Inspection Reports for
Brookdale Scotts Valley

CA, 95066

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Citations (last 6 years)

Citations (over 6 years) 1.3 citations/year

Citations are regulatory findings recorded during state inspections.

68% better than California average
California average: 4 citations/year

Citations per year

8 6 4 2 0
2021
2022
2023
2024
2025
2026

Occupancy

Latest occupancy rate 73% occupied

Based on a March 2026 inspection.

This facility has shown a steady increase in demand based on occupancy rates.

Occupancy rate over time

40% 60% 80% 100% Jul 2021 Jun 2023 May 2024 Nov 2024 Apr 2025 Oct 2025 Mar 2026

Inspection Report

Census: 160 Capacity: 220 Citations: 0 Date: Mar 26, 2026

Visit Reason
The visit was an unannounced Case Management to conduct a Quarterly Visit to ensure the facility is adhering to the Facility's Action Plan submitted after an Informal Conference meeting held on 8/13/2024.

Findings
The Licensing Program Analyst reviewed staff training on personal rights and proper resident approach as part of the facility's Action Plan. The facility is adhering to the Action Plan for staff training, and no deficiencies were cited per California Code of Regulations, Title 22.

Employees mentioned
NameTitleContext
Alex BaiasuExecutive DirectorMet with during the inspection and discussed facility adherence to Action Plan.
Marcella TarinLicensing Program AnalystConducted the unannounced Case Management visit.
Beena KumarAdministrator/DirectorNamed as facility administrator/director.

Inspection Report

Complaint Investigation
Census: 158 Capacity: 220 Citations: 0 Date: Feb 18, 2026

Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 09/17/2025 regarding staffing shortages and a resident sustaining a pressure injury while in care.

Complaint Details
The complaint included allegations that the facility did not have enough staff to meet residents' needs and that a resident sustained a pressure injury while in care. The investigation was unsubstantiated due to lack of sufficient evidence to prove the violations occurred.
Findings
The investigation found no preponderance of evidence to substantiate the allegations. Staff interviews and progress notes indicated residents were checked according to care plans and no deficiencies were cited. The resident's pressure injury was documented and communicated appropriately, with some communication issues noted with the home health agency.

Report Facts
Capacity: 220 Census: 158

Employees mentioned
NameTitleContext
Marcella TarinLicensing Program AnalystConducted the complaint investigation visit
Alex BaiasuExecutive DirectorMet with Licensing Program Analyst during investigation and provided statements
Beena KumarAdministratorFacility administrator named in report header
Christine KabaritiSupervisorSupervisor overseeing the investigation

Inspection Report

Complaint Investigation
Census: 157 Capacity: 220 Citations: 0 Date: Feb 6, 2026

Visit Reason
The inspection was an unannounced complaint investigation conducted in response to allegations received on 2025-05-02 regarding improper transfer assistance, untimely staff response, unsanitary resident rooms, failure to follow infection control protocols, and staff engaging in verbal arguments in front of residents.

Complaint Details
The complaint included multiple allegations: improper transfer assistance, untimely staff response, unsanitary resident rooms, failure to follow infection control protocols, and staff engaging in verbal arguments in front of residents. The investigation involved interviews with 6 staff and 9 residents, testing of pendant response times, and review of training records. The complaint was determined to be unfounded.
Findings
After interviewing staff, residents, and reviewing training records and observations, the investigation found the complaint to be unfounded, meaning the allegations were false, could not have happened, or lacked reasonable basis. Staff were found to be trained and compliant with transfer assistance, timely response, room cleanliness, infection control protocols, and no evidence of verbal arguments in front of residents was substantiated.

Report Facts
Census: 157 Total Capacity: 220 Staff interviewed: 6 Residents interviewed: 9 Pendant response time (R2): 5 Pendant response time (R9): 3

Employees mentioned
NameTitleContext
Marcella TarinLicensing Program AnalystConducted the complaint investigation
Alex BaiasuExecutive DirectorMet with Licensing Program Analyst during investigation and exit interview

Inspection Report

Census: 161 Capacity: 220 Citations: 0 Date: Dec 29, 2025

Visit Reason
The visit was an unannounced Case Management to conduct a Quarterly Visit to ensure the facility is adhering to the Facility's Action Plan submitted after an Informal Conference meeting held on 8/13/2024.

Findings
The Licensing Program Analyst reviewed staff training on personal rights and proper resident approach, confirming adherence to the facility's Action Plan. No deficiencies were cited per California Code of Regulations, Title 22.

Employees mentioned
NameTitleContext
Alex BaiasuExecutive DirectorMet with during the inspection and involved in review of findings.
Marcella TarinLicensing Program AnalystConducted the unannounced Case Management visit.
Beena KumarAdministrator/DirectorNamed as facility administrator/director.

Inspection Report

Census: 168 Capacity: 220 Citations: 0 Date: Oct 23, 2025

Visit Reason
The visit was an unannounced Case Management - Other inspection to amend the findings of a previous complaint (26-AS-20250724093244).

Complaint Details
The visit was related to Complaint 26-AS-20250724093244. The findings were amended from unsubstantiated to unfounded.
Findings
During the visit, the Licensing Program Analyst amended the complaint findings from unsubstantiated to unfounded. No deficiencies were cited during this visit.

Employees mentioned
NameTitleContext
Marcella TarinLicensing Program AnalystConducted the Case Management - Other visit and amended complaint findings.
Alex BaiasuExecutive DirectorMet with Licensing Program Analyst during the visit.
Beena KumarAdministrator/DirectorNamed as facility administrator/director.

Inspection Report

Annual Inspection
Census: 170 Capacity: 220 Citations: 0 Date: Aug 11, 2025

Visit Reason
An unannounced annual inspection was conducted by Licensing Program Analysts to evaluate compliance with licensing requirements at the facility.

