Inspection Reports for Alexandria Victoria II
228 Morrissey Blvd, Santa Cruz, CA 95062, United States, CA, 95062
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Inspection Report
Complaint Investigation
Census: 6
Capacity: 8
Deficiencies: 1
Mar 8, 2025
Visit Reason
The inspection was conducted as an unannounced complaint investigation visit triggered by allegations regarding inadequate food supplies and staff not receiving required trainings.
Findings
The allegation that the facility did not have adequate food supplies was found to be unsubstantiated after observations and interviews. However, the allegation that staff did not receive required trainings was substantiated due to incomplete staff files and expired first aid/CPR certification, resulting in a cited deficiency.
Complaint Details
The complaint investigation was triggered by allegations that the facility lacked adequate food supplies and that staff did not receive required trainings. The food supply allegation was unsubstantiated, while the training allegation was substantiated with a deficiency cited.
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Staff did not receive required trainings; incomplete staff files and expired first aid/CPR certification. | Type B |
Report Facts
Facility census: 6
Facility capacity: 8
Staff files reviewed: 3
Staff without 20 hours training: 2
Staff without current first aid/CPR: 1
Plan of Correction due date: 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| John Gryspos | Administrator | Met with Licensing Program Analyst during complaint investigation; provided information about staff training and food supplies |
| Pang Lee | Licensing Program Analyst | Conducted the complaint investigation visit and authored the report |
| Czarrina A Camilon-Lee | Licensing Program Manager | Oversaw the complaint investigation and signed the report |
Inspection Report
Complaint Investigation
Census: 6
Capacity: 8
Deficiencies: 1
Mar 8, 2025
Visit Reason
The visit was an unannounced complaint investigation conducted in response to multiple allegations including residents sustaining injuries, staff not seeking timely medical care, failure to report incidents, not following care plans, improper incontinence care, and improper maintenance of medication records.
Findings
The investigation found the allegations of injuries, delayed medical care, incident reporting, care plan adherence, and incontinence care to be unsubstantiated based on interviews and record reviews. However, the allegation regarding improper maintenance of residents' medication records was substantiated, with discrepancies found between medication administration records and medication storage documentation, resulting in a cited deficiency.
Complaint Details
The complaint investigation was triggered by allegations received on 06/06/2022 regarding injuries, medical care delays, incident reporting failures, care plan noncompliance, improper incontinence care, and medication record maintenance. The medication record maintenance allegation was substantiated; all others were unsubstantiated.
Deficiencies (1)
| Description |
|---|
| Facility did not ensure residents' Medication Administration Records (MAR) and Centrally Stored Medication and Destruction (CSMD) records were accurately documented to reflect residents' medications, posing potential health, safety, and personal rights risks. |
Report Facts
Capacity: 8
Census: 6
Deficiency POC Due Date: Mar 22, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| John Gryspos | Administrator | Met with Licensing Program Analyst during investigation and named in findings |
| Pang Lee | Licensing Program Analyst | Conducted the complaint investigation |
| Czarrina A Camilon-Lee | Licensing Program Manager | Oversaw the complaint investigation |
Inspection Report
Annual Inspection
Census: 6
Capacity: 8
Deficiencies: 0
Mar 6, 2025
Visit Reason
This is a Case Management - Annual Continuation visit, which is a continuation of the annual inspection conducted on 2025-02-18.
Findings
No deficiencies were cited during the visit. A Technical Assistance was issued. The facility was found to have complete and accurate resident and staff records, properly functioning smoke detectors, up-to-date fire extinguishers, a complete first aid kit, and a recent emergency drill.
Report Facts
Residents: 6
Capacity: 8
Staff records reviewed: 6
Resident records reviewed: 6
Fire extinguisher last serviced: Aug 8, 2024
Last emergency drill: Feb 12, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| John Gryspos Jr | Administrator | Met with Licensing Program Analyst during inspection and involved in findings |
| Marcella Tarin | Licensing Program Analyst | Conducted the inspection visit |
Inspection Report
Annual Inspection
Census: 6
Capacity: 8
Deficiencies: 0
Feb 18, 2025
Visit Reason
The inspection was a required 1-Year annual unannounced inspection conducted to evaluate the facility's compliance with licensing regulations.
Findings
The Licensing Program Analyst toured the facility including resident bedrooms, kitchen, and common areas, finding all exits clear and food storage compliant. No deficiencies were issued during this visit, but the inspection will be continued at a later date due to time constraints.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| John Gryspos Jr | Administrator | Met with Licensing Program Analyst during inspection and participated in exit interview. |
| Marcella Tarin | Licensing Program Analyst | Conducted the facility's required 1-Year annual inspection. |
Inspection Report
Complaint Investigation
Census: 6
Capacity: 8
Deficiencies: 1
Jul 23, 2024
Visit Reason
The inspection was an unannounced complaint investigation visit conducted on 07/23/2024 to address complaints received on 05/08/2024 regarding improper bathroom cleaning, lack of non-skid shower mats, improperly fixed resident door seals, and unclean residents' linens.
Findings
The complaint regarding bathroom cleanliness, shower non-skid mats, and door seal maintenance was substantiated with observed deficiencies including stained shower curtains, lack of non-skid mats, and peeling door seals. Corrections were made during the visit. The complaint about unclean residents' linens was found to be unfounded based on observations and interviews with responsible parties confirming regular laundering and no foul odors.
Complaint Details
The complaint investigation was substantiated for allegations that the bathroom was not cleaned properly, the shower mat was not non-slip, and the resident's door seal was not fixed properly. The complaint regarding unclean residents' linens was unfounded.
