Sunol Creek Memory Care

On 4/1/2026 at 12:45PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with Executive Director, Joan Newman and explained the purpose of the visit. LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, activity rooms, kitchen, common areas, and outdoor area. Centrally stored medications were locked in different carts located in the medication room. First Aid kit is complete. Smoke detectors were interconnected with sprinkler system. Carbon monoxide detectors were observed. Fire extinguishers were observed to be full and last serviced on 7/3/2025. Weekly and daily menus were posted in dining areas. Facility is a memory care facility with the exit doors equipped with delayed egress. Last fire drill was conducted on 3/19/2026. One week supply of nonperishable and 2-day supply of perishable foods were available. Facility orders food twice a week. Freezer’s temperature was registered at 0 degree F while the refrigerator’s temperature was recorded at 35 degrees F. Hot water temperature was measured at 106.5 degrees F in a resident's bathroom. Grab bars for each toilet and shower were installed. Non-skid mats/materials were observed. There were adequate lights in each room. Indoor and outdoor passages were free of obstruction. LPA reviewed 5 resident records and 5 staff records starting at 1:15PM. LPA reviewed a sample of resident's medications during inspection. No deficiencies are being cited on this date. Exit interview conducted with Joan Newman and a copy of this report provided.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did occur, therefore the allegation is UNSUBSTANTIATED . Exit interview conducted. A copy of this report provided.

On 9/30/2024 at 1:00PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct Case Management Inspection in regards to the incident report that was received on 8/29/2024. LPA met with Executive Director, Harmony Venturelli and explained the reason for the visit. Based on the incident report received on 8/29/2024, resident (R1) was found by a neighbor down the street and was brought back to the facility by police. During visit, LPA reviewed R1's file including physician's report, care notes, care plan, and incident report. R1's physician's report and care plan indicated that R1 has a history of wandering behaviors and R1 cannot leave the facility unassisted. Interview with staff revealed that when delayed egress alarm went off, S2 went outside and didn't see any residents outside. When a head count was conducted, R1 was found to be missing. The deficiency was observed (see LIC 809D) and cited from the Health and Safety Code. Failure to correct the deficiency may result in civil penalties. Exit interview conducted. A copy of this report and appeal rights provided.

On 10/24/2025 at 3:30PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct Case Management Inspection in regards to incident report that was received on 10/22/2025. LPA met with Executive Director, Joan Newman and explained the reason for the visit. Based on the incident report received on 10/22/2025, resident (R1) was observed in the room attempting to open the window. R1 left the room and walk around the facility. Staff noticed that R1 was not in the common area and staff searched entire unit and found a window in the activity room had been pushed out and was open. During visit, LPA reviewed R1's file including physician's report, care notes, care plan, and incident report. R1's physician's report indicated that R1 cannot leave the facility unassisted. Interview with staff revealed R1 was anxious around 3:00PM and was pacing around the hallways. At around 3:40PM, care staff noticed R1 was missing. Staff conducted a head count and began to look for R1. Staff found R1 at a local shopping center about 20 minutes later. T he deficiency was observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 . Failure to correct the deficiency may result in civil penalties. Exit interview conducted. A copy of this report and appeal rights provided.

On 7/17/2025 at 2:30PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct Case Management Inspection in regards to incident report that was received on 7/9/2025. LPA met with Executive Director, Joan Newman and explained the reason for the visit. Incident report dated 7/9/2025 states R1 was observed having increased anxiety and yelling. R2 approached R1 trying to calm R1 down. R2 grabbed R1 by the wrist and did not let go. Staff intervene and residents were separated immediately. Both resident's families and doctors were notified. During visit, LPA interview staff and reviewed residents' files. Staff stated that residents' were re-evaluated and there were some medication changes for both residents. Physician's reports for R1 and R2 stated that both residents have a dementia diagnosis. Staff stated residents did not recall the incident afterwards and there was no injuries observed. No deficiencies are being cited on this date. Exit interview conducted with Joan Newman. A copy of this report provided

On 4/18/2025 at 3:55PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct Case Management Inspection in regards to the incident report that was received on 4/14/2025. LPA met with Human Resource Assistant, Jennalaine Gagante and explained the reason for the visit. Incident report dated 4/14/2025 states that R1 was transported to the hospital due to lethagic, lack of appetite, and diarrhea. R1 was diagnosed with C. Diff. R1 was placed in isolation with PPEs provided and supplied in front of R1's room. During visit, LPA reviewed R1's files. Discharge summary revealed that R1 was discharged with medication treatment. Facility observation notes indicated staff are monitoring resident's changes in condition. No deficiencies are being cited on this date. Exit interview conducted with Jennalaine Gagante. A copy of this report provided

