Inspection Reports for Merrill Gardens at Campbell
2115 S Winchester Blvd, Campbell, CA 95008, CA, 95008
Back to Facility Profile
Inspection Report
Annual Inspection
Census: 133
Capacity: 166
Deficiencies: 1
Oct 14, 2025
Visit Reason
An unannounced annual inspection was conducted to evaluate compliance with licensing requirements at Merrill Gardens at Campbell.
Findings
The facility was generally compliant with safety and operational standards, including clear exit pathways, proper food storage, and functioning safety equipment. However, a deficiency was cited for improper storage of a toxic chemical in a resident's room posing an immediate health and safety risk.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Clorox toilet bowl cleaner was found stored in an unlocked cabinet in Resident R10's room, violating chemical storage regulations and posing an immediate health and safety risk due to the resident's neurocognitive disorder. | Type A |
Report Facts
Capacity: 166
Census: 133
Plan of Correction Due Date: Oct 15, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Marcella Tarin | Licensing Program Analyst | Conducted the inspection and authored the report |
| Alex Den | General Manager | Facility representative during inspection and exit interview |
| Jin Jackie | Licensing Program Manager | Oversight of licensing program for the facility |
Inspection Report
Follow-Up
Census: 150
Capacity: 166
Deficiencies: 0
Nov 8, 2024
Visit Reason
The visit was an unannounced case management follow-up to verify correction of deficiencies cited on 2024-10-28 during the facility's annual inspection.
Findings
The Licensing Program Analyst reviewed updated documentation and found that deficiencies related to outdated physician's reports and incomplete CPR/First Aid training records were cleared. No deficiencies were cited during this visit.
Report Facts
Staff records missing CPR/First Aid training: 3
Facility capacity: 166
Resident census: 150
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Bradley Burgoyne | Administrator | Met with Licensing Program Analyst during inspection and provided information on staff training and physician reports. |
| Marcella Tarin | Licensing Program Analyst | Conducted the follow-up inspection and case management visit. |
Inspection Report
Annual Inspection
Census: 148
Capacity: 166
Deficiencies: 2
Oct 28, 2024
Visit Reason
An unannounced annual inspection visit was conducted to evaluate compliance with regulatory requirements at Merrill Gardens at Campbell.
Findings
The facility was found to be generally compliant with environmental, safety, and medication storage standards. However, deficiencies were cited related to incomplete staff CPR/first aid training and outdated physician's reports for residents with neurocognitive disorders.
Severity Breakdown
Type A: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Three out of eight staff records did not contain CPR/first aid training, violating the requirement to have trained staff on duty at all times. | Type A |
| Resident records for two residents with neurocognitive disorder did not contain updated physician's reports within the year as required. | Type A |
Report Facts
Staff records missing CPR/first aid training: 3
Resident records missing updated physician's reports: 2
Facility capacity: 166
Facility census: 148
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Bradley Burgoyne | Administrator | Met with Licensing Program Analyst during inspection and named in findings related to deficiencies |
| Marcella Tarin | Licensing Program Analyst | Conducted the inspection and authored the report |
| Jin Jackie | Licensing Program Manager | Supervisor overseeing the inspection |
Inspection Report
Complaint Investigation
Census: 154
Capacity: 166
Deficiencies: 0
May 2, 2024
Visit Reason
The visit was conducted to follow up on an incident self-reported by the facility in which staff S1 was allegedly observed to have hit resident R1 on the back of the head.
Findings
No deficiencies were cited at this time as per California Code of Regulations Title 22. A wellness check and observation of resident R1 were conducted during the visit.
Complaint Details
The complaint involved an allegation that staff S1 hit resident R1 on the back of the head. Staff S1 was not present during the visit and was not interviewed. Resident records and staff training records were reviewed. The complaint was not substantiated as no deficiencies were cited.
Report Facts
Capacity: 166
Census: 154
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Bradley Burgoyne | Administrator | Met with Licensing Program Analyst during the visit and reviewed the report |
| David Marrufo | Licensing Program Analyst | Conducted the unannounced Case Management - Incident visit |
Inspection Report
Census: 146
Capacity: 166
Deficiencies: 0
Jun 7, 2023
Visit Reason
An unannounced case management visit was conducted regarding an incident report detailing a resident elopement from the facility.
Findings
The resident eloped from the memory care unit but did not leave the facility. The facility has taken multiple corrective actions including increased staffing, training, and security changes. No deficiencies were cited during the visit.
Report Facts
Capacity: 166
Census: 146
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sarum Talivaa | Resident Care Director | Met during the visit and involved in the incident report discussion |
| Scott Shahade | General Manager | Met during the visit and involved in the incident report discussion |
Inspection Report
Annual Inspection
Census: 154
Capacity: 166
Deficiencies: 0
Oct 13, 2022
Visit Reason
Licensing Program Analyst Ryker Heberle conducted an annual inspection as a required 1-year unannounced visit to evaluate the facility's compliance with regulations.
Findings
The facility was found to be in compliance with no deficiencies or advisory notes cited. COVID-19 infection control measures were in place with 100% vaccination rates for staff and residents. Safety equipment and emergency exits were properly maintained and functioning.
Report Facts
Facility water temperature range: Measured between 110.2°F and 114.7°F
Facility temperature range: Measured between 68°F and 77°F
Fire extinguisher last inspection date: 2022
PPE supply duration: 30
COVID-19 vaccination rate: 100
COVID-19 vaccination rate: 100
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sarum Talivaa | Residential Services Manager | Met with Licensing Program Analyst during inspection |
| Ryker Heberle | Licensing Program Analyst | Conducted the annual inspection |
Inspection Report
Annual Inspection
Census: 155
Capacity: 166
Deficiencies: 0
Oct 12, 2021
Visit Reason
The inspection was an unannounced required annual inspection to evaluate compliance with licensing regulations at the assisted living facility.
Findings
No deficiencies were cited during the inspection. Advisory notes were issued regarding minor issues such as missing ceiling tiles due to a recent water leak and lack of handwashing signs in some public bathrooms. The facility demonstrated compliance with COVID-19 mitigation measures, including high vaccination rates and availability of PPE.
Report Facts
Facility temperature range: Facility temperature noted between 68°F and 79°F
Facility water temperature range: Facility water temperature measured between 115.5°F and 116.0°F
PPE supply duration: 30
COVID-19 vaccination rate for staff: 100
COVID-19 vaccination rate for residents: 99
Fire extinguisher last inspection date: 202103
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Joyce Welch | General Manager | Met with Licensing Program Analyst during inspection |
| Ryker Heberle | Licensing Program Analyst | Conducted the annual inspection |
| Sarah Yip | Licensing Program Manager | Named in report header |
Loading inspection reports...