Deficiencies (1)
| Description |
|---|
| Bathroom floors were not maintained clean and sanitary; no non-skid mat in shower area; door seal was peeling off and not properly attached. |
Report Facts
Capacity: 8
Census: 6
Deficiency Type: 1
Plan of Correction Due Date: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| John Gryspos | Administrator | Met during inspection and named in findings related to facility maintenance and corrections |
| Adrian Mendoza | Designated Administrator | Met during inspection and involved in discussion of findings |
| Maria Partoza | Licensing Program Analyst | Conducted the complaint investigation visit and authored the report |
Inspection Report
Complaint Investigation
Capacity: 8
Deficiencies: 2
May 22, 2024
Visit Reason
An unannounced complaint investigation visit was conducted following a complaint received on 2024-04-12 alleging rough handling and inappropriate speech by facility staff towards residents.
Findings
The investigation substantiated that a female staff member handled residents roughly, including pushing a resident against a wall and speaking inappropriately by calling a resident 'nasty.' Staff and emergency contacts denied observing such behavior, but multiple residents reported these incidents. Deficiencies were cited under California Code of Regulations Title 22.
Complaint Details
Complaint was substantiated. Allegations included rough handling of residents and inappropriate speech by staff. Multiple residents reported incidents, including pushing against a wall and verbal abuse. Staff and emergency contacts denied observing these behaviors.
Severity Breakdown
Type A: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Licensee did not ensure that a female staff did not handle residents roughly, including pushing R5 against a wall when changing R5, posing an immediate safety risk. | Type A |
| Licensee did not ensure that a staff did not treat a resident without dignity by saying 'nasty' when changing a resident, posing an immediate safety risk. | Type A |
Report Facts
Facility capacity: 8
Deficiencies cited: 2
Plan of Correction due date: May 23, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| David Marrufo | Licensing Program Analyst | Conducted the complaint investigation visit and interviews |
| Sarah Yip | Licensing Program Manager | Named as Licensing Program Manager on report |
| John Grypsos Jr | Administrator | Facility administrator named in report header |
Inspection Report
Complaint Investigation
Census: 5
Capacity: 8
Deficiencies: 0
May 8, 2024
Visit Reason
The inspection was an unannounced case management visit conducted due to an incident reported on 2024-04-02.
Findings
The licensing program analyst toured the facility and found the premises sanitary and free from obstructions. Interviews were conducted with residents and staff. No deficiencies were cited during the visit, and the case management remains open for further investigation.
Complaint Details
The visit was triggered by an incident reported on 2024-04-02. The case management investigation remains open.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| John Gryspos Jr | Administrator | Met during inspection and participated in exit interview. |
| Adrian Mendoza | Administrator | Met during inspection and toured facility with licensing analyst. |
| Maria Mita Partoza | Licensing Program Analyst | Conducted the unannounced case management inspection. |
| Romeo Manzano | Licensing Program Manager | Named as licensing program manager on report. |
Inspection Report
Annual Inspection
Census: 6
Capacity: 8
Deficiencies: 8
Feb 14, 2024
Visit Reason
An unannounced annual inspection was conducted to evaluate compliance with licensing regulations for the facility.
Findings
The inspection identified several deficiencies including a carbon monoxide detector being out of battery, unlocked cabinets containing hazardous materials, lack of non-skid mats in bathrooms, obstructions in outdoor walkways, staff without valid first aid certificates, missing health screening records for staff, and incomplete medication destruction records.
Severity Breakdown
Type A: 3
Type B: 5
Deficiencies (8)
| Description | Severity |
|---|---|
| One carbon monoxide detector was observed out of battery, posing an immediate health and safety risk. | Type A |
| Dish washing detergent cabinet under the sink was unlocked, posing an immediate health, safety or personal rights risk. | Type A |
| Knives cabinet in kitchen was unlocked, posing an immediate safety risk. | Type A |
| No non-skid mats were observed in the bathrooms, posing a potential health and safety risk. | Type B |
| Outdoor walkway on the left side of the building was obstructed, posing a potential health and safety risk. | Type B |
| Two staff members were observed without valid first aid certificates, posing a potential health and safety risk. | Type B |
| One staff member was without a health screening record in the personnel file, posing a potential health, safety or personal rights risk. | Type B |
| Three residents' centrally stored medication destruction records were not maintained up to date and were inaccurate, posing a potential health and safety risk. | Type B |
Report Facts
Residents observed: 6
Staff observed: 3
Deficiencies cited: 8
POC Due Date: Feb 15, 2024
POC Due Date: Feb 21, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| John Gryspos | Administrator | Met with Licensing Program Analyst during inspection and involved in plan of correction discussions |
Inspection Report
Annual Inspection
Census: 6
Capacity: 8
Deficiencies: 0
Feb 8, 2023
Visit Reason
An unannounced annual inspection was conducted as a required 1-year visit to evaluate the facility's compliance with licensing regulations.
Findings
The facility was found to be clean, well-maintained, and compliant with infection control and safety requirements. No deficiencies were cited during the visit.
Report Facts
PPE supply: 30
Food supply: 2
Food supply: 7
Facility water temperature: 114.6
Capacity: 8
Census: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| John Gryspos Jr | Administrator | Met with Licensing Program Analyst during inspection and reviewed report |
| Ryker Heberle | Licensing Program Analyst | Conducted the unannounced annual inspection |
| Sarah Yip | Licensing Program Manager | Named in report header |
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