Inspection Reports for Belmont Village Senior Living Sunnyvale

The visit was an unannounced complaint investigation triggered by an allegation received on 2025-07-15 that a resident was physically abused while in care.

After interviews with staff and residents, review of records, and law enforcement investigation, there was insufficient evidence to support the allegation of physical abuse. No injuries were observed, the staff member involved resigned, and the allegation was determined to be unfounded.

The complaint alleged that a resident was physically abused while in care. The investigation included interviews with five staff members and five residents, review of incident reports, internal investigations, medical and hospice records, and law enforcement findings. The allegation was found to be unsubstantiated and unfounded due to inconsistent statements, absence of injuries, and corroborating interviews.

The inspection visit was conducted as a Case Management – Incident inspection regarding a self-reported SOC 341 for a financial abuse incident involving a resident writing checks to a staff member.

The investigation found that six checks totaling $6,850 were cashed by the staff member, who was subsequently terminated. The staff member returned $5,000 but lacked funds to return the remaining $1,850. The resident stated they wrote the checks voluntarily and no deficiencies were cited during the visit.

The complaint involved financial abuse where a resident wrote checks to a staff member. The staff member was terminated after evidence showed endorsement and cashing of six checks. Partial repayment was made. The resident confirmed voluntary action and no coercion.

The inspection was a Required 1-Year Annual inspection conducted unannounced to assess compliance with licensing requirements.

The facility was found to be clean, well-maintained, and compliant with all inspected areas including resident rooms, kitchen, medication storage, and emergency equipment. No deficiencies were cited during the visit.

The visit was conducted as a case management - incident visit to address incident reports and death reports that were submitted late to the Department from April 1, 2024 to July 25, 2024.

The facility submitted 15 late incident reports and 4 late death reports to the Department, all reported more than 7 days after the occurrence date. A deficiency was cited for failure to submit reports within the required timeframe, posing a potential health, safety, and personal rights risk to persons in care.

The inspection was conducted as an unannounced complaint investigation visit following allegations that staff neglect led to hospitalization of a resident and that staff did not seek medical attention for the resident in a timely manner.

The Department substantiated the allegations that staff neglect led to the hospitalization of resident R1 due to failure to follow protocol regarding change of condition and failure to report it. An immediate civil penalty of $500 was assessed. Additional allegations regarding failure to ensure resident was fed, maintain clean conditions, and notify responsible party of change in condition were found unsubstantiated.

The complaint was substantiated regarding staff neglect leading to hospitalization and failure to seek timely medical attention. Other allegations about feeding, sanitation, and notification of responsible party were unsubstantiated.

The inspection was an unannounced required 1-year annual inspection conducted by the Licensing Program Analyst to evaluate compliance with regulations at Belmont Village Sunnyvale facility.

The facility was generally well maintained with clean living areas, proper safety equipment, and adequate resident accommodations. However, deficiencies were cited related to incomplete documentation of centrally stored PRN medications, incomplete staff health screenings, and insufficient annual training hours for some staff members.

The visit was an unannounced Case Management - Incident inspection triggered by an incident report received on 2024-04-12 regarding a resident with a black and swollen left eye from an incident occurring on 2024-04-02.

The resident was found with injuries consistent with a fall and was sent to the hospital, then discharged back to the facility. The facility updated the resident's care plan immediately and implemented additional safety measures including a bed alarm and staff escort. No abuse was reported by the resident. No citations were issued during this visit.

The complaint involved a resident found with a black eye and head lacerations after a fall. The resident stated no abuse or hitting occurred. The facility responded by updating care plans and adding safety measures. No substantiation of abuse was noted.

The visit was conducted to ensure the facility is adhering to the Compliance Plan submitted after a Non-Compliance Conference held on 07/25/2023. This case management inspection is part of a series conducted every 3 months for 2 years.

The Licensing Program Analyst reviewed the facility's plans, policies, staff training records, and protocols related to prior deficiencies, resident appraisals, fall risk identification, medication administration, and care plans. The facility was toured and discussions were held with the Executive Director regarding compliance and staff responsibilities.

An unannounced complaint investigation visit was conducted in response to allegations including staff not assisting a resident with obtaining medical care and the facility signal system not being maintained operable.

