Inspection Reports for Piedmont Gardens
110 41st St, Oakland, CA 94611, United States, CA, 94611
Back to Facility ProfileInspection Report Summary
Most inspections found no deficiencies, showing a generally strong compliance record at this facility. The most recent report from September 18, 2025, was a complaint investigation that found all allegations unsubstantiated, with no deficiencies cited. Earlier complaint investigations noted isolated incidents such as a medication error and a resident injury from assistance, but these were addressed promptly and did not result in deficiencies. Several complaints were unsubstantiated, and no fines, enforcement actions, or severe findings were reported in the available records. The facility’s performance appears stable over time, with no clear pattern of worsening or recurring issues.
Deficiencies (last 4 years)
Deficiencies (over 4 years)
0 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
Same as California average
California average: 4 deficiencies/year
Deficiencies per year
4
3
2
1
0
Census
Latest occupancy rate
77% occupied
Based on a September 2025 inspection.
This facility has shown a decline in demand based on occupancy rates.
Census over time
Inspection Report
Complaint Investigation
Census: 247
Capacity: 321
Deficiencies: 0
Sep 18, 2025
Visit Reason
An unannounced complaint investigation visit was conducted in response to allegations that staff did not provide medication assistance, proper supervision resulting in injury, and adequate hygiene care to residents.
Findings
The investigation found all allegations to be unsubstantiated based on interviews, record reviews, and observations. Residents in independent living manage their own medications, staff responded appropriately to a resident fall, and the resident's hygiene and apartment cleanliness were found satisfactory.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included failure to provide medication assistance, proper supervision resulting in injury, and hygiene care needs not met. Evidence did not support these claims.
Report Facts
Capacity: 321
Census: 247
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| David Doidge | Licensing Program Analyst | Conducted the complaint investigation |
| Bennett Fong | Licensing Program Manager | Named in report as Licensing Program Manager |
| Zinnia Koch | Director of Wellness and Assisted Living | Met with investigators during the visit |
Inspection Report
Complaint Investigation
Census: 189
Capacity: 321
Deficiencies: 0
Jun 16, 2025
Visit Reason
An unannounced Case Management visit was conducted regarding an incident reported to the Community Care Licensing Division (CCLD) involving a resident who reported staff were rough while assisting with using a bedside commode.
Findings
The investigation found a skin tear on the resident's left thumb caused during assistance with the commode. The wound was cleaned and re-bandaged. The staff involved was placed on leave pending further investigation. No deficiencies were issued during the visit.
Complaint Details
The visit was triggered by a complaint incident reported on 06/15/2025 involving alleged rough handling by staff causing a skin tear to a resident's thumb. The complaint was investigated with interviews and review of medical reports.
Report Facts
Skin tear length: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Zinnia Koch | Director of Wellness and Assisted Living | Met with Licensing Program Analysts during the visit and involved in incident reporting and investigation |
| David Doidge | Licensing Program Analyst | Conducted the unannounced Case Management visit |
| Andrew Christy | Licensing Program Analyst | Conducted the unannounced Case Management visit |
Inspection Report
Complaint Investigation
Census: 244
Capacity: 321
Deficiencies: 0
May 20, 2025
Visit Reason
An unannounced Case Management visit was conducted regarding an incident reported to the Community Care Licensing Division on 05/06/2025 involving a resident who was administered the wrong medication.
Findings
The facility submitted an Unusual Incident Report for a medication error where an assisted living nurse, unfamiliar with residents, administered medication to the wrong resident. The resident showed no adverse reaction, and staff took corrective actions including monitoring, notifying the PCP and family, and providing in-service training. No deficiencies were issued during the visit.
Complaint Details
The complaint involved a medication error where a resident was given the wrong medication due to staff shortage and unfamiliarity. The incident was reported, monitored, and corrective steps were taken. No deficiencies were cited.
Report Facts
Census: 244
Total Capacity: 321
Staff interviewed: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| David Doidge | Licensing Program Analyst | Conducted the inspection and investigation |
| Zinnia Koch | Director of Wellness and Assisted Living | Met with Licensing Program Analyst during the visit |
Inspection Report
Annual Inspection
Census: 62
Capacity: 321
Deficiencies: 0
Jan 24, 2025
Visit Reason
The inspection was an unannounced 1-Year Annual Required inspection conducted to evaluate compliance with licensing requirements.