Findings
The facility was found to be in compliance with no deficiencies cited during the visit. A Technical Violation was issued related to Centrally Stored Medication and Destruction Records. The facility's environment, emergency preparedness, resident records, and staff records were reviewed and found satisfactory.

Report Facts
Water temperature range: 105.2 Water temperature range: 116.2 Residents observed during activity: 20 Resident records reviewed: 10 Staff records reviewed: 10 Medication records reviewed: 5 Facility capacity: 220 Facility census: 170

Employees mentioned
NameTitleContext
Alex BaiasuExecutive DirectorMet with Licensing Program Analysts during inspection and exit interview
Marcella TarinLicensing Program AnalystConducted the inspection and signed the report
Marcela YanezLicensing Program AnalystConducted the inspection
Jin JackieLicensing Program ManagerNamed in the report header

Inspection Report

Complaint Investigation
Census: 171 Capacity: 220 Citations: 0 Date: Aug 1, 2025

Visit Reason
The visit was an unannounced complaint investigation triggered by allegations that staff did not permit residents to choose their pharmacy and did not notify the resident's responsible party of a fee increase.

Complaint Details
The complaint alleged that staff did not permit residents to choose their pharmacy and failed to notify the resident's responsible party of fee increases. After interviews and document reviews, including a mutual agreement meeting and refund of pharmacy fees, the complaint was determined to be unfounded.
Findings
The complaint was investigated and found to be unfounded, meaning the allegations were false or without reasonable basis. No deficiencies were cited during the visit.

Report Facts
Capacity: 220 Census: 171

Employees mentioned
NameTitleContext
Marcella TarinLicensing Program AnalystConducted the complaint investigation visit
Alex BaiasuExecutive DirectorMet with Licensing Program Analyst during the investigation and provided information

Inspection Report

Complaint Investigation
Census: 171 Capacity: 220 Citations: 0 Date: Jun 4, 2025

Visit Reason
The visit was an unannounced complaint investigation triggered by allegations received on 2025-01-24 regarding feeding assistance, soiled clothing, and repositioning of a resident.

Complaint Details
The complaint alleged that staff did not ensure feeding assistance was provided, allowed a resident to be left in soiled clothing for extended periods, and did not reposition the resident. The investigation found these allegations unsubstantiated due to lack of preponderance of evidence.
Findings
Based on interviews, document reviews, and observations, there was insufficient evidence to substantiate the allegations. Staff and residents generally reported appropriate care practices, and no deficiencies were cited during the visit.

Report Facts
Staff interviewed: 11 Residents interviewed: 10 Residents under hospice care: 1 Residents diagnosed with terminal illness and major neurocognitive disorder: 1 Residents not requiring feeding assistance: 3 Residents requiring repositioning every 2 hours: 1

Employees mentioned
NameTitleContext
Marcella TarinLicensing Program AnalystConducted the complaint investigation and interviews
Jin JackieLicensing Program ManagerOversaw the complaint investigation
Beena KumarAdministratorFacility administrator named in the report
Christine MonelaroStaffStaff member met with during the investigation
Alex BaiasuExecutive DirectorParticipated in exit interview via phone

Inspection Report

Complaint Investigation
Census: 164 Capacity: 220 Citations: 0 Date: May 23, 2025

Visit Reason
The inspection was an unannounced complaint investigation triggered by allegations received on 2024-12-05 regarding staff response times to call buttons, staff behavior towards residents, medication administration, and meal delivery.

Complaint Details
The complaint was unsubstantiated. Allegations included delayed response to call buttons, staff yelling at residents, lack of dignity in staff-resident relationships, failure to follow doctor's orders for medication, and failure to deliver meals as per admission agreement. Investigations included interviews with staff and residents, random call button testing, and medication record review. Evidence did not support the allegations sufficiently to substantiate violations.
Findings
The investigation found that most call buttons were responded to within 15 minutes, with one instance of a 41-minute delay. Allegations of staff yelling at residents and not following doctor's orders for medication were mostly unsubstantiated based on staff and resident interviews. There was some indication that meal delivery did not always occur as agreed, but evidence was insufficient to substantiate violations. No deficiencies were cited.

Report Facts
Capacity: 220 Census: 164 Call button response times: 4 Call button response times: 1 Staff interviewed: 7 Residents interviewed: 11 Medication Administration Records reviewed: 5

Employees mentioned
NameTitleContext
Alex BaiasuExecutive DirectorMet with during inspection and exit interview
Marcella TarinEvaluator / Licensing Program AnalystConducted the complaint investigation
Jin JackieLicensing Program ManagerNamed in report as Licensing Program Manager

Inspection Report

Complaint Investigation
Census: 163 Capacity: 220 Citations: 0 Date: May 14, 2025

Visit Reason
The inspection was an unannounced complaint investigation conducted in response to multiple allegations received on 09/19/2024 regarding visitor restrictions, inappropriate isolation and punishment of residents, medication mismanagement, unqualified staff administering medication, and failure to ensure residents are given showers.

Complaint Details
The complaint investigation addressed nine allegations including visitor restrictions, inappropriate isolation and punishment, medication mismanagement, unqualified staff administering medication, and failure to ensure residents are given showers. All allegations were found to be unfounded except the shower allegation which was unsubstantiated.
Findings
The investigation found all allegations to be either unfounded or unsubstantiated based on interviews with residents, staff, and review of records. No evidence supported visitor restrictions, inappropriate isolation or punishment, medication mismanagement, or unqualified medication administration. The allegation regarding residents not being given showers was unsubstantiated due to inconsistent shower schedules caused by staffing shortages but no neglect was found.

