Los Gatos Senior Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required - 1 Year visit and met with Jeanette Mongeon. During visit, LPA Marrufo toured the facility inside and out. LPA toured the kitchen area and observed there to be a perishable food supply of at least two days and a non-perishable food supply of at least seven days. LPA reviewed the first aid kit and found it to be complete. LPA toured the outside area and found the outdoor exits to be clear of obstructions. LPA toured six out of six resident bedrooms and observed each bedroom to have working lights and available bedding and clothing storage areas. During visit, staff tested the smoke detectors in the hallways and resident bedrooms. Each smoke detector functioned properly when tested. LPA tested the facility carbon monoxide detector and it functioned properly when tested. LPA Marrufo reviewed six out of six resident records, including Centrally Stored Medication and Destruction Records, and found them to be complete. LPA reviewed four staff records and found them to be complete. The Emergency Disaster Drill Log indicates that the last drill was conducted on 07/08/2026. During visit, LPA Marrufo interviewed two staff and two residents. See LIC809-C page for more information. Page 1 of 2. LPA Marrufo requests that the following records be updated and copies sent to the department by 09/22/2026: LIC500 Personnel Report LIC308 Designation of Administrative Responsibility Liability Insurance Administrator's Certificate LIC610E Emergency Disaster Plan No deficiencies were cited at this time as per California Code of Regulations Title 22. This report was reviewed with Jeanette Mongeon and a copy of this report was provided. Page 2 of 2. END REPORTthe state’s words, verbatim · CDSS document, Sep 15, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required - 1 Year visit and met with Irish Ladwig, Administrator. During visit, LPA Marrufo toured the facility inside and out. LPA toured the kitchen area. LPA observed there to be a perishable food supply of at least two days and a non-perishable food supply of at least seven days. LPA observed the first aid kit and found it to be complete. LPA toured two out of two resident bathrooms. LPA observed each bathroom to have available soap and paper towels and working lights. The water temperatures in the bathrooms measured at 106 F and 113 F. LPA toured six out of six resident bedrooms. Each bedroom had working lights and available bedding and clothing storage areas. LPA tested the smoke detectors in each hallway and resident bedrooms. Each smoke detector functioned properly when tested. LPA tested one out of one carbon monoxide detector, which functioned properly when tested. LPA toured the outside area and observed the outdoor exit to be clear of obstructions. LPA reviewed six out of six resident records, including Centrally Stored Medication and Destruction Records (CSMDR) and found them to be complete. See LIC809-C page for more information. Page 1 of 2. The emergency disaster drill log indicates the last drill was conducted on 08/05/2025. LPA reviewed four staff records and found them to be complete. During visit, LPA Marrufo obtained a copy of the following documents: LIC500 Personnel Report Current copy of the General Liability Insurance Certificate LPA Marrufo requests that the licensee submit the following updated form to Community Care Licensing by 09/12/2025: LIC610 Emergency Disaster Plan This report was reviewed with Irish Ladwig, Administrator, and a copy of this report and appeal rights were provided. Page 2 of 2. END REPORTthe state’s words, verbatim · CDSS document, Sep 5, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit and met with Administrator (ADM) Irish Ladwig. LPA observed 4 staff and 6 residents in the facility. LPA checked 3 resident files and 3 staff files. License, personal rights posters, and Administrator Certificate were observed at the main entrance. LPA toured the facility inside and out with ADM. LPA inspected living room, kitchen, dining area, restrooms, laundry room and garage. The facility has 6 resident rooms, 3 restrooms, 2 staff rooms. A storage room was observed in the garage. Medication closet, knives closet, and cleaning product closet were observed locked. Non-skid mats and handle bars were observed in bathrooms. Room temperature was observed at 72 degree F, and hot water temperature was observed at 119 degree F. Refrigerator temperature was measured at 40 degree F, freezer temperature was measured at 0 degree F. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. 3 half rail beds were observed in the facility, ADM provided the document for that. LPA tested resident's call button and the staff came within 1 minute. The facility is equipped with fire alarm and smoke and carbon monoxide detectors. ADM tested the smoke and carbon monoxide detectors, and they were working fine. The fire extinguishers were observed on service on 8/19/2024. LPA inspected the backyard, there was no obstruction to block the walkway. First aid box, Flash lights and night lights were observed in the facility. The last time the facility conducted fire drill was on 8/15/2024. Door alarms are installed at the main door and the door to the back yard. No deficiency noted today. Exit interview was conducted with ADM. The report was provided to ADM for signature. A copy of the reports were provided to ADM.the state’s words, verbatim · CDSS document, Sep 12, 2024