unfounded. Regarding to the allegation of - staff are financially abusing resident in care, the reporting party reported that the facility has attempted extortion of R1's funds, pushed current invoices under R1's door. As part of investigation, LPA interviewed the Administrator who denied the allegation and stated that there were several conversations with R1 regarding to R1's outstanding balances and the facility has provided a copy of the invoices to R1 in person and placed it underneath R1's door. LPA interviewed R1 who stated that the facility was not financially abusing his/her funds but they potentially could without any further details. After the investigation, this allegation is deemed to be unfounded. Regarding to the allegation of- staff prevented resident in care from contacting the Long Term Ombudsman, the reporting party stated that R1 asked one of the facility director's to make a call on behave of him/her to the Ombudsman office but the facility director did not comply so R1 went to the Ombudsman's office.
2024-04-04Other VisitType A · 1 finding
Plain-language summary
On April 4, 2024, regulators conducted a follow-up visit after the facility reported that a resident left without staff assistance on March 28, 2024 and was found at the post office; the resident's doctor had ordered that they could not leave the facility alone, but when the resident signed out at the front desk, staff only reminded them of this restriction and did not prevent them from leaving. The facility was cited for failing to provide adequate supervision and care, and received a $250 penalty for repeating the same violation from a prior year. The facility must correct this deficiency or face further penalties.
“This requirement is not met as evidenced by R1 left the facility unassisted despite R1's LIC 602 indicated that R1 was not to leave the facility unassisted which posed an immediate health risks to residents in care.”
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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.
2024-01-30Other VisitType A · 3 findings
Plain-language summary
During a routine annual inspection on January 30, 2024, inspectors found the facility generally well-maintained with proper emergency systems, medication storage, and secure access to the memory care unit, but noted dirty conditions in the kitchen walk-in refrigerator and freezer (including black particles on metal shelves and soiled equipment) and incomplete First Aid/CPR documentation in staff files. The facility was cited for these deficiencies and must correct them to avoid penalties.
“Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as several areas in the kitchen was observed to be dirty which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/31/2024 Plan of Correction 1 2 3 4 The administrator will develop a plan to ensure compliance and the plan needs to indicate when the kitchen will be cleaned and how is it going to be maintained. The administrator will provide a copy of the plan to CCL by 1/31/2024 and submit photos to proof that the identified areas are cleaned.”
“Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as facility was not able to provide proof that drills were conducted accordingly which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/31/2024 Plan of Correction 1 2 3 4 The administrator will develop a plan to ensure compliance and submit a copy of the plan to CCL by 1/31/2024.”
“Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as 3 out of 4 staff members did not have a valid CPR/First Aid Certificate which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/31/2024 Plan of Correction 1 2 3 4 The administrator will provide a plan to ensure compliance and the plan shall indicate the date that staff members would complete their CPR/First Aid training. In addition, the administrator will provide a copy of S1, S2, and S4's renewed CPR/First Aid certificates. The administrator will provide a copy of the plan to CCL by 1/31/2024”
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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.
2023-10-03Complaint InvestigationNo findings
Plain-language summary
A complaint investigation found that the facility had proper medical documentation in residents' files, including physician orders, admission agreements, and care assessments. One resident's file had an incomplete form that the facility was actively working to update with the resident's responsible party. The complaint was found to be without basis.
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In R1's medical file, LPAs observed including but not limiting LIC 602, pre- placement appraisal, needs and services plan, resident functional needs assessment, admission agreement, etc. In addition, LPAs observed an incomplete LIC 602 in the medical file and according to the resident service director, facility is working with R1's responsible party to obtain an updated LIC 602. LPAs reviewed 3 other resident's file and observed LIC 602 (physician's order), pre-placement appraisal, needs and services plan, resident functional needs assessment, admission agreement, etc. After the investigation, this allegation is deemed to be unfounded. Based on the above information, the Department has found that this allegation to be UNFOUNDED, meaning that this allegation was false, could not have happened and/or is without a reasonable basis. Report was discussed and a copy of this report is provided.
2023-07-20Other VisitType A · 2 findings
Plain-language summary
A licensing analyst conducted an unannounced visit on July 20, 2023, to investigate a complaint about a resident who left the facility unassisted on July 12, 2023. The facility had failed to file a required incident report about this event and had not ensured that one staff member was fingerprint-cleared before working with residents; both violations resulted in civil penalties. The staff member was removed from the facility during the visit and will not return until fingerprint clearance is completed.
“Based on record review and interviews conducted, facility acknowledged to not submitted CCL a incident report for an incident that occurred on July 12, 2023.”