Report Facts
Capacity: 220 Census: 163 Dates of complaint receipt and investigation: Complaint received on 2024-09-19; investigation visit on 2025-05-14 Staff permit validity: Staff S1 interim permit valid from 2023-11-06 to 2024-08-06; Vocational Nurse license issued 2024-10-22

Employees mentioned
NameTitleContext
Manuel MonterLicensing Program AnalystConducted the complaint investigation and interviews
Steve ChangLicensing Program AnalystConducted initial investigation visit and interviews
Marcella TarinLicensing Program AnalystConducted initial investigation visit and interviews
Alex BaiasuExecutive DirectorMet with Licensing Program Analyst during investigation
Beena KumarAdministratorFacility administrator named in report header
S1Staff memberAlleged unqualified staff administering medication; interview revealed permit expired and license issued after alleged period
Romeo ManzanoLicensing Program ManagerNamed as Licensing Program Manager overseeing investigation

Inspection Report

Complaint Investigation
Census: 159 Capacity: 220 Citations: 0 Date: Apr 24, 2025

Visit Reason
An unannounced complaint investigation was conducted following complaints received on October 25, 2023, alleging that staff did not notify the authorized representative when a resident went to the hospital and that a resident was left on the floor for an extended period of time.

Complaint Details
The complaint investigation was triggered by allegations that staff failed to notify the authorized representative of a resident's hospital transfer on August 18, 2023, and that a resident was left on the floor for over two hours after a fall in July 2023. Both allegations were found unsubstantiated after interviews with family members, power of attorney, staff, and residents, as well as review of progress notes and facility policies.
Findings
After interviews, record reviews, and investigation, the Department found both allegations unsubstantiated due to insufficient evidence to prove the claims. The facility followed protocols for notifying responsible parties and responded timely to resident calls.

Report Facts
Capacity: 220 Census: 159 Response time: 10.5 Response time: 4 Time resident was left on floor: 120

Employees mentioned
NameTitleContext
Alex BaiasuAdministratorMet with Licensing Program Analyst during investigation and exit interview
Manuel MonterLicensing Program AnalystConducted the complaint investigation
Beena KumarAdministratorNamed as facility administrator in report header

Inspection Report

Complaint Investigation
Census: 162 Capacity: 220 Citations: 0 Date: Apr 4, 2025

Visit Reason
The inspection was conducted as an unannounced complaint investigation following a complaint received on 2025-01-17 alleging that staff were not meeting residents' laundry needs and that laundry machines were in disrepair.

Complaint Details
The complaint alleged that staff were not meeting residents' laundry needs and that laundry machines were in disrepair. Interviews with staff and residents yielded mixed responses, but overall no preponderance of evidence was found to prove the allegations. The complaint was unsubstantiated.
Findings
Based on interviews with staff and residents, record reviews, and observations, there was insufficient evidence to substantiate the allegations. Laundry machines were observed to be functioning properly, and laundry service once a week is part of the facility's basic service plan. The allegations were determined to be unsubstantiated and no deficiencies were cited.

Report Facts
Number of washers: 15 Number of dryers: 15 Number of staff interviewed: 6 Number of residents interviewed: 9

Employees mentioned
NameTitleContext
Beena KumarAdministratorInterviewed regarding laundry service allegations
Alex BaiasuExecutive DirectorMet with during inspection and report review
Marcella TarinLicensing Program AnalystConducted investigation and signed report
Jin JackieLicensing Program ManagerNamed in report as Licensing Program Manager

Inspection Report

Census: 146 Capacity: 220 Citations: 0 Date: Jan 15, 2025

Visit Reason
The visit was an unannounced Case Management Quarterly Visit to ensure the facility is adhering to its Action Plan submitted to Community Care Licensing after an informal meeting held on 08/13/2024.

Findings
The Licensing Program Analyst reviewed staff training on personal rights and proper resident approach, confirming adherence to the facility's Action Plan. No deficiencies were cited during this visit.

Employees mentioned
NameTitleContext
Alex BaiasuExecutive DirectorMet with during the visit and reviewed the report.
Marcella TarinLicensing Program AnalystConducted the unannounced Case Management visit.

Inspection Report

Complaint Investigation
Census: 139 Capacity: 220 Citations: 1 Date: Dec 21, 2024

Visit Reason
This was an unannounced complaint investigation visit triggered by a complaint received on 07/06/2023 alleging multiple issues including inaccurate resident records, improper wound care, unmet diabetic care needs, medication administration issues, failure to respond to calls for help, elopement prevention failures, hygiene care deficiencies, inadequate laundry and food services, and pest control problems.

Complaint Details
The complaint was substantiated regarding inaccurate resident medication records. The allegation that staff purposely entered inaccurate information was not supported. Other allegations including wound care, diabetic care, medication administration, response to calls for help, elopement prevention, hygiene care, laundry service, food service, and pest control were unsubstantiated. The investigation was conducted by Licensing Program Analyst Christina Valerio and included records review, interviews with residents and staff, and facility documentation review.
Findings
The investigation substantiated that staff did not maintain accurate medication records for two residents, posing potential health risks. Other allegations such as improper wound care, diabetic care, medication administration, response to calls for help, elopement prevention, hygiene care, laundry, food service, and pest control were found unsubstantiated due to lack of evidence or contradictory documentation and interviews.

Citations (1)
Licensee did not ensure staff maintained a complete medication record for Resident 4 and Resident 5 medication dosages, posing a potential health, safety, and personal rights risk to residents in care.
Report Facts
Capacity: 220 Census: 139 Deficiencies cited: 1 Plan of Correction Due Date: Jan 20, 2025

Employees mentioned
NameTitleContext
Christina ValerioLicensing Program AnalystConducted the complaint investigation and authored the report
Alex BaiasuExecutive DirectorInterviewed during investigation regarding findings and resident care
Dimple KamdarAdministratorNamed as facility administrator in report
Stephen RichardsonSupervisorSupervisor overseeing the licensing evaluation

Inspection Report

Follow-Up
Census: 141 Capacity: 220 Citations: 0 Date: Dec 11, 2024

Visit Reason
The visit was an unannounced follow-up to investigate two SOC341 Suspected Adult/Elderly Abuse forms submitted by the facility regarding thefts of residents' belongings.