On 2/19/2026 at 4:45PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct Case Management Inspection in regards to SOC341 that was received on 2/17/2026. LPA met with Executive Director, Joan Newman and explained the reason for the visit. Based on SOC341 received on 2/17/2026, staff observed resident (R1) was sitting on the floor next to walker with door partially opened. Roommate (R2) was yelling and asking staff to leave. Staff did not observed injuries on R1 and R1 was assisted to another room on the other side of the facility for the remainder of the night. Staff observed fecal matter on R1's mattress and sheets. Staff cleaned the soiled linens. Staff notified both resident's responsible parties and doctors regarding the incident. During visit, LPA collected documents including physician's report, care plan, and care notes for two clients. Interview with S1 indicated R1 was relocated to another room with a new roommate. No deficiencies are being cited on this date. LPA may return at a later time. Exit interview conducted. A copy of this report provided.

On 4/21/2022 at 1:36PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct an Infection Control Inspection. LPA met with Assistant Executive Director, Divine Ramirez . Upon entry, LPA was asked to complete the automated system for COVID-19 screening. LPA observed hand sanitizer at screening station. LPA toured facility including but not limited to resident's bedrooms, bathrooms, kitchen, common areas, and outdoor areas. LPA observed cough etiquette, signs & symptoms, and physical distancing are posted in the common areas. All hand washing stations were equipped with soap and paper towel. Hand washing posters were posted in bathrooms. Indoor and outdoor passageways are free of obstruction. During record review, LPA observed visitors log and temperature log for both residents and staff. LPA observed facility has a copy of Mitigation Plan on file. Staff were FIT tested and have documentation on file. LPA observed PPE, food supplies, and paper supplies are sufficient. No deficiencies are being cited on this date. Exit interview conducted. A copy of this report was provided.

On 4/2/2025 at 11:05AM, Licensing Program Analysts (LPAs) G. Luk and Y. Brown arrived unannounced to conduct a Required - 1 Year inspection. LPAs met with Executive Director, Joan Newman and explained the purpose of the visit. LPAs toured the facility with Joan including but not limited to bedrooms, bathrooms, dining area, activity rooms, kitchen, common areas, and outdoor area. Centrally stored medications were locked in different carts located in the med room. First Aid kit is complete. The facility has a written emergency disaster plan. Smoke detectors were interconnected with sprinkler system. Carbon monoxide detectors were observed. Fire extinguishers were observed to be full and last serviced on 6/27/2024. Weekly and daily menus were posted in dining areas. Facility is a memory care facility with the exit doors equipped with delayed egress in operating condition. One week supply of nonperishable and 2-day supply of perishable foods were available. Facility orders food twice a week. Freezer’s temperature was registered at -1 degree F while the refrigerator’s temperature was recorded at 39 degrees F. Hot water temperature was measured at 108 degrees F in a resident's bathroom. Grab bars for each toilet and shower were installed. Non-skid mats/materials were observed. There were adequate lights in each room. Indoor and outdoor passages were free of obstruction. LPA reviewed 5 resident records and 5 staff records starting at 12:00PM. LPA reviewed a sample of resident's medications during inspection. No deficiencies are being cited on this date. Exit interview conducted with Joan Newman and a copy of this report provided.

On 11/4/2024 at 3:10PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct Case Management Inspection in regards to the incident report that was received on 10/25/2024. LPA met with Executive Director (ED), Harmony Venturelli and explained the reason for the visit. Based on the incident report received on 10/25/2024, ED was notified that 8 residents missed their bedtime medications on 10/19/2024. Residents did not have adverse reactions due to med tech mis-communication on assisting with medications and crushing medication. During visit, LPA reviewed incident report, MAR (Medication Administration Record), fax communication to doctors, and staff training. LPA observed S1 has medication training. Interview with staff revealed that S1 did not assist residents with the medications due to a misconception of crushed medications. The deficiency was observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 . Failure to correct the deficiency may result in civil penalties. Exit interview conducted. A copy of this report and appeal rights provided.