Findings
The Licensing Program Analyst toured the facility and reviewed resident and staff records, finding no deficiencies. The facility was found to have adequate lighting, temperature control, food supply, medication security, and up-to-date fire safety measures.
Report Facts
Resident records reviewed: 5
Staff records reviewed: 5
Fire extinguisher last serviced: Sep 9, 2024
Emergency drills last conducted: Jan 9, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Daniel Wittman | Executive Director | Met with Licensing Program Analyst during inspection |
| David Doidge | Licensing Program Analyst | Conducted the inspection |
| Bennett Fong | Licensing Program Manager | Named in report header |
Inspection Report
Complaint Investigation
Census: 63
Capacity: 321
Deficiencies: 0
Apr 3, 2024
Visit Reason
An unannounced Case Management visit was conducted regarding an incident of staff misconduct reported to CCLD on 2024-02-16.
Findings
The facility conducted an internal investigation and found no intent to harm the resident; the handling was misinterpreted. No deficiencies were issued during the visit.
Complaint Details
The complaint involved alleged rough handling of resident R1 by staff S2. The investigation found no complaints or adverse actions and the allegation was not substantiated.
Report Facts
Incident report date: Feb 14, 2024
Suspension period (days): 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Laura Hall | Licensing Program Analyst | Conducted the inspection visit |
| Zinnia Koch | Director of Wellness and Assisted Living | Met with Licensing Program Analyst during the visit |
Inspection Report
Complaint Investigation
Census: 63
Capacity: 321
Deficiencies: 0
Apr 3, 2024
Visit Reason
Unannounced complaint investigation visit conducted due to allegations including staff not administering medication as prescribed, staff mishandling residents' medication, and a resident's bathroom fan being in disrepair.
Findings
The investigation found all allegations to be unsubstantiated after reviewing records, interviewing staff and the reporting party, and conducting a facility tour. Medication refusals by the resident were documented, no evidence of mishandling medication was found, and no bathroom fans in disrepair were observed during the visit.
Complaint Details
The complaint was unsubstantiated, meaning there was not a preponderance of evidence to prove the alleged violations occurred.
Report Facts
Capacity: 321
Census: 63
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Laura Hall | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Harpreet Humpal | Licensing Program Manager | Named in report as Licensing Program Manager |
| Zinniz Koch | Director of Wellness and Assisted Living | Met with Licensing Program Analyst during investigation |
Inspection Report
Complaint Investigation
Census: 63
Capacity: 321
Deficiencies: 0
Apr 3, 2024
Visit Reason
Unannounced complaint investigation visit conducted due to allegations that the facility neglected to provide adequate basic care needs and did not follow physician's orders.
Findings
The investigation included interviews, record reviews, and observations. The allegations were found to be unsubstantiated as evidence showed the facility provided adequate care and followed physician's orders.
Complaint Details
The complaint was unsubstantiated. Allegations included neglect of basic care needs and failure to follow physician's orders. Investigation found no preponderance of evidence to prove violations occurred.
Report Facts
Facility capacity: 321
Census: 63
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Laura Hall | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Harpreet Humpal | Licensing Program Manager | Named in report as Licensing Program Manager |
| Zinnia Koch | Director of Wellness and Assisted Living | Met with Licensing Program Analyst during investigation |
| Daniel Wittman | Administrator | Facility administrator named in report |
Inspection Report
Annual Inspection
Census: 64
Capacity: 321
Deficiencies: 0
Mar 22, 2024
Visit Reason
The visit was an unannounced 1-Year Annual Required inspection conducted to evaluate compliance with licensing requirements.
Findings
The facility was inspected thoroughly including resident apartments, common areas, kitchen, and safety features. No deficiencies were cited; the facility was found clean, well-maintained, and compliant with safety and health standards.
Report Facts
Residents records reviewed: 6
Staff records reviewed: 8
Staff with current first aid training: 8
Fire extinguisher last inspection date: Mar 1, 2024
Fire/Earthquake Emergency drill date: Mar 14, 2024
Hot water temperature range: Measured between 110 and 118 degrees Fahrenheit
Refrigerator temperature: 35
Freezer temperature: -5
Administrator certificate expiration date: Jun 10, 2025
Liability insurance expiration date: Jan 1, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Daniel Wittman | Executive Director | Met with Licensing Program Analyst during inspection |
| Zinnia Koch | Director of Wellness and Assisted Living | Met with Licensing Program Analyst during inspection |
Inspection Report
Capacity: 321
Deficiencies: 0
Sep 29, 2023
Visit Reason
The visit was an unannounced case management visit conducted to deliver an Immediate Exclusion letter and advise the facility to disassociate the individual from their facility.
