The Sequoias San Francisco

Type of visit: Required - 1 Year

On 5/14/2026, LPA Grace Donato conducted an unannounced Annual Required – 1 yr. inspection for this facility. LPA met with Administrator, Terence Tumbale, Executive Director, Tomas Mendez & Director of Assisted Living and Memory Care, RoxAnn King. The facility currently provides care for 31 residents in the assisted living and memory care units. LPA continued with a tour of the facility which included the kitchen, assisted living and memory care wing. Food is prepped in the kitchen and delivered in assisted living and memory care areas which are transported in a warm cart. LPA observed residents engaged in different activities. Facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Fire Extinguishers located on each resident floor, kitchen and common spaces were found to be charged. Bathrooms are equipped with grab bars and non-skid floors. There is adequate amount of food, 2 days for perishables and & 7 days non-perishable. A spot check of medications in the assisted living and memory care units, was conducted and found that all medication counts and records are in order. Emergency disaster drills are done quarterly. Nine resident records and nine staff records were reviewed. Resident records are updated, complete and signed. Staff records are complete. Facility accepts hospice residents and are in compliance with the required waiver requirements. LPA requested to submit the Liability Insurance through email. No deficiencies cited today. Report is reviewed and copy is provided.the state’s words, verbatim · CDSS document, May 14, 2026

Allegation investigated: Staff did not provide proper care to a resident

On January 15, 2026, Licensing Program Analyst (LPA) Murial Han conducted an unannounced visit to deliver the complaint investigation. LPA met with the Memory Care Director, Roxann King and explained the purpose of today's visit. Regarding allegation of- staff did not provide proper care to a resident, the reporting party stated that staff #1 (S1) observed resident #1(R1) was sleeping in a wet bed full of urine or with briefs above R1's knees because night shift staff #2 (S2) did not clean R1. As part of the investigation, LPA interviewed the director and facility staff members and conducted observation. LPA interviewed the director who stated that S1 is no longer working at the facility and the director acknowledged that a few months ago, S1 reported a resident was not being cleaned by the CNA (S2) on the previous shift (night shift). Subequently, the director went to observed R1 and witnessed the situation with R1 that was not as reported by S1 but the director provided one-to-one meeting/education to S2 regarding the incident. Unsubstantiated LPA interviewed S2 who remembered the meeting/education with the director, however, denied leaving resident in a wet bed full of urine or with briefs above their knees. S2 stated that he/she always made sure the residents are cleaned and S2 also stated that it is common for a resident to urinate right after they were cleaned and changed. LPA interviewed 4 other staff members and all of them reported that they have not witnessed residents sleeping in a wet bed full of urine or with briefs above the resident's knees from the previous shifts. During LPA's visit on 12/18/2025, LPA observed R1 appeared to be well groomed, cleaned and pleasant. LPA attempted to interview R1 but R1 did not remember staff not providing proper care. Based on record review, observation and interviews during the investigation, this allegation is deemed to be unsubstantiated as the director stated that she went to observed R1 after S1's reporting and she did not observed R1 was in the condition that was described by S1. In addition, the director stated that re- education was provided to S2 who denied the allegation. Furthermore, 4 out of 4 staff members stated that they have not witnessed residents sleeping in a bed full of urine or with the briefs above their knees. Although the above allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.the state’s words, verbatim · CDSS document, Jan 15, 2026 · control 14-AS-20251211155543

Type of visit: Case Management - Other

On 10/3/2025, Licensing Program Analyst(LPA) John Calandra arrived at the facility to conduct a Case Management visit in regards to a Change in Administrator. LPA Calandra was greeted by Marc Shores, CFO and Tomas Mendez, Executive Director and explained the purpose of the visit. LPA Calandra collected the following documents while at the facility: -Terence Tumbale's Administrator Certificate LPA requested the following documents by 10/8/2025: -Updated LIC 200 with new administrator name. -LIC 501-Personnel Report -LIC 503-Health Screening Report -Copy of photo ID -Copy of current Administrator Certificate -Copy of First Aid/CPR Certificate -Fingerprint clearance. -Updated LIC 610E Emergency Disaster Plan -Updated LIC 9282 Infection Control Plan -If you signed the hospice waiver request, please submit new request for new administrator. -Board Resolution Letter(Letter appointing the new administrator from the Board) No deficiencies were cited during today's visit. An exit interview was conducted. This report was emailed to facility representative.the state’s words, verbatim · CDSS document, Oct 3, 2025