Complaint Details
The visit was complaint-related, investigating allegations of theft involving staff member S1. Law enforcement investigated S1 for thefts outside the facility but could not prove theft within the facility. The facility had not submitted unusual incident reports for the thefts.
Findings
The investigation found that one resident recovered their missing necklace and cash, and another resident found their missing necklace after misplacing it. No deficiencies were cited, but advisory notes were issued.

Report Facts
Capacity: 220 Census: 141 Suspension Form Date: Oct 4, 2024 Reported theft amounts: 300 Reported theft amounts: 2000 Reported theft amounts: 500

Employees mentioned
NameTitleContext
Alex BaiasuAdministratorMet with Licensing Program Analysts during the visit and provided information about the investigation
David MarrufoLicensing EvaluatorConducted the inspection and authored the report
Marcella TarinLicensing Program AnalystConducted the inspection

Inspection Report

Complaint Investigation
Census: 140 Capacity: 220 Citations: 0 Date: Dec 6, 2024

Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations that a non-medical skilled professional was administering insulin injections to diabetic residents and that staff were not administering residents' insulin as prescribed.

Complaint Details
The complaint alleged improper insulin administration by non-nurses and missed insulin doses for residents R1 and R2. The investigation included interviews with staff, residents, and review of physician reports and medication records. The findings were unsubstantiated due to lack of preponderance of evidence.
Findings
Based on interviews, document reviews, and medication administration records, the allegations were found to be unsubstantiated. Staff nurses were confirmed to be administering insulin as prescribed, and missing medication entries were attributed to computer errors.

Report Facts
Capacity: 220 Census: 140 Medication Administration Records missing entries: 1

Employees mentioned
NameTitleContext
Steve ChangLicensing Program AnalystConducted the unannounced investigation visit and delivered findings
Alex BaiasuExecutive DirectorMet with Licensing Program Analyst during investigation and exit interview
Beena KumarAdministratorNamed as facility administrator
Chihhsien ChangLicensing Program AnalystConducted complaint investigation and signed report
Romeo ManzanoLicensing Program ManagerOversaw complaint investigation
S1Staff Nurse (LVN permit holder)Interviewed regarding insulin administration; stated only administered insulin with nurses
S2Staff Nurse (LVN license holder)Interviewed regarding insulin administration; confirmed adherence to doctor orders

Inspection Report

Complaint Investigation
Census: 134 Capacity: 220 Citations: 0 Date: Nov 9, 2024

Visit Reason
The inspection visit was an unannounced complaint investigation triggered by allegations received on 07/05/2022 regarding rough handling of a resident, inappropriate speech to a resident, and delayed medical attention.

Complaint Details
The complaint involved allegations that a resident was handled roughly causing a skin tear, was spoken to inappropriately, and did not receive timely medical attention. Interviews with staff and the resident were conducted, but attempts to interview the reporting party were unsuccessful. The facility no longer uses the staffing agency involved. The resident recalled the incident but could not identify the staff member by name. The wounds were treated several days after the incident. The complaint was unsubstantiated due to insufficient evidence.
Findings
The investigation found insufficient evidence to substantiate the allegations. Despite some reports of rough handling causing a skin tear and inappropriate comments by a staff member, the facility no longer uses the implicated staffing agency and no deficiencies were cited. The allegations were determined unsubstantiated due to lack of preponderance of evidence.

Report Facts
Complaint Control Number: 26-AS-20220705084955 Number of allegations: 3

Employees mentioned
NameTitleContext
Christina ValerioLicensing Program AnalystConducted the complaint investigation and authored the report
Alex BaiasuExecutive DirectorMet with Licensing Program Analyst during the investigation and received the report
Stephen RichardsonSupervisorSupervisor overseeing the investigation

Inspection Report

Complaint Investigation
Census: 137 Capacity: 220 Citations: 0 Date: Oct 13, 2024

Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint received on 2022-07-05 regarding allegations of pests in a resident's room, residents threatening other residents, and staff threatening a resident.

Complaint Details
The complaint involved three allegations: 1) Resident's room had pests; 2) Resident was threatened by other residents while in care; 3) Resident was threatened by staff while in care. The investigation included interviews with residents and staff, review of pest control records, and attempts to interview the reporting party. The allegations were unsubstantiated due to lack of preponderance of evidence.
Findings
The investigation found no substantiated evidence to support the allegations. Pest control services were documented as active, and interviews with residents and staff did not confirm threats by residents or staff. The allegations were deemed unsubstantiated with no deficiencies cited.

Report Facts
Complaint received date: Jul 5, 2022 Number of allegations: 3 Pest control service dates: 3 Work order pages: 4 Years resident 2 lived in community: 7

Employees mentioned
NameTitleContext
Christina ValerioLicensing Program AnalystConducted the complaint investigation and authored the report
Alex BaiasuExecutive DirectorFacility representative met during the investigation and exit interview
Dimple KamdarExecutive DirectorNamed in allegation of threatening resident but no interview conducted as no longer ED

Inspection Report

Complaint Investigation
Census: 125 Capacity: 220 Citations: 3 Date: Aug 16, 2024

Visit Reason
An unannounced complaint investigation visit was conducted following a complaint received on 2023-07-11 regarding allegations that staff did not provide resident's records to the responsible party, did not follow the resident's care plan, and did not give sufficient notice of rate and service increases.

