San Francisco Towers

Type of visit: Case Management - Incident

In response to Report of Suspected Abuse of 1/26/26, LPA Jeung met with director of resident services to obtain more information on alleged abuse of client #1. LPA interviewed client and staff. Ms. Ascalon advised that home care agencies were instructed to provide advance notification to facility when new caregivers are sent to facility. Written documentation of this new directive is requested to be sent to CCLD within TEN DAYS. No deficiencies are cited today.the state’s words, verbatim · CDSS document, Feb 4, 2026

Type of visit: Required - 1 Year

On 10/20/2025, Licensing Program Analyst(LPA) John Calandra arrived at the facility to conduct the Annual 1-year required inspection. LPA Calandra was greeted by Lucy Ascalon, Director of Residential Health Services and explained the purpose of the visit. Mark Nitsche, Executive Director/Administrator arrived later during the visit. This is a 12-story building with 264 units including Assisted Living, Memory Care and Independent Living. Each unit has its own bathroom. All bedrooms had the required furniture and sufficient lighting. No accessible bodies of water or hazards were observed. The facility's hot water temperature was measured between 105-120 degrees Fahrenheit. The facility's Fire Extinguishers were observed to be fully charged. According to building maintenance, the facility's fire alarms and Carbon Monoxide detectors are directly connected to the San Francisco Fire Department. The facility had the required 7 days of non perishables and 2 days of perishables on hand. No food was expired. The facility's first aid kit had the required items. All sharp objects, soap, detergents, and poisons were observed to be locked and in-accessible to persons in care. A review of Centrally Stored Medications indicated that medications for residents were properly labeled with instructions on dosage and times of day and matched the Centrally Stored Medication Records(CSMR) kept at the facility. LPA reviewed 5 resident and 5 staff files. All were observed to be complete. LPA received the following documents: Liability Insurance, LIC 500, updated facility sketch No deficiencies cited during today's visit. An exit interview was conducted. This report was reviewed with facility representatives and a copy provided via email.the state’s words, verbatim · CDSS document, Oct 20, 2025

Allegation investigated: Licensee is not appropriately addressing change in resident's condition

On 9/2/2025, LPA Grace Donato conducted an unannounced complaint investigation visit. LPA met with Executive Director Mark Nitsche, Director of Resident Health Services (DRHS), Lucy Ascalon, Health Care Administrator (HCA) Akendel Omoli and LPA explained the purpose of the visit. For the allegation of Licensee is not appropriately addressing change in resident's condition, Reporting party (RP) stated that the resident (R1) was observed to have a decline in condition over the past 9 months, both physical and cognitive. RP noted two significant events: when R1 was admitted to the hospital with an infection (on or about November 6, 2024) and when R1 had a fall in his/her room (on or about January 6, 2025). RP expressed concern that the resident, who is currently in independent living, may need to move to assisted living. page 1 of 2 Unfounded During today's investigation it was discovered that RP resides in independent living (IL). According to the interview with the administrator (ADM), DRHS and HCA, R1 is highly capable to make his/her own decisions. It was never mentioned by R1 that he/she wants to move to assisted living. DRHS also mentioned that facility has addressed the infection since there is an in-house nurse 24/7 and the primary care doctor has a regular visit to the resident. Based on observation, while LPA was interviewing R1, it was observed that he/she is able to answer basic questions and doesn't look confused or disoriented. Based on records review, R1s recent physician's report states that R1 is able to communicate his/her needs, R1 is not confused/disoriented. Power of Attorney is able to get copy of health assessments and progress notes from the doctor. Based on interviews & records review, the department has determined that that the allegations were false, could not have happened and/or is without a reasonable basis, therefore the allegations are UNFOUNDED. Report is reviewed and copy is provided.the state’s words, verbatim · CDSS document, Sep 2, 2025 · control 14-AS-20250825160508