Type of visit: Required - 1 Year

On 5/16/2025, Licensing Program Analyst (LPA) Tobola conducted an unannounced Annual Required – 1 yr. inspection for this facility and was greeted by Administrator, Terrence Tumbale, Executive Director, Tomas Mendez & Director of Assisting and Memory Care, RoxAnn King. The facility currently provides care for 31 residents in the assisted living and memory care units, 2 of which are 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, kitchen and common spaces were found to be charged. A spot check of medications in the assisted living and memory care units, was conducted and found that all medication counts and records are in order. 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 multiple times throughout the week and stored properly. Facility provides a wide variety of meal preferences and preparation while also ensuring proper dietary restrictions are followed. There was a supply of hygiene products and paper products available for residents with replenishment throughout the week. All resident’s bedrooms have lighting & appropriate furnishings and bedding items. LPA observed a housekeeping cart located outside of the housekeeping closet within the assisted living portion of the facility. Light cleaning supplies were observed unsecured and potentially accessible. House keeping was actively working on their routine during inspection with no residents observed near the cart. Items were immediately stored in secured location and will be discussed with staff. Technical Violation issued. Continued onto LIC809-C Residents that were out in the community 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 and abilities. LPA found that staff and resident engagement is well practiced with activity calendars developed on a monthly basis. The facility also integrates memory care residents into facility wide events and activities to promote inclusion and interaction. Residents were observed to have a positive and personable relationship with staff. There are two outdoor patios for resident use, all equipped with appropriate shading and a large sun room plaza for resident use. LPA conducted a sample file review for residents and found all items to be in order including needs & service plans and physician's reports. Upon a spot check of staff files, LPA found that caregiver staff have current 1st aid and CPR and annual training and health screening reports on file. LPA noted that Administrator, Terence Tumbale is associated to a partnered facility under the same license but not to the Sequoias San Francisco. LPA discussed with Administrator and provided technical assistance. Terence Tumbale's Administrator Certificate 7018528740 is currently active through 2/25/2027. Roxanne King's Administrator Certificate 6075229740 is currently active through 3/4/2027. LPA requested the following documents be sent to CCL by COB 5/30/2025: LIC 308 Designated Facility Responsibility LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan Liability Insurance No deficiencies cited during today's visit.the state’s words, verbatim · CDSS document, May 16, 2025

Allegation investigated: Residents are not provided care with activities of daily living Residents are not provided social interaction and participation in activities Resident are not provided appropriate foods that meet dietary restrictions Resident's incontinence care needs or not being met

On 1/28/2025, Licensing Program Analyst (LPA) Tobola arrived unannounced for the purpose of delivering complaint investigation findings and was greeted by Executive Director, Glen Goddard. LPA toured the facility, interviewed staff and residents, gathered facility records and made observations during the course of the investigation. Complaint alleges residents are not provided care with activities of daily living. Upon multiple tours of the facility, LPA did not observe any signs of resident needs not being met. Residents in the assisted living and memory care portions of the facility appeared to be in a comfortable manner. LPA conducted interviews with residents (R1, R2, R3) all of which found facility level of care and assistance with daily living to be adequate. Residents also stated that they utilize pendants to call staff in emergencies with no reports of concern. Lastly, upon interviews with staff (S1, S2, S4, & S5) LPA received contradicting information towards the allegation with no indication of other caregiver staff not meeting resident needs. Complaint alleges residents are not provided social interaction and participation in activities. Upon multiple tours of the facility, LPA observed residents engaged in various group and individual activities. LPA also conducted interview with Director of Life Enrichment (S3) who provided LPA with monthly activity calendars specialized for both assisted living and memory care. In addition, LPA observed staff encouraging residents to participate in integrated events that are offered to all residents. During inspection LPA observed staff escorting memory care residents to an animal/pet education event with staff and residents actively engaging. Continued onto LIC9099-C Unsubstantiated Complaint alleges resident are not provided appropriate foods that meet dietary restrictions. Upon tour of the facility, LPA found that the facility kitchen is equipped with a sufficient amount of food supplies, meeting nutritional value. LPA found that the facility provides several entree options each meal with additional daily items and snacks to choose from. Residents also mark or write requests on meal preferences. Kitchen staff have record of resident dietary restrictions with notation of restrictions labeled on the menu for each individuals' diet. Upon interviews with residents (R1, R2, R3), LPA received inconsistent information regarding food taste but was found that the facility provides 3 meals a day with a variety of nutritious food options. Upon interviews with staff (S4, S5), LPA received contradicting information towards the allegation with no indication that resident dietary needs are not met. Complaint alleges resident's incontinence care needs or not being met. Based upon multiple tours of the facility assisted living and memory care, LPA found resident living areas to be clean with no signs of foul odors or residents left soiled. Interviews with residents (R1, R2, R3) indicated no concerns with staff providing toileting or hygiene needs. Upon interviews with staff (S2, S4, S5) LPA found that staff conduct routine room checks for incontinence and general care. Staff (S1, S2, S4 & S5) also stated that there no concerns of caregiver staff not meeting incontinence care requirements. A finding that the complaint allegations, residents are not provided care with activities of daily living, residents are not provided social interaction and participation in activities, resident are not provided appropriate foods that meet dietary restrictions and resident's incontinence care needs or not being met are unsubstantiated meaning that although the allegations 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 allegations are UNSUBSTANTIATED. No deficiencies cited.the state’s words, verbatim · CDSS document, Jan 28, 2025 · control 14-AS-20241029161809