Complaint Details
The complaint was substantiated. Allegations included failure to provide resident's records to the responsible party, failure to follow the resident's care plan, and failure to provide sufficient notice of rate and service increases. The investigation included interviews, document reviews, and evidence collection confirming these issues.
Findings
The investigation substantiated the allegations: the facility failed to provide resident records timely to the responsible party, did not follow the resident's care plan resulting in the resident not being ready for a doctor's appointment, and failed to provide written notice prior to increasing rates. Deficiencies were cited under California Code of Regulations Title 22.

Citations (3)
Failure to arrange or assist in arranging incidental medical and dental care appropriate to the conditions and needs of residents, evidenced by resident not being ready in time for a doctor's appointment.
Failure to ensure resident's records were provided within two business days to the resident's Power of Attorney.
Failure to provide at least 60 days prior written notice of rate increases to responsible parties as required by admission agreements.
Report Facts
Capacity: 220 Census: 125 Rate increase amount: 3300 Plan of Correction Due Date: Aug 17, 2024 Plan of Correction Due Date: Aug 23, 2024

Employees mentioned
NameTitleContext
Grace DonatoLicensing Program AnalystConducted the complaint investigation visit
Alex BaisuExecutive DirectorMet with Licensing Program Analyst during the investigation
Dimple KamdarAdministratorFacility administrator at the time of the complaint

Inspection Report

Annual Inspection
Census: 125 Capacity: 220 Citations: 1 Date: Aug 15, 2024

Visit Reason
An unannounced required 1-year annual inspection visit was conducted to evaluate compliance with licensing regulations.

Findings
The facility was toured including resident bedrooms, kitchen, and safety equipment. One deficiency was cited for a staff member (S1) lacking a California Criminal Record Clearance after turning 18 years old, posing an immediate health and safety risk. A civil penalty of $500 was assessed for S1 working without clearance for more than 5 days.

Citations (1)
Staff S1 did not have a California Criminal Record Clearance after turning 18 years of age, posing an immediate Health, Safety, or Personal Rights risk to persons in care.
Report Facts
Civil penalty amount: 500 Census: 125 Total capacity: 220

Employees mentioned
NameTitleContext
Alex BaiasuAdministratorMet during inspection and reviewed report findings
Simranjit RaiLicensing Program AnalystConducted inspection and authored report
Beena KumarAdministrator/DirectorNamed as facility administrator/director

Inspection Report

Complaint Investigation
Capacity: 220 Citations: 0 Date: Aug 13, 2024

Visit Reason
The visit was conducted to discuss an incident regarding physiological abuse reported on April 30, 2024, and to follow up on a subsequent case management visit conducted on May 3, 2024.

Complaint Details
The visit was complaint-related regarding physiological abuse reported on April 30, 2024. A subsequent case management visit occurred on May 3, 2024. The complaint is under further review with requested corrective actions.
Findings
An informal meeting was held with the facility administrator and district director to discuss the abuse incident and to request an action plan addressing staff training on personal rights, handling residents with Mild Cognitive Impairment (MCI), respecting residents' personal rights, and reassessing residents with MCI. The facility was informed of increased monitoring and use of surveillance cameras.

Report Facts
Capacity: 220

Employees mentioned
NameTitleContext
Alex BaiasuAdministratorMet during the informal meeting and discussed the incident and action plan
Grace NdomoDistrict Director of OperationsParticipated in the informal meeting regarding the abuse incident

Inspection Report

Complaint Investigation
Census: 130 Capacity: 220 Citations: 1 Date: Aug 2, 2024

Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 2024-07-01 regarding staff leaving residents soiled for extended periods, rough handling of residents, yelling at residents, and failure to ensure medication administration.

Complaint Details
The complaint investigation was substantiated for the allegation that staff left resident R3 soiled for an extended period. The other allegations regarding rough handling, yelling, and medication administration were unsubstantiated. Interviews included 7 residents, 6 staff members, and 1 witness. Documentation and observations supported the substantiated finding.
Findings
One allegation regarding staff leaving a resident soiled was substantiated with a deficiency cited for failure to keep incontinent residents clean and dry. Other allegations including rough handling of residents, yelling at residents, and failure to ensure medication administration were unsubstantiated with no deficiencies cited.

Citations (1)
Failure to ensure resident (R3) was kept clean and dry; resident was found in dirty double diapers posing immediate health, safety, and personal rights risk.
Report Facts
Residents interviewed: 7 Staff interviewed: 6 Witnesses interviewed: 1 Deficiencies cited: 1

Employees mentioned
NameTitleContext
Alex BaisuExecutive DirectorMet with Licensing Program Analysts during complaint investigation and report review
Christine DoloresLicensing Program AnalystConducted complaint investigation and authored report
Marcella TarinLicensing Program AnalystAssisted in complaint investigation and report delivery
Sarah YipLicensing Program ManagerOversaw complaint investigation and signed report
Beena KumarAdministratorFacility administrator mentioned in report header
Valentine MathanganiHealth & Wellness Director IIIReceived report copy during review

Inspection Report

Complaint Investigation
Census: 119 Capacity: 220 Citations: 0 Date: May 16, 2024

Visit Reason
The inspection was conducted as an unannounced complaint investigation following a complaint received on 2024-03-13 alleging that the licensee was charging a resident for services not provided.

Complaint Details
The complaint alleged that the licensee was charging a resident for services not provided while the resident was hospitalized and admitted to a skilled nursing facility. The investigation included interviews with facility staff and the resident's spouse, and review of billing and admission agreements. The allegation was determined to be unfounded.
Findings
The investigation found that the resident was admitted to a skilled nursing facility and did not return to the facility. The facility reimbursed the resident for care services after 14 days of absence as per the Admission Agreement. The allegation was found to be unfounded with no deficiencies cited.