The allegation that staff did not assist a resident with obtaining medical care was substantiated due to delayed 911 call after a resident's fall. The allegation regarding the facility signal system not being maintained operable was found to be unfounded based on records and interviews.

The complaint investigation was substantiated for the allegation that staff did not assist a resident with obtaining medical care, specifically that 911 was not called promptly after a resident fell. The allegation regarding the facility signal system was determined to be unfounded.

The visit was conducted to ensure the facility is adhering to the Compliance Plan submitted after a Non-Compliance Conference held on 07/25/2023. This case management inspection is part of a series to be conducted every 3 months for 2 years.

The Licensing Program Analyst reviewed plans, policies, and staff training records related to prior deficiencies, resident appraisals/reappraisals, fall risk identification and safety plans, residents' needs and service plans, medication administration, and staff responsibilities. The facility was toured including various units and common areas, and discussions were held with the Executive Director regarding compliance and staff training.

The Noncompliance Conference meeting was conducted to discuss serious violations that occurred at the facility on 03/18/2022 and 03/19/2022, which resulted in a resident sustaining a fracture and missed medications. The substantiated complaint findings were delivered on 12/20/2022.

Deficiencies cited on 12/20/2022 for violations of Title 22 California Code of Regulations were amended. Additional civil penalties of $10,000 may be assessed pending review. A 2-year monitoring plan including more frequent licensing inspections was established.

The visit was related to substantiated complaint findings regarding a resident who sustained a fracture and missed medications in March and April 2022.

The inspection was an unannounced annual required one year inspection conducted to evaluate compliance with regulatory standards at Belmont Village Sunnyvale facility.

The inspection found that emergency systems and supplies were generally in place and functioning, but deficiencies were cited including outdated physician reports for residents with dementia and expired first aid certifications for staff. A Technical Advisory note was also issued.

The inspection was an unannounced complaint investigation visit triggered by multiple allegations including a resident sustaining a fracture while in care, a resident not receiving medication, and a motion detector being in disrepair.

The investigation substantiated that a resident sustained a fracture due to inadequate reassessment and care plan updates after falls, and that medications were missed without explanation. An immediate civil penalty was assessed. The allegation regarding the motion detector was found unsubstantiated after testing and interviews confirmed the system was functioning and monitored by a third party.

The complaint investigation was substantiated for allegations that a resident sustained a fracture while in care and did not receive medication as ordered. The allegation regarding a motion detector in disrepair was unsubstantiated. An immediate civil penalty of $500 was assessed, with an additional $10,000 penalty pending review.

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

The facility was found to be clean, well maintained, and compliant with all observed requirements including infection control, emergency preparedness, and safety measures. No deficiencies were cited during the visit.

The visit was conducted to gather additional information following a death report received on 06/30/2021 regarding a resident who passed away on 06/27/2021.

The resident was found unresponsive and pronounced dead by paramedics; staff reported no signs of suicidal ideation prior to the incident. No deficiencies were cited during the visit.

An unannounced complaint investigation was conducted following a complaint received on 10/20/2020 regarding allegations of resident dehydration and lack of dignity in staff relationships.

The investigation found the allegations to be unfounded after interviews with staff, the alleged victim, and relatives, as well as review of medical notes. The resident was in independent living and consciously chose not to eat or drink due to psychological issues, not due to facility neglect.

The complaint involved allegations that a resident was severely dehydrated and not accorded dignity in relationships with staff. The allegations were found to be unfounded based on interviews and records review.

An unannounced tele-Case Management visit was conducted related to COVID-19 surveillance testing compliance following concerns that the facility was not testing all staff as required.

The facility was found to be testing only staff who did not receive COVID-19 vaccination, which was not in compliance with Department guidance requiring 25% surveillance testing of all staff weekly. A deficiency was cited for failure to comply with this requirement, posing an immediate risk to resident health.

Due to the COVID-19 pandemic, Licensing Program Analysts and a Nurse Evaluator conducted a Case Management - Other tele-visit via FaceTime to provide technical assistance to prevent and mitigate the spread of COVID-19 at the facility.

The virtual tour observed staff wearing masks, availability of hand sanitizing stations, COVID-19 signage, and infection control practices including PPE use. One recommendation was made to place a covered trash bin inside an isolation room for PPE disposal, which was immediately addressed. No deficiencies were cited during the tour.