Moldaw Family Residences at 899 Charleston

On 10/21/2025, Licensing Program Analyst(LPA) John Calandra arrived at the facility to conduct the Annual 1-year required inspection. LPA Calandra was greeted by Karen Lerner, Health and Wellness Navigator and explained the purpose of the visit. Layana Santos, Director of Health Services and Mark Baddas, Executive Director arrived later during the visit. LPA toured the physical plant. This is a 13-building, 4 floor, 193-unit facility, with a combination of memory care, assisted living, and independent living residents. All bedrooms had the required furniture and sufficient lighting. No accessible bodies of water or hazards were observed. The facility's hot water temperature was measured between 105-120 degrees Fahrenheit. The facility's Fire Extinguishers were observed to be fully charged. According to building maintenance, the facility's fire alarms and Carbon Monoxide detectors are directly connected to the Palo Alto Fire Department. The facility had the required 7 days of non perishables and 2 days of perishables on hand. No food was expired. The facility's first aid kit had the required items. All sharp objects, soap, poisons, and detergents were observed to be locked and in-accessible to persons in care. LPA reviewed 5 resident files and 6 staff files. All were observed to be complete. A review of Centrally Stored Medications indicated that medications for residents were properly labeled with instructions on dosage and times of day and matched the Centrally Stored Medication Records(CSMR) kept at the facility. LPA received a copy of the facility's Liability Insurance and requested a copy of their updated LIC 500 be sent to the Department by 10/23/2025. No deficiencies cited during today's visit. An exit interview was conducted. This report was reviewed with facility representative and a copy provided.

Based on training records reviewed, in-service trainings were provided to staff by Suncrest Hospice on 12/12/25, 3/21/25, and 4/30/25 in regards to catheter care. According to the Director of Health Services and the Wellness Nurse Supervisor, R1 goes to the doctor when his/her tubing needs to be changed and LVNs assist with emptying R1's foley catheter. Regarding the allegation, staff do not have proper training, according to the reporting party, facility staff does not have proper equipment to lift residents who are not mobile and they do not have proper lifting training. During the investigation, LPA interviewed the Director of Health Services and Wellness Nurse Supervisor, reviewed training records, and reviewed resident files. Based on records reviewed, there are 3 residents who are two persons assist, however the residents do not require hoyer lifts currently. Based on observations, LPA did observe a hoyer lift at the community. According to training records, an in-service training for proper body mechanics/transfers was completed by the facility's in-house therapy, Empower Me vendor on 3/27/25. According to Director of Health Services and Wellness Nurse Supervisor, besides the Relias training that are being done in regards to proper lifting, Empower me vendor will being conducting quarterly trainings for proper lifting/body mechanics, in addition to as needed training when there is a change in condition. Based on information collected, and records reviewed, the department has determined that although the above allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegations are UNSUBSTANTIATED. Report is reviewed with Director of Health Services, Layana Santos and a copy is provided.

On April 16, 2025, at 11:50 AM, Licensing Program Analyst (LPA) Kiran Jain arrived unannounced at the facility to conduct a Case Management – Incident visit regarding a medication error incident that occurred on 04/06/2025 when the resident (R1) was given medications of another resident. Upon arrival, the LPA was greeted by the Director of Health Services (DHS) Layana Santos. The LPA disclosed the purpose of the visit. The Executive Director (ED) Mark Baddas joined shortly after. LPA interviewed one (1) resident (R1) and three (3) staff members: Director of Health Services (DHS), Medication Technician (S1) and LVN Community Nurse (S2). R1 stated they were not bothered about the medication error, but this could happen was disturbing. R1 stated they always asked what medicines were given to them and thought more training could help to prevent such errors in the future. R1 confirmed they had no adverse side effects of the wrong medications given. S1 stated they felt the work overload caused the medication error and they were honest about the error and made sure the resident was doing ok and hence they followed the process of informing the nurse on duty. S1 stated they have been retrained on the med training on 04/09/2025. S2 stated that S1 came to them and informed about the medication error. S2 followed the procedure by taking resident vitals, told the doctor and the family. S2 checked on R1 every hour after that to make sure there are no side effects. DHS stated they were putting more checks in place, more frequent audits, added additional layers to make sure the med techs were properly dispensing medications. The facility followed the protocols by frequently checking R1 for change of condition, informed their doctor and the family member. DHS stated that the med tech had been given additional training to ensure that they do not make the medication error again. Continued on LIC809-C 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 reviewed R1’s Alert charting notes for 04/06/2025, which showed R1 was monitored for medication adverse reactions, if R1 was feeling dizziness. R1’s vitals were checked, noted and was put on hourly check for the day. R1’s vitals were noted with BP reading 137/75, Heart rate 70, Temperature 97.3 and Oxygen saturation levels at 97.3%. LPA reviewed R1’s Centrally Stored Medication and Destruction Records. LPA reviewed the message sent from R1’s PCP office regarding the follow up on the wrong medications given to R1. The nurse advised that wrong medications taken should not be harmful for R1 and advised the facility to report any changes in R1’s condition. No deficiencies were cited during today's visit. An exit interview was conducted with the Executive Director. A copy of this report was provided to the Executive Director, Mark Baddas, whose signature on this form confirms receipt of the report.