Findings
An Immediate Exclusion letter was delivered to the Director of Human Resources, who stated that the individual was not currently a staff member at the facility. No further findings or deficiencies were noted.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Yuri Flores | Director of Human Resources | Met during the visit and recipient of the Immediate Exclusion letter. |
| Gregory Clark | Licensing Program Analyst | Conducted the case management visit and delivered the Immediate Exclusion letter. |
Inspection Report
Complaint Investigation
Census: 275
Capacity: 321
Deficiencies: 0
Aug 31, 2023
Visit Reason
The visit was an unannounced case management inspection related to an incident that occurred at the facility.
Findings
During the visit, the Licensing Program Analyst interviewed staff and residents who reported feeling safe and well-treated. Records for one resident were reviewed, and it was confirmed that the agency caregiver involved in the incident was removed from the facility. Video footage was reviewed but not obtained from the facility.
Complaint Details
The visit was triggered by an incident complaint. The incident will be cross-reported to the Home Care Services Bureau for further investigation.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Zinnia Koch | Director of Wellness | Met with Licensing Program Analyst during the visit and confirmed removal of agency caregiver. |
| Laura Roberts | Memory Care Manager | Met with Licensing Program Analyst and provided information related to the incident. |
| Luisa Fontanilla | Licensing Program Analyst | Conducted the case management visit. |
| Yvonne Flores-Larios | Licensing Program Manager | Named in the report header. |
Inspection Report
Census: 280
Capacity: 321
Deficiencies: 0
Feb 22, 2023
Visit Reason
The visit was an unannounced case management visit to deliver an amended report regarding the allegation of unlawful eviction.
Findings
No deficiencies were cited during the visit. The amended report was delivered to the administrator and an exit interview was conducted.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jana Gesinger | Health Services Administrator | Met with Licensing Program Analyst during the visit. |
| Gregory Clark | Licensing Program Analyst | Conducted the unannounced visit and delivered the amended report. |
| Yvonne Flores-Larios | Licensing Program Manager | Named in the report header. |
Inspection Report
Complaint Investigation
Census: 280
Capacity: 321
Deficiencies: 0
Feb 16, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by an allegation of unlawful eviction received on 2021-12-21.
Findings
Based on interviews and investigation, the allegation of unlawful eviction was found to be unfounded. The resident was hospitalized and not evicted, and the facility was unable to accept the resident back until stabilized. No deficiencies were noted.
Complaint Details
The complaint alleged unlawful eviction of Resident 1 (R1). The investigation found the allegation to be false and without reasonable basis, resulting in dismissal of the complaint.
Report Facts
Capacity: 321
Census: 280
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Gregory Clark | Licensing Program Analyst | Conducted the complaint investigation and delivered the amended report |
| Zinnia Koch | Assisted Living Director | Interviewed during investigation denying eviction |
| Jana Gesinger | Health Services Administrator | Met with during inspection and explained purpose of visit |
Inspection Report
Census: 269
Capacity: 321
Deficiencies: 0
Nov 23, 2022
Visit Reason
The visit was an unannounced case management visit conducted as a result of receiving residents from Grand Lake Gardens and to check on those residents.
Findings
During the visit, staff schedules were reviewed, and 37 residents from Grand Lake Gardens were confirmed living in the facility. Residents reported feeling safe and comfortable, with one minor concern about call button use addressed. Supplies were adequate and staffing was stable, with no imminent health or safety concerns noted.
Report Facts
Residents from Grand Lake Gardens: 37
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Catherine Lin | Licensing Program Analyst | Conducted the unannounced case management visit |
| Zinnia Koch | Wellness Director | Met with Licensing Program Analyst during the visit and addressed resident concerns |
Inspection Report
Census: 265
Capacity: 321
Deficiencies: 0
Nov 9, 2022
Visit Reason
An unannounced case management visit was conducted as a result of receiving residents from Grand Lake Gardens (GLG) and to check on residents' well-being.
