Public Record
Pacific Care Home V
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About this facility
Operating details and county context
Operating details
- Capacity
- 6 residents
- Phone
- (650) 315-2152
- Address
- 1790 Brooks St
- 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
5 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.
2024
- 87355(e)(2)Type A
Obtain required California clearance or exemption
CRIMINAL BACKGROUND CLEARANCEAll individuals subject to a criminal record review pursuant to HSC 1569.17(b) shall prior to working, residing or volunteering in a licensed facility, request a transfer of a criminal record clearance as specified in Section 87355(c). This requirement was not met, as staff #1 does not have criminal record clearance associated to this facility. Licensee failed to ensure that all staff have criminal record clearance associated to facility, which poses an immediate health and safety risk to clients in care.
- 87411(c)(1)Type B
First aid training requirements
PERSONNEL REQUIREMENTSStaff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross.This requirement was not met, as staff #1 and #2 do not have current first aid training. Licensee failed to ensure that caregivers have current first-aid training, which poses a potential health, safety, or personal rights risk to clients in care.
- 87465(h)(2)Type A
Store centrally held medications in locked secure place
INCIDENTAL MEDICAL CARECentrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement is not met, as hall cabinet where medications are secured is unlocked upon LPA's arrival. Also, Clearlas for client 2 & Miralax for client 5 are stored in unlocked kitchen cabinet.Licensee failed to ensure that medications are inaccessible to clients, which poses an immediate health and safety risk to clients in care.
2023
- 87506(b)(15)Type B
Maintain admission agreement and appraisal
Based on records review, the licensee did not comply with the section cited above in 1 out of 3, which poses a potential health, safety or personal rights risk to persons in care.
2021
- 87411(f)Type B
Health screening and fitness requirements
Based on record review, the licensee did not comply with the section cited above, as 3 out of 5 staff do not have health screenings and/or TB test results on file, which poses a potential health, safety or personal rights risk to persons in care.Staff CB and HC do not have health screenings and TB test results on file. Staff MS does not have TB test results on file.
Inspection record
4 visits on record since 2023. Most recent on 2026-04-28.
4 routine inspections.
- InspectionNo citationsRead inspector’s narrative
- InspectionNo citationsRead inspector’s narrative
- Inspection2 Type A · 1 Type BRead inspector’s narrative
- Inspection1 Type BRead inspector’s narrative
- Other1 Type BRead inspector’s narrative
5 citations across the record on file
Nearby
Other licensed assisted living facilities in San Mateo
FAQ
Common questions about this facility
Is Pacific Care Home V licensed in California?
Yes, Pacific Care Home V is currently licensed in California. It has been licensed since 2020.
How many citations does Pacific Care Home V have?
Pacific Care Home V has 5 citations on record: 2 Type A (more serious) and 3 Type B citations. It has received 4 visits (4 inspections).
When was Pacific Care Home V last inspected?
Pacific Care Home V was last inspected on April 28, 2026 (6 weeks 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 V?
Pacific Care Home V 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 Mateo, San Mateo County, California.
How does Pacific Care Home V compare to other assisted living facilities in San Mateo County?
Pacific Care Home V has 5 citations, which is below the county average of 6.0 citations per facility. There are 209 assisted living facilities in San Mateo County.
Does Pacific Care Home V have any serious violations?
Pacific Care Home V has 2 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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