Licensing Program Analyst (LPA) David Marrufo, Licensing Program Manager (LPM) Romeo Manzano, and Regional Manager (RM) Vivien Helbling had an office meeting with facility representatives Administrator Mark Baddas, Manager of Operations Manny Lopez, and Legal Counsel Pam Kaufmann. During the meeting, the facility representatives discussed the plans to renovate the facility and presented diagrams and renovation plans to the Department. Administrator Baddas stated that the renovations will primarily include the facility dinning rooms and will also include changes to the carpeting, lighting, and painting of other areas in the facility. He stated there are plans to utilize other portions of the facility to continue dining services to the residents. He stated that the renovation of the Independent Living dining room is expected to take four to six months. RM requested a written Plan of Operation that will explain the renovation plans and the plans to mitigate the interruption of services to residents during construction. No deficiencies were cited at this time as per California Code of Regulations Title 22. This report was reviewed with Administrator Mark Baddas and a copy of this report was provided.

On September 25, 2024, Licensing Program Analysts (LPAs) Kiran Jain and Komal Charitra arrived at the facility at 09:15 AM to conduct the Annual 1-year required inspection. LPAs met with Layana Santos, Director of Health Services and explained the purpose of the visit. Mark Baddas, Executive Director joined shortly after. This is a multi-building, multi-floor 193-unit facility, with a combination of memory care (9 residents), assisted living (14 residents), and independent living (184 residents). LPAs toured the physical plant and observed it as clean, orderly, in good repair, well furnished, and at a comfortable temperature. Assisted living units are one or two bedrooms with private bathrooms. The memory care unit has its own common areas, secure courtyard, and activity rooms. The facility has outdoor spaces, dining rooms, and recreational rooms such as activity rooms, fitness centers, and wellness spaces. The residents have access to the Oshman Family Jewish Community Center for pools, cultural events, and other activities. All common areas were observed to be free from obstructions, and hallways were well-lit. The fire extinguishers were fully charged and last serviced on February, 2024. Emergency exit routes were clear and evacuation plans were posted at multiple locations throughout the facility. The facility’s emergency disaster plan was reviewed. No accessible bodies of water or hazards were observed. LPAs observed that the facility was equipped with keypad access security features. Auditory alarm on exit doors in memory care unit were observed to be operational. The smoke detector and carbon monoxide detector were fully operational. LPAs inspected resident’s rooms and bathrooms at random in the Memory care and Independent Living units. Rooms were observed to be clean with the required furniture and sufficient lighting. The hot water temperature was measured in the residents’ units between 113.6°F and 117.2°F. Sharp objects, detergents, poisons, and chemicals were observed to be locked and inaccessible to persons in care. The residents were seen actively engaged in recreational programs and activities. 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 LPAs observed the dining room and the main kitchen. The kitchen was observed to be clean and well-organized and had the required 7 days of non-perishables and 2 days of perishables. LPAs toured three walk-in refrigerators, 1 freezer, and 1 pantry for the dry food. Food items was wrapped, dated and no expired food items were observed. LPAs reviewed five resident records and six staff records. All were observed to be complete. The resident’s medications are securely stored in a locked room. Medication administration records (MARs) were reviewed and found to be complete, and no expired medications were observed. The First Aid kit was checked and observed to be complete. Emergency drills are conducted monthly with the last drill documented on 08/30/2024. The following updated forms are requested to be submitted to CCLD by 10/02/2024: · LIC 500: Personnel Report · LIC 308: Designation of Facility Responsibility · Administrator Certificate(s) · Liability Insurance No deficiencies were cited during today's visit. An exit interview was conducted. This report was reviewed with Mark Baddas, Executive Director, and Layana Santos, Director of Health Services, and a copy of this report was left at the facility.