On 9/30/2024 at 2:30PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct Case Management Inspection in regards to the incident report that was received on 9/26/2024. LPA met with Executive Director, Harmony Venturelli and explained the reason for the visit. Incident report dated 9/26/2024 states that R1 returned from the dermatologist for follow up on a rash and was diagnosed with scabies. During visit, LPA interviewed staff and reviewed R1's files. R1's care notes revealed that R1 was seen by the doctors when R1 first had signs of itchiness or a rash in the beginning of August 2024. R1's rash was treated by the doctors and facility staff followed up with R1's doctor as needed until the doctor recommended R1 to see a dermatologist. No deficiencies are being cited on this date. Exit interview conducted. A copy of this report provided

Based on LPA's information obtained during investigation, the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED . California Code of Regulations, Title 22, are being cited on the attached LIC9099D. Exit interview conducted with Harmony Venturelli. A copy of this report and 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 R1 was evaluated by facility nurse and R1 was alert and responsive, able to display range of motion in all extremities, able to stand and bear weight with assistance, but complained of mild right shoulder pain. Hospital records revealed that R1 was found to have a fracture on right proximal humerus. R1 was medically cleared to return to the facility after a couple days at the hospital. On 4/30/2023, R1 was sent out to the hospital due to shortness of breath. Medical records revealed that R1’s tongue rolled up which obstructed airway. The CT exam showed no signs of intracranial hemorrhage. R1 returned to the facility with hospice services on 5/1/2023. Hospice records revealed that R1 had regular difficulty swallowing medication and food which lead to a decline in health. R1’s death certificate indicated the cause of death was vascular dementia. Resident sustained severe injuries due to staff neglect Interview with staff indicated that R1’s fall was an accident and R1 have not fallen off the wheelchair before. S2 stated R1 was known to lean forward and to prevent R1 from falling off the wheelchair, staff would place pillows on R1’s side. When S2 was taking R1 to the room to change diaper, R1 leaned forward and fell off the wheelchair into her right side. S2 was unsure how R1 fell because R1 had pillows on her sides. Facility staff have conducted training on dementia care, alternatives to restraints in elder care, proper positioning, safe transfers, and falls in assisted living. Staff handled residents in a rough manner Interview with staff revealed that they have not witness staff being rough with residents. Interview with resident indicated that staff are very nice and polite people. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did occur, therefore the allegations are UNSUBSTANTIATED . Exit interview conducted. A copy of this report provided.

On 6/27/2024 at 10:30AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct Case Management Inspection in regards to the incident report that was received on 6/25/2024. LPA met with Executive Director, Harmony Venturelli and Human Resources Assistant, Jacqueline Scott Garcia. LPA explained the reason for the visit. Incident report dated 6/25/2024 states that R1 was taken to the doctors due to pain and weakness. R1 had x-rays completed with results of closed fracture. During visit, LPA interviewed staff and reviewed R1's files. Discharge summary indicated that R1 will follow up with the doctor in one week. After reviewing chart notes, R1 was given PRN medications when experiencing pain. No deficiencies are being cited on this date. Exit interview conducted with Jacqueline Scott Garcia. A copy of this report provided

On 4/2/2024 at 10:30AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with Business Office Manager, Jacqueline Scott Garcia and Executive Director, Harmony Venturelli. The facility’s fire clearance was approved for 46 residents, 40 may be non-ambulatory, 6 may bedridden, and 20 residents may be under hospice care. LPA toured the facility with Jacqueline including but not limited to bedrooms, bathrooms, dining area, activity rooms, kitchen, common areas, and outdoor area. Centrally stored medications were locked in different carts located in the med room. First Aid kit is complete. The facility has a written emergency disaster plan. Smoke detectors were interconnected with sprinkler system. Carbon monoxide detectors were observed. Fire extinguishers were observed to be full and last serviced on 6/29/2023. Weekly and daily menus were posted in dining areas. Facility is a memory care facility with the exit doors equipped with delayed egress. One week supply of nonperishable and 2-day supply of perishable foods were available. Facility orders food twice a week. Freezer’s temperature was registered at -1 degree F while the refrigerator’s temperature was recorded at 37 degrees F. Hot water temperature was measured at 110.5 degrees F in a resident's bathroom. Grab bars for each toilet and shower were installed. Non-skid mats were observed. There were adequate lights in each room. Indoor and outdoor passages were free of obstruction. LPA reviewed 5 resident records and 5 staff records starting at 11:55AM. LPA interviewed 3 residents and 3 staff during inspection. LPA reviewed a sample of resident's medications starting at 4:00PM. No deficiencies are being cited on this date. Exit interview conducted with Jacqueline and a copy of this report provided.

On 9/29/2023 at 11:30 AM, Licensing Program Analyst (LPA) Greg Clark arrived unannounced to conduct a case management visit. LPA met with Health Service Director, Carolyn Appeal (HSD) and explained the purpose of the visit. LPA went to the facility to deliver an Immediate Exclusion letter. It was confirmed S1 is currently employed at the facility. Immediate Exclusion letter was delivered to HSD. LPA has advised HSD to disassociate the individual from their roster and submit an updated LIC 500 to CCL. Facility called S1 and advised him of the immediate exclusion. Exit interview conducted and a copy of this report provided.