Allegation investigated: Staff interfered with residents visits

On 1/22/2025, Licensing Program Analyst (LPA), Tobola arrived unannounced for the purpose of delivering complaint investigation findings and was greeted by Executive Director, Mark Nitsche. LPA toured the facility, interviewed staff, resident, outside parties and reviewed resident records and made observations during the course of the investigation. Complaint alleges facility staff interfered with resident (R1) visit with individual (I1). LPA conducted interviews with several individuals including staff (S1, S2, S3, S4, S5, S6) and outside individuals (I2 & I3) who confirmed that it was either directly observed or reported that a visiting individual (I1) was in fact granted access into the facility for visitation but had been observed or reported to be in a disruptive manner. Based upon review of facility visitation protocols, the facility is allowed to exercise their ability to limit or restrict visitations to protect residents including denying access to visitors who are inebriated or disruptive for the safety of residents in care. In addition, LPA conducted interview with resident (R1) and was provided conflicting statements towards the allegation. R1 did not report any concerns of the facility disrupting or interfering with visitation or telephone calls. Due to a lack of corroborating evidence and contradicting information gathered, the allegation is found to be unsubstantiated. A finding that the complaint allegation, staff interfered with residents visits is unsubstantiated meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED. No Unsubstantiatedthe state’s words, verbatim · CDSS document, Jan 22, 2025 · control 14-AS-20241029151555

Allegation investigated: Facility did not provide resident records upon legal request

On 12/10/2024, Licensing Program Analyst (LPA) Tobola arrived unannounced for the purpose of delivering complaint investigation findings and was greeted by Ryan Banner, Healthcare Administrator. LPA Interviewed staff, outside parties and reviewed records during the course of the investigation. Complaint alleges, Facility did not provide resident records upon legal request. Based upon interviews and information provided by Executive Director (S1) and Healthcare Administrator (S2), LPA found that the facility received notification from legal attorney’s office representing former resident, (R1). The letter request was dated 9/27/2024 and received by the facility on 9/30/2024. Based upon review of facility records, LPA found that S2 had been in contact with the attorney’s office and provided all requested documents regarding R1 beginning 10/2/2024 with a final date of all records provided by 10/8/2024. The facility had complied with the legal record request and provided R1’s records within a timely manner. This agency has investigated the complaint allegation listed above. We have found that the complaint allegation was UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. Nothe state’s words, verbatim · CDSS document, Dec 10, 2024 · control 14-AS-20241122165817

Type of visit: Required - 1 Year

On 10/17/2024, Licensing Program Analysts (LPA's) Tobola & Jain conducted an unannounced Annual Required – 1 yr. inspection for this facility and was greeted by Executive Director, Mark Nitcsche & Healthcare Administrator, Ryan Banner. The facility currently provides care for 298 residents, 1 of which is receiving hospice services, along with a designated memory care unit. LPA continued with a tour of the facility with staff, facility found to be clean and at a comfortable temperature with all exits free from obstruction. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguishers located on each resident floor and kitchen were found to be last charged on 1/25/2024. Smoke and carbon monoxide detectors were interconnected and found throughout the facility. Fire Safety Inspection is completed on a monthly basis with all fire safety devices and systems to be in order. Water at faucets accessible to residents measured between 105.4 and 108.5 degrees F which is within regulation. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations, with food stored in the kitchen, sufficient for residents in care. Food supply is replenished constantly through the week and stored properly. Facility provides a wide variety of meal preferences and preparation while also ensuring proper dietary restrictions are followed. Cleaning supplies and other toxins are safely stored in locked closets throughout each floor, and housekeeping/maintenance rooms all of which were secured upon inspection. There was a supply of hygiene products and paper products available for residents. All resident’s bedrooms have lighting & appropriate furnishings and bedding items. Residents that were awake during the inspection were observed interacting with staff, fellow residents and visitors in the common areas, or in their bedrooms resting. The facility encourages regular family visits and utilizes a wide variety of activities with LPA observing staff engaging continuously with residents, offering activities based on individualized preferences. LPA found that staff and resident engagement is well practiced with activity calendars developed on a monthly basis. Residents were observed to have a positive and personable relationship with staff and Executive Director. There are multiple outdoor patios for resident use, all equipped with appropriate shading. Continued onto LIC809-C LPA conducted a sample file review for five (5) residents and found that resident (R1) physician's report is in need of updating. Technical Violation issued. Upon a spot check of five (5) staff files, LPA found that caregiver staff have annual training completed. However, 2 out of 5 staff reviewed are in need of updated 1st aid certification. Technical Violation issued. Lastly, a spot check of medication was conducted in the assisted living unit and found that all medication counts and records are in order. Upon spot check of medications in the memory care unit, LPA's found several medications in need of reconciled start dates and input. Technical Violation issued. Ryan Banner's Administrator Certificate 7026388740 is currently active through 10/05/2025. LPA requested the following documents be sent to CCL by COB 10/31/2024: LIC 308 Designated Facility Responsibility LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan Liability Insurancethe state’s words, verbatim · CDSS document, Oct 17, 2024