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required 1 Year visit and met with Elyse Gerson and Assistant Executive Director Preet Kaur. During visit, LPA Marrufo toured the facility. The facility entrance had a visitor screening area. LPA Marrufo observed a 30-day supply of PPEs. LPA Marrufo observed a perishable food supply of at least 2 days and a non-perishable food supply of at least 7 days. LPA Marrufo also observed emergency water supplies. LPA Marrufo observed the facility bathroom had available soap and paper towels. No deficiencies were cited at this time as per California Code of Regulations - Title 22. This report was reviewed with Assistant Executive Director Preet Kaur and a copy of the report was provided.

Licensing Program Analyst (LPA) David Marrufo conducted a quarterly non-compliance visit and met with Administrator Elyse Gerson and Assistant Executive Director Preet Kaur. LPA Marrufo reviewed the facility training logs that are part of the following facility non-compliance plan: 1. Licensee shall develop a plan in writing describing the training of facility staff on identifying and reporting residents’ change in conditions for timely appropriate medical attention. 2. Licensee shall develop a plan in writing describing the training of facility staff on observation and assessment of residents for any changes in physical, mental, emotional and social functioning to develop a plan of care to meet the resident’s needs. 3. Licensee shall develop a plan in writing describing training of facility staff on identifying prohibited and restricted health conditions and on submitting exception requests to the Department for residents with prohibited or restricted health conditions. Staff should be trained on when to retain a resident, when to request an exception request for the resident, and when to seek a higher level of care for the resident. 4. Licensing shall develop a plan in writing describing the facility protocol when readmitting residents to the facility from the hospital or skilled nursing facility. The plan should include re-appraisals of the resident and developing a new plan of care to meet the resident's needs. 5. Licensee shall develop a plan in writing describing how the personal rights of residents are not violated when resident exhibits wandering behavior, particularly for residents diagnosed with dementia. 6. Licensee shall develop a plan in writing describing the facility protocol to collaborate with other agencies such as hospice agencies and home health agencies to ensure that doctors' orders in the care of the resident are met. 7. Licensee shall develop a plan in writing describing the duties and responsibilities of the Administrator to ensure that resident's health conditions and needs area addressed. The plan shall include staff meetings to communicate resident health conditions and needs. See LIC809-C for more information. Page 1 of 2. 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 Marrufo observed training for the non-compliance plans were conducted on 08/16/2022, 08/30/2022, 10/11/2022, and 10/13/2022. No deficiencies were cited at this time as per California Code of Regulations Title 22. This report was reviewed with Assistant Executive Director Preet Kaur and a copy of the report was provided.

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced annual Required 1 Year visit and met with Karen Lerner. During visit, LPA Marrufo toured the facility. The facility entrance had a visitor screening area. LPA observed the facility bathroom had signs related to COVID-19 and hand washing guidelines. LPA Marrufo observed the facility PPE supply and found the facility had a PPE supply of at least 30-days. LPA Marrufo observed the common areas in the Assisted Living and Memory Support sections of the facility and observed there to be socially distanced seating and COVID-19 related signs posted. LPA Marrufo observed the dinning areas in the Assisted Living and Memory Support areas. LPA Marrufo observed the facility kitchen and found there to be a perishable food supply of at least 3 days and a non-perishable food supply of at least 7 days. LPA Marrufo observed facility staff to be wearing face coverings. No deficiencies were cited as per California Code of Regulations Title 22. This report was reviewed with Karen Lerner and a copy of the report was provided.

Licensing Program Manager (LPM) Jackie Jin, Licensing Program Analyst (LPA) David Marrufo, and Nurse Cristina Wong conducted a tele-visit via Zoom to provide technical assistance to prevent and mitigate the spread of COVID-19 at the facility and met with Administrator Elyse Gerson and Wellness Director Gabriella Brigham. The Administrator reports that there are currently 8 COVID-19 positive residents and 4 COVID-19 positive staff. During today's tele-visit, the following recommendations were made to the facility by Nurse Cristina Wong: 1. Remind staff to label cleaning spray bottles with expiration dates 2. Ensure no more than 2 households in an elevator at a time 3. Continue training staff regarding donning and doffing of PPEs 4. Continue training staff regarding wiping down surfaces No deficiencies were cited as per California Code of Regulations, Title 22. This report was reviewed with Wellness Director Gabriella Brigham. A copy of the report will be sent to her for it to be signed and returned to CCL.