“Based on observations and record review, LPA observed S1 to not be fingerprint cleared.”
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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.
2023-07-20Complaint InvestigationSubstantiatedType A · 1 finding
“Based on interviews conducted and files reviewed, R1 has a secondary diagnosis of dementia and is unable to leave the facility unassisted, however on July 12, 2023, R1 left the facility unassisted. In addition, according to staff interviewed R1 has left the facility mulitple times in the past without a staff member accompanying R1. Furthermore, LPA observed R1's service plan in a resident service plan binder on the front desk to indicate R1 is not allowed to leave the facility unassisted.”
2023-07-14Other VisitNo findings
Plain-language summary
On July 14, 2023, the state conducted a follow-up visit to confirm that the facility had corrected a violation related to reporting requirements that was found during inspections in late June. The facility had failed to submit a plan to fix the violation by the deadline and was assessed a $400 civil penalty; however, when they submitted the required plan on July 10, the violation was cleared and penalties stopped.
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On July 14, 2023, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced plan of correction visit to follow up on visits made on 6/29/23 and 7/10/23. LPA met with Sales Director, Kristal Robinson and explained the purpose of the visit. On 7/10/23, LPA conducted a plan of correction visit to ensure facility is in compliance with citations that were issued on 6/29/2023. During this visit, LPA assessed civil penalties for facility failing to provide plan of correction for CCR 87211 Reporting Requirements. Due to the citation not being corrected by 7/6/2023, a civil penalty in the amount of $400.00 was assessed from 7/7/2023 through 7/10/2023. On 7/10/2023, LPA received the plan of correction from the facility for CCR 87211. Deficiency is now verified and citation is now cleared. Civil penalties will be stopped on 7/10/2023. LPA reviewed report with Sales Director and a copy is provided.
2023-07-10Other VisitNo findings
Plain-language summary
This was a follow-up visit on July 10, 2023, to check whether the facility had fixed violations found during a previous inspection on June 29, 2023. The facility corrected most of the violations related to personnel records, resident records, and staff reappraisals, but failed to correct a violation about reporting requirements—the facility was assessed a $400 civil penalty for this uncorrected violation.
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On July 10, 2023, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced plan of correction (POC) visit to verify and confirm that the facility is in compliance with the citations that were issued on 6/29/2023. LPA met with Executive Director, Emaude (Alex) Tayebi and explained the purpose of the visit. On 6/29/2023, LPA cited the facility California Code of Regulations (CCR) Title 22, 87355 Criminal Record Clearance, 87412 Personnel Records, 87211 Reporting Requirements, 87463 Reappraisals, and 87506 Resident Records. The Executive Director was able to associate the staff members who were observed to not be associated on 6/29/2023 in LPAs presence. During the visit today, the Executive Director was unable to provide LPA with the plan of correction for CCR 87211 Reporting Requirements. Due to the citation not being corrected by 7/6/2023, a civil penalty in the amount of $400.00 is being assessed ($100/day) from 7/7/2023 through 7/10/2023 and will continue to accrue until corrected. In addition during the visit, the Executive Director was able to provide LPA with the plan of correction for CCR 87463 Reappraisals, 87506 Resident Records, and 87412 Personnel Records. Deficiencies are now verified as corrected and cleared. Report is reviewed with Executive Director and a copy is provided with civil penalty.
2023-06-29Other VisitType A · 5 findings
Plain-language summary
A licensing analyst visited on June 29, 2023, to follow up after a resident with Alzheimer's disease fell unwitnessed in their room on June 7 and was hospitalized with head injuries—this was the resident's third fall in one month, but the facility had not reassessed the resident's care plan after the two previous falls in May. The facility also failed to report the first two falls to the state and did not have proper documentation that two staff members were authorized to work at the facility. The state assessed civil penalties totaling $450 for these violations.
“Based on file reviewed, the Licensee reassessed R1 after having an unwitnessed fall incident on 5/1/2023, however the facility failed to reassess R1 after having two additional unwitnessed falls on 5/23/2023 and 6/7/2023.”
“Based on file reviewed, LPA observed that R1's service plan was incomplete as it was not signed by R1's responsible party.”
“Based on record review, LPA observed S1 and S2 to have fingerprint clearance, however was not associated to the facility.”
“Based on record review, the Licensee failed to submit two incident reports from 5/1/2023 and 5/23/2023 to CCLD.”
“Based on record review of personnel files, LPA did not observe documentation of criminal record clearance for S1 and S2.”
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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.
8 older inspections from 2022 are not shown in the free view.
8 older inspections from 2022 are not shown in the free view.
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