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Inspection visit

Follow-up on corrections

ARBOR AT BERKELEYLicense 0192011432 citations on this visit
2 citations recorded

Inspector’s narrative

What the inspector wrote

On 05/02/2025 around 01:00 PM, Licensing Program Analyst (LPA) L. Holmes conducted a case management as result of a complaint dated 04/22/2025 #15-AS-20250422160308 and UIRs. LPA met with Justin Zackzewski, Director of Hospitality. In addition to the complaint, LPA received LIC 624 dated 04/24/25 stating that R1 was sent out (to the hospital) for repeated exit seeking. On 05/02/2025 around 1:10 PM, LPA toured the perimeter of the facility and observed a gray, cable wired, combination lock on the side gate. This gate exits from the facility's court yard. LPA advised S1 to remove the lock. On 04/21/25, S1 submitted an LIC 624 stating. “The community will be seeking a three-day discharge” for R1; no Eviction Notice was provided to CCLD at that time. On 04/24/25, LPA requested the Eviction Notice that was provided to R1. On 04/28/25, S1 emailed LPA a 30-day notice of discharge addressed to W1 dated 04/22/25. On 04/29/25, LPA advised S1, S2, and S3 via email, W1 by voicemail on 04/29/25 and by phone conversation on 04/30/25 that the Notice of Eviction presented to R1 was unlawful, and that the facility’s Licensee would be required to provide notification to R1 and R1’s responsible party that the notice would be rescinded immediately. Continued on LIC 809C... ...continued from LIC 809. On 04/29/25, LPA advised S1, S2 and S3 that the notice and the previously noticed deadlines for eviction were invalid. LPA reviewed the eviction notice. Per Title 22 87224 Eviction Procedures, the Licensee shall set forth in the notice to quit the reasons relied upon for the eviction with specific facts to permit determination of the date, place, witnesses, and circumstances concerning those reasons. In addition, the exact statement as specified in Title 22 for an unlawful detainer shall be documented; these items were not documented. *An immediate civil penalty of $500.00 will be assessed on today's day for fingerprint clearance* Deficiency cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. A copy of the LIC421M, appeal rights, and this report provided.

Citations

5 citations recorded*CCLD

What does Type A vs Type B mean?

Type A. Serious citation. Imminent or substantial risk to children. The regulator requires corrective action immediately and may impose a civil penalty.

Type B. Lower-severity citation. Corrective action required, no imminent risk. The regulator monitors compliance on the next visit.

  • 1569.80(b)Type B

    1569.80 Care and services decision making; meeting; written record (b) Once prepared, the written record...to determine the care and services provided to the resident written record shall be sent by the facility to that physician. Licensee/ED did not provide written record to R1's physician for the decision making for care and services.

  • 87303(b)(3)Type B

    87303 Maintenance and Operation (b) A comfortable temperature for residents shall be maintained at all times. (3) Nothing in this section shall prohibit residents from adjusting individual thermostatic controls. -This requirement is not met as evidenced by: Licensee/ED did not ensure the facility maintained a comfortable temperature for all residents at all times.

  • 87468.2(a)(2)Type B

    87468.2...Personal Rights of Residents in Privately Operated Facilities(a) ...Residents in All Facilities...shall have all of the following personal rights:(2) To have their records and personal information remain confidential...-This requirement is not met as evidenced by: Licensee/ED did not ensure that R1's and RP's records be presented and maintained with confidentiality.

  • 87203Type A

    87203 Fire Safety All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic.-This requirement is not met as evidenced by: Licensee to review the regulation, provide training to staff and submit proof to CCLD by POC. Locks removed from two gates during the visit to allow emergency exiting on both sides.

  • 87224(f)Type B

    87224 Eviction Procedures (f) A written report of any eviction shall be sent to the licensing agency within five (5) days.-This requirement is not met as evidenced by: Licensee did not provide the notice of eviction in a timely matter to CCLD. The notice provided to R1's RP was unlawful.

FAQ · About this visit

Common questions about this visit

What happened during the May 2, 2025 inspection of ARBOR AT BERKELEY?

This was a other inspection of ARBOR AT BERKELEY on May 2, 2025. 2 citations were issued: 1 Type A (serious) and 1 Type B.

Were any citations issued to ARBOR AT BERKELEY on May 2, 2025?

Yes, 2 citations were issued (1 Type A, 1 Type B). The first citation was for: "1569.80 Care and services decision making; meeting; written record (b) Once prepared, the written record...to determine ..."

What type of inspection was this?

This was a other inspection. other inspections are conducted by CCLD as part of their licensing oversight.

SourceView on CCLDView original report

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