Routine inspection·May 16, 2025

On 5/16/2025, Licensing Program Analyst (LPA) Tobola conducted an unannounced Annual Required – 1 yr. inspection for this facility and was greeted by Administrator, Terrence Tumbale, Executive Director, Tomas Mendez & Director of Assisting and Memory Care, RoxAnn King. The facility currently provides care for 31 residents in the assisted living and memory care units, 2 of which are receiving hospice services, along with a designated memory care unit. LPA continued with a tour of the facility with staff, facility found to be clean and at a comfortable temperature with all exits free from obstruction. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguishers located on each resident floor, kitchen and common spaces were found to be charged. A spot check of medications in the assisted living and memory care units, was conducted and found that all medication counts and records are in order. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations, with food stored in the kitchen, sufficient for residents in care. Food supply is replenished multiple times throughout the week and stored properly. Facility provides a wide variety of meal preferences and preparation while also ensuring proper dietary restrictions are followed. There was a supply of hygiene products and paper products available for residents with replenishment throughout the week. All resident’s bedrooms have lighting & appropriate furnishings and bedding items. LPA observed a housekeeping cart located outside of the housekeeping closet within the assisted living portion of the facility. Light cleaning supplies were observed unsecured and potentially accessible. House keeping was actively working on their routine during inspection with no residents observed near the cart. Items were immediately stored in secured location and will be discussed with staff. Technical Violation issued. Continued onto LIC809-C Residents that were out in the community the inspection were observed interacting with staff, fellow residents and visitors in the common areas, or in their bedrooms resting. The facility encourages regular family visits and utilizes a wide variety of activities with LPA observing staff engaging continuously with residents, offering activities based on individualized preferences and abilities. LPA found that staff and resident engagement is well practiced with activity calendars developed on a monthly basis. The facility also integrates memory care residents into facility wide events and activities to promote inclusion and interaction. Residents were observed to have a positive and personable relationship with staff. There are two outdoor patios for resident use, all equipped with appropriate shading and a large sun room plaza for resident use. LPA conducted a sample file review for residents and found all items to be in order including needs & service plans and physician's reports. Upon a spot check of staff files, LPA found that caregiver staff have current 1st aid and CPR and annual training and health screening reports on file. LPA noted that Administrator, Terence Tumbale is associated to a partnered facility under the same license but not to the Sequoias San Francisco. LPA discussed with Administrator and provided technical assistance. Terence Tumbale's Administrator Certificate 7018528740 is currently active through 2/25/2027. Roxanne King's Administrator Certificate 6075229740 is currently active through 3/4/2027. LPA requested the following documents be sent to CCL by COB 5/30/2025: LIC 308 Designated Facility Responsibility LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan Liability Insurance No deficiencies cited during today's visit.