Inspection Reports for
Belmont Village San Ramon

6151 Bollinger Canyon Rd, San Ramon, CA 94583, United States, CA, 94583

Back to Facility Profile

Deficiencies (last 3 years)

Deficiencies (over 3 years) 3 deficiencies/year

Deficiencies are regulatory violations found during state inspections.

25% better than California average
California average: 4 deficiencies/year

Deficiencies per year

8 6 4 2 0
2024
2025
2026

Occupancy

Latest occupancy rate 88% occupied

Based on a March 2026 inspection.

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

Occupancy rate over time

0% 30% 60% 90% 120% Nov 2024 Jan 2025 Jan 2026 Mar 2026

Inspection Report

Complaint Investigation
Census: 154 Capacity: 176 Deficiencies: 1 Date: Mar 4, 2026

Visit Reason
The inspection visit was an unannounced Case Management visit conducted to investigate a complaint (15-AS-20260227115032) regarding facility safety.

Complaint Details
The visit was conducted as a complaint investigation (15-AS-20260227115032). The complaint was substantiated by the observation of unsecured scissors in resident rooms.
Findings
The Licensing Program Analyst observed unlocked and unsecured scissors in three memory care resident rooms, posing an immediate safety risk to residents. This deficiency was cited under California Code of Regulations, Title 22.

Deficiencies (1)
Unlocked/unsecured scissors found in 3 memory care resident rooms, posing an immediate safety risk.
Report Facts
Residents with unsecured scissors observed: 3 Facility census: 154 Facility capacity: 176

Employees mentioned
NameTitleContext
Jennifer CoonsExecutive DirectorMet with Licensing Program Analyst during the inspection.
Alona GomezLicensing Program AnalystConducted the complaint investigation and inspection.
Yvonne Flores-LariosLicensing Program ManagerNamed in the report as Licensing Program Manager.

Inspection Report

Complaint Investigation
Census: 154 Capacity: 176 Deficiencies: 2 Date: Mar 4, 2026

Visit Reason
The visit was an unannounced complaint investigation conducted in response to allegations of the facility mismanaging residents' medications and not keeping accurate medication records/logs.

Complaint Details
The complaint investigation was substantiated based on observations, interviews, and record reviews. The allegations involved medication mismanagement and inaccurate medication records. Civil penalties of $250 were assessed for a repeat violation within 12 months.
Findings
The investigation substantiated the allegations, finding medication mismanagement for residents R1 and R2, including incorrect medication counts, duplicate medications being used simultaneously, missed medication administration, and improper documentation in the electronic medication administration record (E-MAR). Staff were unfamiliar with proper medication administration and documentation procedures.

Deficiencies (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 Capacity: 176 Census: 154 Plan of Correction Due Date: 03/18/2026 for cited deficiencies

Employees mentioned
NameTitleContext
Jennifer CoonsExecutive DirectorMet with Licensing Program Analyst during investigation and provided statements regarding medication management
Alona GomezLicensing Program AnalystConducted the complaint investigation and authored the report
Yvonne Flores-LariosSupervisorSupervisor overseeing the investigation

Inspection Report

Complaint Investigation
Census: 154 Capacity: 176 Deficiencies: 1 Date: Mar 4, 2026

Visit Reason
The inspection visit was an unannounced Case Management visit conducted to investigate a complaint (15-AS-20260227115032) regarding facility safety.

Complaint Details
The visit was complaint-related, investigating complaint number 15-AS-20260227115032. The complaint was substantiated by the observation of unsecured scissors in resident rooms.
Findings
The Licensing Program Analyst observed unlocked and unsecured scissors in three memory care resident rooms, posing an immediate safety risk to residents. This was cited as a Type A deficiency under CCR 87309(a).

Deficiencies (1)
Unlocked/unsecured scissors found in 3 memory care resident rooms posing an immediate safety risk.
Report Facts
Residents with unsecured scissors observed: 3 Census: 154 Total Capacity: 176

Employees mentioned
NameTitleContext
Jennifer CoonsExecutive DirectorMet with Licensing Program Analyst during inspection
Alona GomezLicensing Program AnalystConducted the complaint investigation and inspection
Yvonne Flores-LariosLicensing Program ManagerNamed in report as Licensing Program Manager

Inspection Report

Complaint Investigation
Census: 154 Capacity: 176 Deficiencies: 2 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.

Deficiencies (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
NameTitleContext
Alona GomezLicensing Program AnalystConducted the complaint investigation and observations
Jennifer CoonsExecutive DirectorFacility administrator involved in the investigation and interviews
Yvonne Flores-LariosSupervisorSupervisor overseeing the investigation

Inspection Report

Complaint Investigation
Census: 144 Capacity: 176 Deficiencies: 1 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.

