Inspection Reports for
Pacifica Royale Assisted Living Community
15022 PACIFIC ST., MIDWAY CITY, CA, 92655
Back to Facility ProfileDeficiencies (last 4 years)
Deficiencies (over 4 years)
0.8 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
80% better than California average
California average: 4 deficiencies/yearDeficiencies per year
4
3
2
1
0
Occupancy
Latest occupancy rate
58% occupied
Based on a July 2025 inspection.
Occupancy rate over time
Inspection Report
Complaint Investigation
Census: 77
Capacity: 132
Deficiencies: 0
Date: Jul 1, 2025
Visit Reason
The visit was an unannounced complaint investigation triggered by allegations that staff bathed a resident with cold water causing pain, made inappropriate comments to a resident, and did not treat a resident with dignity and respect.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included staff bathing a resident with cold water causing pain, making inappropriate comments, and not treating a resident with dignity and respect. Interviews and record reviews did not support these claims.
Findings
The investigation included interviews with residents and staff, and record reviews. The allegations were found to be unsubstantiated due to insufficient evidence to prove the violations occurred.
Report Facts
Capacity: 132
Census: 77
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Edward Maslobodsky | Administrator | Facility administrator met during the investigation |
| Fred Arias | Licensing Program Analyst | Evaluator who conducted the complaint investigation |
| Alisa Ortiz | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 77
Capacity: 132
Deficiencies: 0
Date: Jul 1, 2025
Visit Reason
The visit was an unannounced complaint investigation regarding an allegation that facility staff did not meet a resident's dental hygiene needs.
Complaint Details
The complaint alleged that facility staff did not meet resident 1's dental hygiene needs, specifically that dentures were found dirty and with old adhesive during a hospital admission in 2021. The investigation found no evidence to substantiate this claim.
Findings
The investigation included interviews with residents and staff, and a review of records. The allegation was found to be unsubstantiated as residents and staff reported no issues with dental care, and the resident in question was able to manage their own dental hygiene.
Report Facts
Capacity: 132
Census: 77
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Edward Maslobodsky | Administrator | Facility administrator present during the investigation |
| Fred Arias | Licensing Program Analyst | Evaluator who conducted the complaint investigation |
| Alisa Ortiz | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Annual Inspection
Census: 77
Capacity: 132
Deficiencies: 1
Date: Apr 17, 2025
Visit Reason
An unannounced required annual inspection visit was conducted to evaluate compliance with licensing requirements at the assisted living facility.
Findings
The facility was generally compliant with regulations, including physical plant, food service, emergency plans, and resident care documentation. One deficiency was cited related to improper medication storage for Resident 2, posing an immediate health and safety risk.
Deficiencies (1)
CCR 87465(h)(2) requires centrally stored medicines to be kept in a safe and locked place accessible only to authorized employees. Resident 2 had medication stored in the bathroom, which is not allowed and poses an immediate health and safety risk.
Report Facts
Facility Capacity: 132
Resident Census: 77
Plan of Correction Due Date: Apr 18, 2025
Number of Resident Files Reviewed: 8
Number of Staff Files Reviewed: 6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Edward Maslobodsky | Administrator | Facility administrator who assisted with the inspection and was involved in the plan of correction |
| Fred Arias | Licensing Program Analyst | Conducted the inspection and authored the report |
| Alisa Ortiz | Licensing Program Manager | Oversaw the licensing program and is named on the report |
Inspection Report
Annual Inspection
Census: 91
Capacity: 132
Deficiencies: 0
Date: Apr 13, 2024
Visit Reason
An unannounced required annual inspection was conducted to evaluate compliance with licensing regulations for Pacifica Royale Assisted Living Community.
Findings
The facility was found to be in good repair with operational safety equipment and adequate supplies. No citations were issued during this inspection.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Edward Maslobodsky | Facility Administrator | Met with Licensing Program Analyst during inspection and participated in exit interview. |
| Celine De Perio | Licensing Program Analyst | Conducted the unannounced annual inspection. |
Inspection Report
Census: 65
Capacity: 132
Deficiencies: 0
Date: Apr 10, 2024
Visit Reason
The visit was an unannounced case management inspection to follow up on an incident report received dated 2024-04-04.
Findings
No health and safety concerns were noted during the visit. The facility reported the incident to the department, police, and the resident's family. No citations were issued.
Inspection Report
Complaint Investigation
Census: 65
Capacity: 132
Deficiencies: 0
Date: Jan 23, 2024
Visit Reason
An unannounced complaint investigation was conducted in response to an allegation that facility staff threatened a resident after the resident refused to take a prescribed medication.
Complaint Details
The complaint alleged that facility staff threatened a resident after the resident refused prescribed medication. The allegation was deemed unsubstantiated due to lack of evidence.
Findings
The investigation included interviews with staff and the resident, a facility tour, and review of medical documentation. The allegation was found to be unsubstantiated as staff denied threatening the resident and no evidence corroborated the claim.
Report Facts
Capacity: 132
Census: 65
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Edward Maslobodsky | Administrator | Facility administrator present during the investigation |
| Kimberly Lyman | Licensing Program Analyst | Evaluator who conducted the complaint investigation |
| Alisa Ortiz | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Census: 84
Capacity: 132
Deficiencies: 0
Date: May 27, 2022
Visit Reason
The visit was an unannounced Case Management follow-up on an Incident Report received regarding Resident #1.
Findings
No deficiencies were issued during this Case Management visit. The Licensing Program Analyst conducted interviews, reviewed documentation, and toured the resident's room.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Edward Maslobodsky | Administrator | Met with Licensing Program Analyst during the visit and involved in the interview and facility tour. |
| Patricia Velazquez | Licensing Program Analyst | Conducted the unannounced visit, interview, file review, and facility tour. |
Inspection Report
Annual Inspection
Census: 82
Capacity: 132
Deficiencies: 2
Date: Apr 7, 2022
Visit Reason
The visit was an unannounced Required 1 Year inspection of Pacifica Royale Assisted Living Community to evaluate compliance with licensing regulations.
Findings
The inspection found the facility generally compliant with adequate supplies, functioning equipment, and safe environment. However, deficiencies were cited for lack of physician's written orders for postural supports in 3 cases and one inoperable resident signal alarm.
Deficiencies (2)
CCR 87608(a)(3) Postural Supports. The licensee did not have a written physician's order for the postural support in 3 resident records, posing an immediate health and safety risk.
CCR 87303(i)(1)(A-C) Maintenance and Operation. The signal system was not operating in 1 of 9 resident rooms, posing an immediate health and safety risk.
Report Facts
Deficiencies cited: 2
Resident rooms with inoperable alarm: 1
Resident records missing physician orders: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Edward Maslobodsky | Administrator | Facility administrator involved in inspection and exit interview |
| Patricia Velazquez | Licensing Program Analyst | Licensing evaluator conducting the inspection |
| Ala Yarashevich | Activities Coordinator | Facility staff assisting with inspection and verification |
Inspection Report
Census: 83
Capacity: 132
Deficiencies: 0
Date: Dec 15, 2021
Visit Reason
The visit was an unannounced Case Management follow-up on an Incident report submitted to Community Care Licensing regarding a resident's complaint of lower back pain and a reported fall.
Findings
No health and safety concerns were observed during the visit, and no deficiencies were cited according to Title 22, Division 6 of the California Code of Regulations.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Edward Maslobodsky | Administrator | Met with Licensing Program Analyst during the visit and involved in incident report discussion. |
| Lydia Martinez | Licensing Program Analyst | Conducted the unannounced Case Management visit. |
Viewing
Loading inspection reports...