Findings
The visit found that 35 residents from GLG were currently living at Piedmont Gardens. Residents reported feeling safe, well-fed, and that their needs were met. Supplies were adequate and staffing was stable. There were no imminent health or safety concerns on the date of the visit.
Report Facts
Residents from GLG currently living in facility: 35
Residents met during visit: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Zinnia Koch | Wellness Director | Met with Licensing Program Analyst during the visit and discussed resident concerns |
| Catherine Lin | Licensing Program Analyst | Conducted the unannounced case management visit |
| Bennett Fong | Licensing Program Manager | Named in the report header |
Inspection Report
Census: 261
Capacity: 321
Deficiencies: 0
Nov 2, 2022
Visit Reason
An unannounced case management visit was conducted as a result of receiving residents from Grand Lake Gardens and to check on residents.
Findings
During the visit, 32 residents from Grand Lake Gardens were found living at Piedmont Gardens, with one resident having moved out. Residents reported feeling safe, well-fed, and their needs met. Adequate supplies and stable staffing were observed with no imminent health or safety concerns.
Report Facts
Residents from Grand Lake Gardens currently living in Piedmont Gardens: 32
Resident moved out: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Catherine Lin | Licensing Program Analyst | Conducted the unannounced case management visit |
| Zinnia Koch | Wellness Director | Met with Licensing Program Analyst during the visit |
Inspection Report
Census: 260
Capacity: 321
Deficiencies: 0
Oct 28, 2022
Visit Reason
The visit was an unannounced case management inspection conducted due to receiving residents from Grand Lake Gardens (GLG) and to check on those residents.
Findings
The inspection found that 32 residents from GLG had moved into Piedmont Gardens, including 3 admitted prior to a fire. Five residents interviewed reported satisfaction with their care, and staffing was stable with some GLG staff transferred to Piedmont Gardens. Adequate food, paper, and PPE supplies were observed, and no imminent health or safety concerns were identified.
Report Facts
Residents transferred from Grand Lake Gardens: 32
Residents admitted prior to fire: 3
Residents interviewed: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Catherine Lin | Licensing Program Analyst | Conducted the unannounced case management visit |
| Zinnia Koch | Wellness Director | Met with Licensing Program Analyst during the visit |
Inspection Report
Census: 236
Capacity: 321
Deficiencies: 0
Oct 17, 2022
Visit Reason
The visit was an unannounced case management visit conducted due to receiving residents from Grand Lake Gardens following evacuation from a major fire.
Findings
The report found that 20 residents from Grand Lake Gardens were admitted to Piedmont Gardens between 10/14/22 and 10/16/22, with residents placed in skilled nursing, assisted living, and independent living. Supplies such as food, paper, and PPE were adequate, and staffing was stable.
Report Facts
Residents admitted from Grand Lake Gardens: 20
Residents staying at Hyatt House: 20
Residents staying at home with family: 43
Facility capacity: 321
Facility census: 236
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Daniel Wittman | Administrator | Administrator of Piedmont Gardens |
| Zinnia Koch | Wellness Director | Met with Licensing Program Analysts during visit |
| Scott Mueller | Administrator from Grand Lake Gardens who provided updates on residents | |
| Catherine Lin | Licensing Program Analyst | Conducted the case management visit |
| Bennett Fong | Licensing Program Manager | Named in report header |
Inspection Report
Census: 268
Capacity: 321
Deficiencies: 0
Oct 14, 2022
Visit Reason
An unannounced case management visit was conducted due to receiving residents from Grand Lake Gardens following evacuation from a major fire.
Findings
The facility opened two dining halls to accommodate evacuees, residents were safe and staff were assisting with clothing, medication refills, and family contact. Supplies and staffing were adequate and stable.
Inspection Report
Routine
Census: 286
Capacity: 321
Deficiencies: 0
Mar 1, 2022
Visit Reason
An unannounced Infection Control Inspection was conducted to assess compliance with infection control protocols.
Findings
The facility was found to have proper infection control measures in place including screening, PPE usage, and adequate food and PPE supplies. No deficiencies were cited during the visit.
Report Facts
Food supply duration: 2
Food supply duration: 7
PPE supply duration: 30
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Zinnia Koch | Wellness and Assisted Living Director | Met with Licensing Program Analyst during inspection |
| Catherine Lin | Licensing Program Analyst | Conducted the Infection Control Inspection |
| Bennett Fong | Licensing Program Manager | Named in report header |
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