On 9/1/2023 at 2:30PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a case management visit in regards to death report received on 8/23/2023. LPA met with Health Service Director, Carolyn Appeal and explained the purpose of the visit. LPA received death report on 8/23/2023 for resident (R1). Death report revealed that R1 passed away at the hospital on 8/18/2023. R1 was sent to the hospital on 8/7/2023 due to respiratory distress. LPA interviewed staff and obtained R1's documents (physician's report, care plan, and care notes). LPA was informed that R1 sent out to the hospital on 8/7/2023 due to low oxygen level. Facility staff followed up with the hospital after R1 was admitted. Care notes indicated that R1 was tested positive at the hospital on 8/7/2023 and was admitted to ICU with diagnosis of respiratory failure. Physician's report dated 4/25/2023 indicated that R1's diagnosis include COPD and atrial fibrillation. No deficiencies are being cited on this date. Exit interview conducted. A copy of this report provided.

On 7/5/2023 at 10:30AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a health and safety check as a result of a priority 1 complaint. LPA met with Business Office Manager, Jacqueline Scott. LPA toured facility including but not limited to the resident bedrooms, bathrooms, common area, kitchen, and outdoor area. Hot water temperature was measured at 109.7 degrees F in a resident's bathroom sink. 7-day of non-perishable and 2-day of perishable food supplies were sufficient. Facility order food supplies twice a week. Refrigerator temperature was observed at 40 degrees F and freezer temperature was observed at 0 degrees F. Resident's medications were kept locked in the medication carts. Smoke detectors are interconnected with sprinkler system. Carbon monoxide detector observe. First-aid kit was complete. Fire extinguisher was observed to be full and last serviced on 6/29/2023. There are no accessible bodies of water observed. No deficiencies are being cited on this date. Exit interview conducted. A copy of this report was provided.

On 4/7/2023 at 2:30PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct Case Management Inspection in regards to the two SOC341 that was received. LPA met with Business Office Manager, Jacqueline Scott. SOC341 dated 2/9/2023 states that R1 and R2 was sitting next to each other on the couch. R1 and R2 had an altercation and R2 was back handed by R1. Staff immediately separated the two residents. Both residents' responsible party and doctors were notified. SOC341 dated 3/30/2023 states that R3 was sitting on a wheelchair in the dining area with legs extended. R1 grabbed R3's legs and attempted to pull R3 to the floor. Staff was nearby to catch R3 and assisted R3 to the floor. Both residents' responsible party and doctors were notified. During visit, LPA interviewed staff and reviewed R1's files. For incident on 2/9/2023, R1's family was informed and facility required 1:1 companion for the next 72 hours during the daytime. R1's doctor adjusted medication for R1. For incident on 3/29/2023, R1's family was informed and facility required 1:1 companion for the next 72 hours during the daytime. R1's medications was increased. No deficiencies are being cited on this date. Exit interview conducted. A copy of this report provided.

On 4/7/2023 at 11:10AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct Case Management - Annual Continuation. LPA met with Business Office Manager, Jacqueline Scott. During visit, LPA interviewed 3 staff starting at 11:43AM. At around 12:30PM, LPA reviewed staff training records and observed staff completed training which includes dementia, emergency, resident rights, hospice, ADL (Activities of Daily Living) care, and other topics. At 2PM, LPA reviewed two residents' medications with their centrally stored records and MAR (Medication Administration Records). LPA observed medications were written on the centrally stored records and MAR showed medications were administered as prescribed by physician. No deficiencies are being cited on this date. Exit interview conducted and a copy of this report provided.

On 1/10/2023 at 3:15PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a case management visit regarding the incident report received on 1/3/2023. LPA met with Interim Executive Director, Divine Ramirez and informed her the reason for the visit. Incident report states that on 12/31/2022 Fire Marshal was on site due to the flooding on the south side parking lot caused by a storm water line. There was minor flooding and water damaged that was centralized to the south side of the facility. Affecting rooms include room 101-108. Residents were escorted to the north side of the facility and moved to different accommodations. All residents were fine and no injuries. During visit, LPA toured the rooms that the residents were relocated and observed the residents were doing well. LPA obtained temporary relocation sites and a list of residents. LPA was informed that 8 rooms were affected and 13 residents were relocated to unoccupied rooms in the facility. Interim Executive Director will update LPA once repair plans have been made. LPA requested flood mitigation plan with repair information and a flood prevention plan. No deficiencies are being cited on this date. Exit interview conducted. A copy of this report provided.