Report Facts
Capacity: 220 Census: 119 Dates of charges: 4 Dates of credits: 3

Employees mentioned
NameTitleContext
Simranjit RaiLicensing Program AnalystConducted the complaint investigation and interviews
Valentine MathanganiHealth and Wellness DirectorMet with during the investigation and exit interview
Alex BaisuAEDInterviewed during the investigation regarding resident billing

Inspection Report

Complaint Investigation
Census: 126 Capacity: 220 Citations: 0 Date: May 3, 2024

Visit Reason
An unannounced case management-incident visit was conducted regarding a SOC341 report received by the Department alleging psychological abuse by staff.

Complaint Details
The complaint involved allegations of psychological abuse from staff S1-S4 reported on April 30, 2024. The investigation included interviews with resident R1 and the administrator, and requests for staff licensing and training documents, videos, and resident medical and service records.
Findings
The Licensing Program Analyst conducted interviews and requested documentation related to the allegations. The incident requires further investigation and the report was reviewed with the facility administrator.

Employees mentioned
NameTitleContext
Manuel MonterLicensing Program AnalystConducted the unannounced case management-incident visit and investigation.
Momo DuoaAdministratorMet with Licensing Program Analyst during the visit and reviewed the report.
Beena KumarAdministrator/DirectorNamed as facility administrator/director in the report header.

Inspection Report

Complaint Investigation
Census: 129 Capacity: 220 Citations: 0 Date: Apr 24, 2024

Visit Reason
An unannounced complaint investigation was conducted following a complaint received on 2021-01-05 alleging that staff were not meeting residents' care needs and that a resident was not administered medication as prescribed.

Complaint Details
The complaint was unsubstantiated as the investigation did not find sufficient evidence to prove the alleged violations occurred.
Findings
The investigation included interviews and record reviews but was unable to substantiate the allegations due to lack of preponderance of evidence. No deficiencies were cited during the visit.

Report Facts
Capacity: 220 Census: 129

Employees mentioned
NameTitleContext
Grace DonatoLicensing Program AnalystConducted the complaint investigation
Momo DuoaExecutive DirectorMet with the Licensing Program Analyst during the investigation
Paul HarrisonAdministratorNamed as facility administrator
Jackie JinSupervisorSupervisor overseeing the investigation

Inspection Report

Complaint Investigation
Census: 121 Capacity: 220 Citations: 0 Date: Apr 2, 2024

Visit Reason
An unannounced complaint investigation was conducted based on a complaint received on 2021-03-08 alleging improper staff training, understaffing, and failure to follow doctor's orders.

Complaint Details
The complaint alleged that facility staff had not been trained properly, the facility was understaffed, and staff was not following doctor's orders. The investigation was unable to prove these allegations, resulting in an unsubstantiated finding.
Findings
The investigation found no preponderance of evidence to substantiate the allegations. No deficiencies were cited during the visit, and the allegations were deemed unsubstantiated at this time.

Report Facts
Complaint received date: Mar 8, 2021

Employees mentioned
NameTitleContext
Grace DonatoLicensing Program AnalystConducted the complaint investigation
Alex BaiasuAssociate Executive DirectorMet with Licensing Program Analyst during the visit
Paul HarrisonAdministratorFacility administrator named in report header
Jackie JinLicensing Program ManagerNamed in report

Inspection Report

Complaint Investigation
Census: 121 Capacity: 220 Citations: 0 Date: Mar 20, 2024

Visit Reason
The inspection was an unannounced complaint investigation visit conducted to investigate allegations received on 2023-12-11 regarding COVID mitigation protocol noncompliance, unsanitary kitchen conditions, pest presence, and retention of a resident with a prohibited health condition.

Complaint Details
The complaint included allegations that the facility did not follow COVID mitigation prevention protocols, staff did not maintain the kitchen in a clean and sanitary condition, staff did not ensure the facility was free of pests, and staff retained a resident with a prohibited health condition (active MRSA). The investigation concluded these allegations were unsubstantiated or unfounded.
Findings
The investigation found that the allegations regarding COVID mitigation, kitchen sanitation, and pest presence were unsubstantiated or unfounded based on staff interviews, observations, and record reviews. No deficiencies were cited. The allegation about retaining a resident with a prohibited health condition (active MRSA) was also unfounded.

Report Facts
Staff interviewed: 7 Extermination services dates: Extermination services were conducted on 2023-11-07 and 2023-12-05 with no pest activity found

Employees mentioned
NameTitleContext
Simranjit RaiLicensing Program AnalystConducted the complaint investigation visit
Alex BaiasuAssociate Executive DirectorMet with Licensing Program Analyst during the investigation
Beena KumarAdministratorFacility administrator mentioned in the report
Romeo ManzanoLicensing Program ManagerNamed as Licensing Program Manager on the report
Health and Wellness DirectorInterviewed regarding COVID-19 procedures and resident health conditions
Executive Head ChefInterviewed regarding kitchen cleaning schedules

Inspection Report

Complaint Investigation
Census: 125 Capacity: 220 Citations: 0 Date: Nov 3, 2023

Visit Reason
The visit was an unannounced complaint investigation conducted in response to a complaint received on 2023-10-25 alleging that staff did not ensure the facility was free of pests.

Complaint Details
The complaint alleged that staff did not ensure the facility was free of pests. The investigation found no preponderance of evidence to prove the alleged violation occurred, resulting in an unsubstantiated finding.
Findings
The investigation included interviews, record reviews, and observations. The facility had a pest control contract with frequent service visits. Although mice droppings were found in three resident apartments on 2023-08-15, the pest control company applied measures to terminate the pests and the droppings were cleaned. The allegation was determined to be unsubstantiated due to insufficient evidence.

