Public Record
Pacific Care Home Iii
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About this facility
Operating details and county context
Operating details
- Capacity
- 6 residents
- Phone
- (650) 615-9071
- Address
- 2880 St. Cloud Drive
- Licensed since
San Mateo County context
209*CCLD
Total facilities
6.0*CCLD
Avg citations
8.0*CCLD
Avg visits
1.9*CCLD
Avg complaint visits
*CCLD: California Community Care Licensing Division. Updated weekly. Last refresh .
Ownership
J & I LLC
4assisted living facilities in California licensed to the same operator
Grouped by the operator name recorded in public CCLD licensing records. Common control is an inference, not a legal determination; confirm it independently before relying on it. How we determine ownership
Citations
14 citations on record
Every regulation cited on a CCLD inspection of this facility, sourced from the public record. Each row links to the visit’s inspector narrative.
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.
2026
- 87465(a)(6)Type B
Maintain records of centrally stored medication dosages
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above LPA and IB investigator observed R2, R3 and R4's centrally stored medication records were incomplete and medication was not logged which poses/posed a potential health, safety or personal rights risk to persons in care.
- 87465(e)Type A
Require physician order and label for PRN medication
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA and IB investigator observed an over the counter Blink Eye Drop in R2's room without a physician's order which poses an immediate health, safety or personal rights risk to persons in care.
- 87465(h)(5)Type A
Keep prescriptions in original containers
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA and IB investigator observed medication was removed from its original container which poses an immediate health, safety or personal rights risk to persons in care.
- 87307(a)Type B
Living accommodations aligned with facility function
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA and IB investigator observed clothing, Rosary, futon bed, medication, comb, shoes in the garage which poses/posed a potential health, safety or personal rights risk to persons in care.
- 87608(a)(5)(B)Type A
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA and IB investigator observed R3 has full bedrails which poses an immediate health, safety or personal rights risk to persons in care.
2025
- 87633(a)(2)Type B
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as the facility has an approved hospice waiver for 2 but currently has 3 residents who are on hospice which poses/posed a potential health, safety or personal rights risk to persons in care.
- 87618(b)(3)(A)Type B
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as R1, R2 and R3 have oxygen and there is no proof that a report has been made to the local fire jurisdiction which poses/posed a potential health, safety or personal rights risk to persons in care.
2024
- 87309(a)Type A
Ensure hazardous items are locked and not unattended
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA observed chemicals in the kitchen area and in the garage are unlocked and accessible to residents which poses an immediate health, safety or personal rights risk to persons in care.
- 1569.695(c)Type A
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as facility was not able to provide documents that emergency drill were conducted which poses an immediate health, safety or personal rights risk to persons in care.
- 87305(a)Type A
Requirement for building permit before construction
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA observed garage has livable items such as toiletries, futon beds, personal hygiene items, clothing, shoes, etc. which poses an immediate health, safety or personal rights risk to persons in care.
- 87755(c)Type B
Authority to audit and copy facility records
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as 1 out of 3 staff personnel file was not available for review during the inspection which poses/posed a potential health, safety or personal rights risk to persons in care.
2023
- 1569.618(c)(3)Type A
Based on record review, the licensee did not comply with the section cited above in [1] out of [5] facility personnel files did not have updated, and certified, first aid training which posed an immediate health, safety or personal rights risk to persons in care.
- 87309(a)Type A
Ensure hazardous items are locked and not unattended
Based on observation while touring this facility, the licensee did not comply with the section cited above in that cleaning solutions, detergents, and cleaning supplies were found to be under restrooms sinks, kitchen sink, and the garage area where they were not secured and made accessible to the residents which posed an immediate health, safety or personal rights risk to persons in care.
- 87705(c)(5)Type A
Based on record review, the licensee did not comply with the section cited above in that [3] out of [5] residents diagnosed with dementia did not have a required updated annual medical assessment which posed an immediate health, safety or personal rights risk to persons in care.
Inspection record
4 visits on record since 2023. Most recent on 2026-03-03.
4 routine inspections.
- Inspection3 Type A · 2 Type BRead inspector’s narrative
- Inspection2 Type BRead inspector’s narrative
- Inspection3 Type A · 1 Type BRead inspector’s narrative
- Inspection3 Type ARead inspector’s narrative
14 citations across the record on file
Nearby
Other licensed assisted living facilities in San Bruno
FAQ
Common questions about this facility
Is Pacific Care Home Iii licensed in California?
Yes, Pacific Care Home Iii is currently licensed in California. It has been licensed since 2015.
How many citations does Pacific Care Home Iii have?
Pacific Care Home Iii has 14 citations on record: 9 Type A (more serious) and 5 Type B citations. It has received 4 visits (4 inspections).
When was Pacific Care Home Iii last inspected?
Pacific Care Home Iii was last inspected on March 3, 2026 (about 4 months ago). California inspects licensed assisted living facilities (RCFEs) on a periodic basis or following a complaint.
What type of assisted living facility is Pacific Care Home Iii?
Pacific Care Home Iii is a Residential Care Facility for the Elderly (RCFE), which is a licensed assisted living facility serving older adults with a licensed capacity of 6 residents. It is located in San Bruno, San Mateo County, California.
How does Pacific Care Home Iii compare to other assisted living facilities in San Mateo County?
Pacific Care Home Iii has 14 citations. The county average is 6.0 citations per facility. There are 209 assisted living facilities in San Mateo County.
Does Pacific Care Home Iii have any serious violations?
Pacific Care Home Iii has 9 Type A citations on record. Type A citations indicate conditions that pose an immediate health or safety risk to residents. Review the inspection timeline above for details on each citation.
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