Deficiencies (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
NameTitleContext
Jennifer CoonsExecutive DirectorMet during inspection and provided information about the medication error incident
Alona GomezLicensing Program AnalystConducted the inspection visit
Yvonne Flores-LariosLicensing Program ManagerNamed in relation to deficiency citations

Inspection Report

Complaint Investigation
Census: 144 Capacity: 176 Deficiencies: 1 Date: Feb 6, 2026

Visit Reason
The inspection visit was conducted as a case management visit in response to an incident report received on 2026-02-05 regarding a medication error involving two residents.

Complaint Details
The visit was triggered by a complaint/incident report regarding a medication error on 2026-01-31 where resident one was given medication intended for resident two by staff one. The staff member resigned following the incident. The complaint was investigated and substantiated by the deficiency cited.
Findings
The facility was found to have a deficiency related to medication administration errors by a staff member who has since resigned. The resident who received the wrong medication did not sustain any negative side effects. The facility provided additional training and guidance to staff.

Deficiencies (1)
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 evidenced by a prior medication error by staff resulting in a resident receiving another resident's medication, posing a potential health and personal rights risk.
Report Facts
Census: 144 Total Capacity: 176 Deficiencies cited: 1

Employees mentioned
NameTitleContext
Jennifer CoonsExecutive DirectorMet with Licensing Program Analyst during inspection and provided information about the medication error incident
Alona GomezLicensing Program AnalystConducted the inspection visit
Yvonne Flores-LariosLicensing Program ManagerNamed in report as Licensing Program Manager

Inspection Report

Annual Inspection
Census: 138 Capacity: 176 Deficiencies: 0 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
NameTitleContext
Jennifer CoonsExecutive DirectorMet with Licensing Program Analyst during inspection and mentioned in findings
Alona GomezLicensing Program AnalystConducted the inspection and authored the report
Yvonne Flores-LariosLicensing Program ManagerNamed as Licensing Program Manager on the report

Inspection Report

Annual Inspection
Census: 138 Capacity: 176 Deficiencies: 0 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 facility was found to be in compliance with no deficiencies cited. Observations included adequate lighting, proper temperature controls, locked pool gate, proper medication storage, and valid CPR certification for staff. Emergency equipment and disaster plans were up to date.

Report Facts
Hot water temperature readings: Measured at 109, 116.8, 116.6, 107.5, and 116.4 degrees Fahrenheit in residents' bathrooms Freezer temperature: -1 Refrigerator temperature: 39 Fire extinguisher service date: Last serviced on 2026-01-08 Emergency disaster drill date: Last conducted on 2025-12-10 Emergency Disaster Plan posting date: Last posted on 2025-06-18 Residents records reviewed: 6 Staff records reviewed: 5

Employees mentioned
NameTitleContext
Jennifer CoonsExecutive DirectorMet with Licensing Program Analyst during inspection and mentioned in report
Alona GomezLicensing Program AnalystConducted the inspection and signed the report
Yvonne Flores-LariosLicensing Program ManagerNamed as Licensing Program Manager on report

Inspection Report

Census: 98 Capacity: 176 Deficiencies: 0 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
NameTitleContext
Jennifer CoonsExecutive DirectorMet with Licensing Program Analyst during visit and involved in incident review
Alona GomezLicensing Program AnalystConducted the unannounced case management visit
Yvonne Flores-LariosLicensing Program ManagerNamed as Licensing Program Manager on report
Director of Resident Care ServicesInterviewed regarding resident falls R2 and R3

Inspection Report

Original Licensing
Capacity: 176 Deficiencies: 0 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
NameTitleContext
Jennifer CoonsExecutive DirectorMet with Licensing Program Analyst during inspection
Alona GomezLicensing Program AnalystConducted the pre-licensing inspection
Yvonne Flores-LariosLicensing Program ManagerNamed as Licensing Program Manager on report

Inspection Report

Original Licensing
Capacity: 176 Deficiencies: 1 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.

Deficiencies (1)
Hot water temperature is measuring over 120 degrees F
Report Facts
Facility capacity: 176 Census: 0

Employees mentioned
NameTitleContext
Jennifer CoonsExecutive DirectorMet with Licensing Program Analyst during inspection and involved in facility tour
Alona GomezLicensing Program AnalystConducted the prelicensing inspection

Inspection Report

Original Licensing
Capacity: 176 Deficiencies: 0 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
NameTitleContext
Jennifer CoonsAdministratorParticipated in COMP II and was verified as applicant/administrator.
Douglas ArmstrongApplicant/LicenseeParticipated in COMP II as applicant/licensee.

Viewing

Loading inspection reports...