Report Facts
Pest control service dates: 8 Resident apartments with mice droppings: 3

Employees mentioned
NameTitleContext
Christine DoloresLicensing Program AnalystConducted the complaint investigation
Alex BaiasuAssociate Executive DirectorMet with Licensing Program Analyst during investigation and reviewed report
Beena KumarAdministratorFacility administrator named in report header
Sarah YipLicensing Program ManagerNamed in report as Licensing Program Manager

Inspection Report

Complaint Investigation
Census: 120 Capacity: 220 Citations: 0 Date: Oct 19, 2023

Visit Reason
The inspection visit was conducted as an unannounced complaint investigation following a complaint received on 2023-08-17 alleging that staff admitted a resident with prohibited health conditions.

Complaint Details
The complaint alleged that staff admitted a resident with prohibited health conditions. The allegation was investigated through interviews with the Executive Director, staff, residents, and a Home Health Care Provider, as well as review of medical and assessment documents. The allegation was determined to be unfounded.
Findings
The investigation found the allegation to be unfounded based on interviews, observations, and document reviews. The resident was assessed and cleared to return to the facility, and their condition improved before moving to a higher level of care facility.

Report Facts
Capacity: 220 Census: 120

Employees mentioned
NameTitleContext
Beena KumarAdministratorNamed as facility administrator
Dimpler KamdarOperation Specialist/Interim Executive DirectorMet with investigators during inspection and exit interview
Chihhsien ChangLicensing EvaluatorConducted the complaint investigation
Steve ChangLicensing Program AnalystConducted unannounced investigation visit
Maria PartozaLicensing Program AnalystConducted unannounced investigation visit

Inspection Report

Complaint Investigation
Capacity: 220 Citations: 0 Date: Jun 20, 2023

Visit Reason
An unannounced complaint investigation visit was conducted in response to allegations that unqualified staff administered medications to residents and that the facility did not provide food of adequate quality and quantity to meet residents' needs.

Complaint Details
The complaint was unsubstantiated based on interviews with 10 staff members and 8 residents, medication audits, and record reviews. Residents and staff did not confirm the allegations, and no violations were found.
Findings
The investigation found no preponderance of evidence to substantiate the allegations. Interviews with staff and residents did not confirm unqualified medication administration, and residents generally reported adequate food quantity and quality. No deficiencies were cited during this visit.

Report Facts
Staff interviewed: 10 Residents interviewed: 8 Facility capacity: 220

Employees mentioned
NameTitleContext
Ryker HeberleLicensing Program AnalystConducted the complaint investigation visit and delivered findings
Beena KumarAdministratorFacility administrator met during investigation and reviewed report
Sarah YipLicensing Program ManagerNamed as Licensing Program Manager on report

Inspection Report

Complaint Investigation
Census: 127 Capacity: 220 Citations: 1 Date: Jun 20, 2023

Visit Reason
An unannounced complaint investigation was conducted regarding an allegation that staff did not inform residents when food was delivered.

Complaint Details
The complaint was substantiated based on observations and interviews. The allegation was that staff did not inform residents when food was delivered.
Findings
The investigation found that the facility did not ensure a resident was aware of breakfast delivery, which posed a potential risk to resident health and safety. The allegation was substantiated based on observations and interviews.

Citations (1)
Facility did not ensure resident was aware of breakfast delivery, violating General Food Service Requirements.
Report Facts
Deficiency Type B: 1 Capacity: 220 Census: 127

Employees mentioned
NameTitleContext
Ryker HeberleLicensing Program AnalystConducted the complaint investigation and authored the report.
Beena KumarAdministratorFacility administrator met with the Licensing Program Analyst during the investigation.
Sarah YipLicensing Program ManagerNamed as Licensing Program Manager overseeing the investigation.
Elizabeth ReynagaBusiness Office ManagerConfirmed food delivery process during resident interviews.

Inspection Report

Complaint Investigation
Census: 118 Capacity: 220 Citations: 0 Date: May 3, 2023

Visit Reason
An unannounced complaint investigation was conducted in response to allegations received on 09/21/2020 regarding medication mismanagement, inappropriate staff communication, and unmet resident toileting and showering needs.

Complaint Details
The complaint investigation was unsubstantiated. Allegations included medication mismanagement, inappropriate staff communication, and failure to meet residents' toileting and showering needs. Interviews, record reviews, and observations did not confirm these allegations.
Findings
The investigation found no evidence of medication mismanagement or inappropriate staff behavior towards residents. Residents reported satisfaction with assistance for daily living needs, including showering. One resident reported a delayed response for bathroom assistance, but this could not be verified. Overall, the allegations were determined to be unsubstantiated.

Report Facts
Residents interviewed: 10 Staff interviewed: 9 Resident records reviewed: 6 Medication drawers audited: 6 Allegations: 4

Employees mentioned
NameTitleContext
Jayden BettencourtAssistant Executive DirectorMet with Licensing Program Analyst during investigation
Ryker HeberleLicensing Program AnalystConducted the complaint investigation
Sarah YipSupervisorSupervisor overseeing the investigation

Inspection Report

Annual Inspection
Census: 135 Capacity: 220 Citations: 0 Date: Aug 9, 2022

Visit Reason
An unannounced annual inspection was conducted as a required one-year visit to evaluate the facility's compliance with regulations.

Findings
The facility was found to be clean, well maintained, and compliant with infection control measures including COVID-19 protocols. No deficiencies were cited during the inspection.

Report Facts
COVID-19 vaccination rate for residents: 90 COVID-19 vaccination rate for staff: 100 Facility capacity: 220 Facility census: 135

Employees mentioned
NameTitleContext
Dimple KamdarInterim AdministratorMet with Licensing Program Analyst during inspection
Ryker HeberleLicensing Program AnalystConducted the unannounced annual inspection
Sarah YipLicensing Program ManagerNamed in report header

Inspection Report

Complaint Investigation
Census: 141 Capacity: 220 Citations: 0 Date: Apr 15, 2022

Visit Reason
An unannounced complaint investigation was conducted in response to an allegation that facility staff failed to give resident medication as prescribed.

