Inspection visit

Routine inspectionJune 25, 2021

BURLINGAME SENIOR HOMELicense 4156000891 citation on this visit

1 citation recorded

Inspector’s narrative

What the inspector wrote

On 06/25/2021, Licensing Program Analyst (LPA) Jaime Vado toured facility's building and grounds. LPA met with caregiver Amelia Dayag and explained purpose of today's inspection. No accessible bodies of water or fire safety hazards observed. Infection control practices are reviewed: entry procedures, staff training and policies, resident monitoring, containment strategies, environmental preparation and cleaning. PPE supply is observed as in place. Medications, toxins and sharps are stored appropriately and inaccessible to clients. Facility ambient temperature is measured at 75F, and lighting is sufficient for residents and staff safety. Toilet and bathing facilities are equipped with grab bars and non-skid flooring material. Liquid soap is available. First-aid kit is inspected and complete. A Disaster and Mass Casualty Plan is located within staff files. There are 3 residents present and 1 staff. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed. LPA is unable to review staff files due to the administrator locking the storage area. Staff person is unable to open at the time of this inspection for LPA review. The following updated forms are requested to be submitted to CCLD by 06/29/2021 : • Administrator Certificate • LIC 308 Designation of Administrative Responsibility • LIC 309 Administrative Organization • LIC 500 Personnel Report • LIC 610E Emergency Disaster Plan • Updated lease agreement or control of property information Deficiency of the RCFE California Code of Regulations, Title 22, Division 6, Chapter 8 is observed and cited on a following page. Report is reviewed with Amy

Citations

1 citation 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.

87412(f)Type B
Allow licensing inspection and controlled record removal
Personnel Records - All personnel records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. Based on observation, the licensee did not comply with the section cited above. During inspection LPA was unable to reveiw administrator and staff records due to them being locked in a storage drawer within staff room. Staff did not have the key to open the drawers.

FAQ · About this visit

Common questions about this visit

What happened during the June 25, 2021 inspection of BURLINGAME SENIOR HOME?

This was an inspection of BURLINGAME SENIOR HOME on June 25, 2021. 1 citation were issued: 1 Type B.

Were any citations issued to BURLINGAME SENIOR HOME on June 25, 2021?

Yes, 1 citation was issued (0 Type A, 1 Type B). The first citation was for: "Personnel Records - All personnel records shall be available to the licensing agency to inspect, audit, and copy upon de..."

What type of inspection was this?

This was an inspection. Inspections are conducted by CCLD as part of their licensing oversight.

SourceView on CCLD View original report

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Data from CCLD public records. Last updated June 8, 2026. If you believe any information is inaccurate, report it here.

Routine inspection·June 25, 2021