Inspection Reports for
Belmont Village San Ramon
6151 Bollinger Canyon Rd, San Ramon, CA 94583, United States, CA, 94583
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Inspection Report — Mar 4, 2026
Complaint Investigation
Date: Mar 4, 2026
Visit Reason
The inspection was an unannounced complaint investigation visit conducted due to allegations of the facility mismanaging residents' medications and not keeping accurate medication records/logs.
Complaint Details
The complaint investigation was substantiated. The allegations included mismanagement of residents' medications and failure to keep accurate medication records/logs. The Licensing Program Analyst observed medication discrepancies and improper documentation, and staff were unfamiliar with proper medication administration and documentation procedures. Additional staff training was scheduled. Civil penalties of $250 were assessed for repeat violations within 12 months.
Findings
The investigation substantiated the allegations, finding medication mismanagement for residents R1 and R2, including incorrect medication counts, improper documentation, and staff unfamiliarity with medication administration procedures. Civil penalties were assessed for repeat violations.
Citations (2)
Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs; this requirement was not met as staff did not know how to provide proper medication assistance which contributed to medication mismanagement for R1 and R2.
A record of each dose is maintained in the resident's record including date, time, dosage, and resident's response; staff did not properly document the PRN medication history for R2.
Report Facts
Civil Penalty: 250
Deficiencies cited: 2
Plan of Correction Due Date: Mar 18, 2026
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Alona Gomez | Licensing Program Analyst | Conducted the complaint investigation and observations |
| Jennifer Coons | Executive Director | Facility administrator involved in the investigation and interviews |
| Yvonne Flores-Larios | Supervisor | Supervisor overseeing the investigation |
Inspection Report — Feb 6, 2026
Complaint Investigation
Date: Feb 6, 2026
Visit Reason
The inspection visit was conducted as a case management visit in response to an incident report received regarding a medication error involving two residents on 2026-01-31.
Complaint Details
The visit was complaint-related due to an incident where resident one (R1) was given medication intended for resident two (R2) by staff one (S1). The staff member resigned following the incident. The complaint was substantiated by the findings.
Findings
The facility was found to have a deficiency related to medication administration errors by a staff member who has since resigned. The error posed a potential health and personal rights risk to residents, but no negative side effects were reported. The facility provided additional training and guidance to address the issue.
Citations (1)
Facility personnel were not sufficient in numbers and competence to provide necessary services, evidenced by a staff member (S1) previously making medication errors resulting in a resident receiving another resident's medication.
Report Facts
Deficiencies cited: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jennifer Coons | Executive Director | Met during inspection and provided information about the medication error incident |
| Alona Gomez | Licensing Program Analyst | Conducted the inspection visit |
| Yvonne Flores-Larios | Licensing Program Manager | Named in relation to deficiency citations |
Inspection Report — Jan 22, 2026
Annual Inspection
Date: Jan 22, 2026
Visit Reason
The inspection was an unannounced 1-Year Annual Required inspection conducted to evaluate compliance with licensing requirements for the facility.
Findings
The inspection found no deficiencies. The facility met all licensing requirements including adequate safety measures, proper food storage, medication security, and valid CPR certification among staff.
Report Facts
Fire extinguisher service date: Jan 8, 2026
Emergency disaster plan posting date: Jun 18, 2025
Emergency disaster drill date: Dec 10, 2025
Hot water temperatures (Fahrenheit): Array
Freezer temperature (Fahrenheit): -1
Refrigerator temperature (Fahrenheit): 39
Residents records reviewed: 6
Staff records reviewed: 5
Staff records associated with facility: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jennifer Coons | Executive Director | Met with Licensing Program Analyst during inspection and mentioned in findings |
| Alona Gomez | Licensing Program Analyst | Conducted the inspection and authored the report |
| Yvonne Flores-Larios | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report — Sep 23, 2025
Date: Sep 23, 2025
Visit Reason
The visit was an unannounced case management inspection conducted in response to three incident reports involving resident falls resulting in right hip fractures between 08/23/2025 and 09/09/2025.
Findings
The Licensing Program Analyst reviewed footage and interviewed staff, finding that the falls were not due to staff fault and that staff responded promptly. Residents involved were transferred to the hospital and responsible parties notified. No deficiencies were cited during the visit.
Report Facts
Incident reports: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jennifer Coons | Executive Director | Met with Licensing Program Analyst during visit and involved in incident review |
| Alona Gomez | Licensing Program Analyst | Conducted the unannounced case management visit |
| Yvonne Flores-Larios | Licensing Program Manager | Named as Licensing Program Manager on report |
| Director of Resident Care Services | Interviewed regarding resident falls R2 and R3 |
Inspection Report — Jan 9, 2025
Original Licensing
Date: Jan 9, 2025
Visit Reason
The visit was an unannounced second pre-licensing inspection to evaluate the facility's readiness for licensing.
Findings
All issues noted during the first pre-licensing visit were corrected and observed. No issues were noted during this inspection, and the facility was found ready to be licensed, pending final approval by the Central Applications Unit.
Report Facts
Hot water temperature range: Measured between 111.7 and 113.8 degrees Fahrenheit
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jennifer Coons | Executive Director | Met with Licensing Program Analyst during inspection |
| Alona Gomez | Licensing Program Analyst | Conducted the pre-licensing inspection |
| Yvonne Flores-Larios | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report — Jan 7, 2025
Original Licensing
Date: Jan 7, 2025
Visit Reason
The inspection was a prelicensing visit conducted to evaluate the facility's readiness for licensing.
Findings
The facility was toured and found to have appropriate furniture, safety equipment, and environmental conditions, but the hot water temperature was measured over 120 degrees F, indicating the facility is not yet ready to be licensed.
Citations (1)
Hot water temperature is measuring over 120 degrees F
Report Facts
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jennifer Coons | Executive Director | Met with Licensing Program Analyst during inspection and involved in facility tour |
| Alona Gomez | Licensing Program Analyst | Conducted the prelicensing inspection |
Inspection Report — Nov 27, 2024
Original Licensing
Date: Nov 27, 2024
Visit Reason
The visit was an initial licensing evaluation (COMP II) for Belmont Village San Ramon to verify the applicant and administrator's understanding of community care facility licensing laws and readiness for licensing.
Findings
The Component II completion was successful. The applicant and administrator demonstrated understanding of facility operation, admission policies, staffing, health conditions, emergency preparedness, complaints, and pre-licensing readiness.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jennifer Coons | Administrator | Participated in COMP II and was verified as applicant/administrator. |
| Douglas Armstrong | Applicant/Licensee | Participated in COMP II as applicant/licensee. |
Report — July 17, 2026
July 17, 2026
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