Complaint Details
The complaint alleged failure to give resident medication as prescribed. The investigation included interviews with staff and residents, and review of Medication Administration Records and Medication Delivery Logs. The allegation was determined to be unsubstantiated due to insufficient evidence of violation.
Findings
Based on interviews with staff and residents, and review of medication records, the allegation was found to be unsubstantiated. Most residents received medications on time, with one noted 24-hour delay in administering antibiotics, which was not required to be immediate per doctor's order or facility policy.

Report Facts
Staff interviewed: 9 Residents interviewed: 6 Medication Administration Records reviewed: 9 Residents receiving medications on time: 8 Residents receiving medications late: 1 Facility capacity: 220 Census: 141

Employees mentioned
NameTitleContext
Ryker HeberleLicensing Program AnalystConducted the complaint investigation and delivered findings.
Robert AlveradoInterim Executive DirectorSpoke with Licensing Program Analyst during investigation and reviewed report.
Christine MontelaroBusiness Operation ManagerSigned the report and approved on behalf of Interim Executive Director.
Sarah YipLicensing Program ManagerNamed as Licensing Program Manager overseeing the investigation.

Inspection Report

Monitoring
Census: 141 Capacity: 220 Citations: 1 Date: Apr 15, 2022

Visit Reason
An unannounced site inspection was conducted to ensure the facility had implemented all recommended COVID-19 precautions from previous Department visits and a recent HAI inspection.

Findings
The inspection found that the facility had generally implemented COVID-19 safety measures including mask wearing, social distancing, PPE use, and hand sanitizer availability. However, there was a deficiency cited for failure to report COVID-19 positive residents and staff to the licensing agency within 24 hours, posing an immediate health and safety risk.

Citations (1)
Failure to report COVID positive residents and staff member to licensing within 24 hours, which posed an immediate health, safety or personal rights risk to persons in care.
Report Facts
Capacity: 220 Census: 141 Deficiencies cited: 1 Plan of Correction Due Date: 1

Employees mentioned
NameTitleContext
Ryker HeberleLicensing Program AnalystConducted the inspection and authored the report
Christine MontelaroBusiness Operations ManagerMet with Licensing Program Analyst during inspection and reviewed findings
Patricia OlveraBusiness Operations ManagerMet with Licensing Program Analyst during inspection
Robert AlveradoInterim Executive DirectorAttended inspection telephonically and involved in review of findings
Kim La ForceMedication and Wellness DirectorProvided information on isolation room cleaning and PPE procedures

Inspection Report

Monitoring
Census: 130 Capacity: 220 Citations: 0 Date: Apr 9, 2022

Visit Reason
The inspection visit was conducted in response to a recent COVID-19 outbreak among residents to assess the facility's compliance with COVID-19 mitigation plans and infection control measures.

Findings
The facility was found not to be following the COVID-19 mitigation plan effectively, with issues such as residents eating in the dining hall without social distancing, lack of necessary PPE items, absence of precautionary signage, and inadequate staff separation for COVID positive residents. Multiple recommendations were made to improve infection control and safety during the outbreak. No deficiencies were cited during this visit.

Report Facts
Capacity: 220 Census: 130

Employees mentioned
NameTitleContext
Christine MontelaroBusiness Office ManagerMet with Licensing Program Analyst and Manager during the inspection and reviewed the report
Ryker HeberleLicensing Program AnalystConducted the facility tour and inspection
Sarah YipLicensing Program ManagerConducted the facility tour and inspection

Inspection Report

Annual Inspection
Census: 134 Capacity: 220 Citations: 0 Date: Aug 25, 2021

Visit Reason
An unannounced annual inspection was conducted as a required one-year visit to evaluate the facility's compliance with regulations.

Findings
The inspection found no deficiencies. The facility was observed to be following COVID-19 safety protocols, including vaccination rates, PPE availability, and visitor policies.

Report Facts
COVID-19 vaccination rate for residents: 76.9 COVID-19 vaccination rate for staff: 54.6 Facility water temperature range: 113.7 Facility water temperature range: 119.6 Facility temperature range: 71 Facility temperature range: 85

Employees mentioned
NameTitleContext
Nicole BaconExecutive DirectorMet with Licensing Program Analyst during inspection
Junior ZavalaMaintenance DirectorAccompanied Licensing Program Analyst during facility tour
Ryker HeberleLicensing Program AnalystConducted the inspection
Sarah YipLicensing Program ManagerNamed in report header

Inspection Report

Complaint Investigation
Census: 132 Capacity: 220 Citations: 0 Date: Jul 8, 2021

Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 09/17/2020 regarding neglect to assess a resident's injury, failure to ensure residents were fed, and staff not answering the facility telephone.

Complaint Details
The complaint investigation was unannounced and focused on allegations that the facility neglected to assess a resident's injury, failed to ensure residents were fed during an evacuation, and staff did not answer the facility telephone. Interviews and record reviews showed that the resident's injury was assessed and treated, residents were fed during evacuation, and staff answered telephone calls. The complaint was unsubstantiated/unfounded.
Findings
The investigation included interviews with 11 residents and 7 staff, review of records, and telephone calls to the facility. The allegations were found to be unsubstantiated or unfounded due to lack of preponderance of evidence. No deficiencies were cited.

Report Facts
Residents interviewed: 11 Staff interviewed: 7 Complaint received date: Sep 17, 2020

Employees mentioned
NameTitleContext
David MarrufoLicensing Program AnalystConducted the unannounced complaint investigation visit
Nicole BaconFacility staff member met during the investigation and report review
Paul HarrisonAdministratorFacility administrator named in the report
Jackie JinSupervisorSupervisor overseeing the complaint investigation

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