Inspection Reports for Merced Residential Care III
259 Broad Street San Francisco, CA 94112, CA, 94112
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Inspection Report
Annual Inspection
Census: 14
Capacity: 14
Deficiencies: 0
Jul 28, 2025
Visit Reason
The inspection was conducted as the Annual 1-year required inspection to evaluate compliance with licensing requirements.
Findings
The facility was found to be in full compliance with no deficiencies cited. The physical plant, infection control, medication storage, safety equipment, and environmental conditions were all inspected and met required standards.
Report Facts
Capacity: 14
Census: 14
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Luong Ly | Administrator | Met with Licensing Program Analyst during inspection |
| Yi Sam Jian | Licensing Program Analyst | Conducted the inspection |
| April Cowan | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Annual Inspection
Census: 14
Capacity: 14
Deficiencies: 2
Sep 11, 2024
Visit Reason
The visit was conducted as the Annual 1-year required inspection to evaluate compliance with licensing regulations.
Findings
The facility was generally well maintained with proper safety measures, but deficiencies were found including missing Annual Needs and Services Plans for 4 residents and an improper use of postural supports restricting a resident's movement in bed.
Severity Breakdown
Technical Violation: 1
Type A Violation: 1
Deficiencies (2)
| Description | Severity |
|---|---|
| Missing 4 resident Annual Needs and Services Plans. | Technical Violation |
| Restricting a resident's movement while in bed using a foam pad. | Type A Violation |
Report Facts
Resident files reviewed: 5
Staff files reviewed: 6
Deficiencies cited: 2
Plan of Correction Due Date: Sep 12, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Luong Jack Ly | Administrator | Met with Licensing Program Analysts during inspection and discussed findings |
| John Calandra | Licensing Program Analyst | Conducted the inspection |
| Yi Sam Jian | Licensing Program Analyst | Conducted the inspection and signed the report |
| Andrea Medlin | Licensing Program Manager | Supervised the inspection and named in report |
Inspection Report
Annual Inspection
Census: 14
Capacity: 14
Deficiencies: 0
Jan 3, 2022
Visit Reason
The inspection was a required unannounced 1-year visit to evaluate compliance with regulations for the Merced Residential Care Facility.
Findings
No deficiencies of the RCFE California Code of Regulations, Title 22, Division 6, Chapter 8 were observed. Infection control practices, safety measures, and staff certifications were reviewed and found adequate.
Report Facts
Residents present: 13
Staff present: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Tommy Lee | Certified RCFE Administrator | Oversees facility operations |
| Luong Ly | Certified RCFE Administrator | Oversees facility operations and met with during inspection |
Inspection Report
Complaint Investigation
Census: 14
Capacity: 14
Deficiencies: 0
Feb 16, 2021
Visit Reason
An unannounced complaint investigation was conducted regarding allegations that individuals having access and contact with residents who tested positive for COVID-19 were not reported to the Community Care Licensing Division (CCL).
Findings
The investigation found that the Community Care Licensing Division had received a report from the facility regarding the positive COVID-19 case. Staff confirmed the individual was asymptomatic before testing and that testing was routine. The facility ensured residents were in their rooms before transferring the positive individual for isolation. The allegation was unsubstantiated due to lack of preponderance of evidence.
Complaint Details
The complaint alleged failure to report individuals with access and contact to residents who tested positive for COVID-19 to the Community Care Licensing Division. The allegation was found to be unsubstantiated.
Report Facts
Facility capacity: 14
Census: 14
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Mohamed Filouane | Licensing Program Analyst | Conducted the complaint investigation and follow-up visit |
| Julio Montes | Licensing Program Manager | Named as Licensing Program Manager on the report |
| James D. Wu | Administrator | Facility Administrator mentioned in the report |
| Luong Ly | Met with during the investigation (phone interview) |
Inspection Report
Complaint Investigation
Census: 14
Capacity: 14
Deficiencies: 1
Feb 16, 2021
Visit Reason
An unannounced complaint investigation visit was conducted due to allegations of inimical conduct by the licensee for not following COVID-19 guidelines.
Findings
The investigation substantiated that the licensee and family traveled out of state against COVID-19 travel advisories and quarantined within the facility upon return, resulting in a family member testing positive for COVID-19. This placed the elderly residents at risk of infection.
Complaint Details
The complaint was substantiated based on evidence that the licensee's conduct endangered residents by not following COVID-19 safety guidelines, resulting in a positive COVID-19 case within the facility.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| The licensee traveled out of state against CDC and local health department advisories and quarantined in the facility where elderly residents resided, violating personal rights to safe and healthful accommodations. | Type A |
Report Facts
Capacity: 14
Census: 14
Deficiencies cited: 1
Plan of Correction Due Date: Feb 17, 2021
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Mohamed Filouane | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Julio Montes | Licensing Program Manager | Oversaw the complaint investigation |
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