Office review·September 18, 2025

Licensing Program Analyst Manuel Monter and Licensing Program Manager Romeo Manzano conducted an Office visit with Administrator Melinda Manalo. The purpose of the visit is to discuss an annual inspection report and non ambulatory fire clearance of the facility (Bedroom #5). During today's visit, LPM discussed the annual inspection report, dated July 22, 2025. During inspection R1 was observed occupying bedroom #5, which is an ambulatory room. R1 is considered non-ambulatory, based on his/her physician's report (health condition). Licensee/ADM stated R1 has been provided a 60 day eviction notice on August 5, 2025. R1 refused to leave the facility. A review of the current STD850, the facility has been approved for 4 non ambulatory, 1 bedridden, and 1 ambulatory. CCLD will issue a new license, reflecting the fire clearance. ADM stated that upon talking to fire department inspector, she was informed that bedroom #5 was cleared to be non ambulatory by the fire department inspector. LPM and ADM contacted the fire inspector to verify the ambulatory status of bedroom #5. Fire inspector stated bedroom #5, in its current state will not be approved for a non-ambulatory bedroom, because there is no direct door. ADM hired an architect, who inspected the facility and will submit the plan to the city for the construction of a door in bedroom #5. Licensee/ ADM was advised to inform CCLD when construction will begin. ADM stated she will submit a written plan of action, to ensure care and supervision of residents in care, while the construction process for bedroom #5 is underway. Once construction has completed, ADM will contact the Department for a new fire clearance request. Page 1 Out of 2. ADM stated resident R1 will be staying in another RCFE, in a non ambulatory bedroom for a respite, while there is ongoing construction and change of ambulatory status for bedroom #5. R1 has agreed. After the construction and change of ambulatory status, R1 will return to the care home. This report will be shared with San Bruno Regional Office Managers. No deficiencies cited. This report was reviewed with Administrator Melinda Manalo. A copy of this report was provided. Page 2 Out of 2. END OF REPORT.