Type of visit: Case Management - Health Checks

On 11/20/2024, Licensing Program Analyst (LPA) Tobola arrived unannounced for the purpose of conducting a health & safety check regarding incident report dated 11/5/2024 and received by the Regional Office on 11/6/2024 involving the health status of resident (R1) and was greeted by Executive Director, Glen Goddard and Director of Assisted Living and Memory Care, RoxAnn King. The incident involves resident (R1) being hospitalized for having ingested an illegal substance. LPA Tobola interviewed both Executive Director and Director of Assisted Living and Memory Care, toured the facility, gathered facility and resident records and made observations. LPA found that the facility had reported the incident involving R1 in a timely manner along with additional documentation submitted to all appropriate agencies and outside parties. No deficiencies cited during today's visit.the state’s words, verbatim · CDSS document, Nov 20, 2024

Type of visit: Case Management - Annual Continuation

On May 31, 2024, Licensing Program Analyst(LPA) John Calandra arrived at the facility at 9:06 AM to complete the Annual Inspection. LPA Calandra was greeted by Casey Hobbs, Director of Nursing Services and explained the purpose of the visit. Steve Martinez, Human Resources(HR) Manager joined later during the visit. LPA Calandra reviewed 5 staff files. All were observed to be complete. LPA Calandra also interviewed 5 staff. A review of Centrally stored medications in the Memory Care unit 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. No deficiencies were cited during today's visit. This report was reviewed with Steve Martinez, HR Manager and a copy of the report left at the facility.the state’s words, verbatim · CDSS document, May 31, 2024

Type of visit: Case Management - Annual Continuation

On May 29, 2024, Licensing Program Analyst(LPA) John Calandra arrived at the facility at 2:00 PM, to complete the Annual 1-year required inspection. LPA Calandra was greeted by Roxann King, Director of Memory Care and Assisted Living and explained the purpose of the visit. LPA Calandra reviewed 5 resident files and 3 staff files. No deficiencies were cited during today's visit. The Annual inspection will be completed at a later date. This report was reviewed with Roxann King, Director of Memory Care and Assisted Living and a copy of the report left at the facility.the state’s words, verbatim · CDSS document, May 29, 2024

Type of visit: Required - 1 Year

On May 23, 2024, at 9:30 AM, Licensing Program Analyst(LPA) John Calandra arrived at the facility to conduct the Annual 1-year required inspection. LPA Calandra was greeted by Terrence Tumbale, Administrator and explained the purpose of the visit. LPA Calandra toured the physical plant. This is a 26 story building. Assisted Living occupies one floor and Memory Care occupies one floor. LPA Calandra inspected 4 rooms (2 in Memory Care and 2 in Assisted Living). All bedrooms had the required furniture and sufficient lighting. Hot water in Assisted Living and Memory Care was measured between the required 105-120 degrees Fahrenheit. Fire extinguishers were observed to fully charged and last inspected on January 16, 2024. Fire alarms and carbon monoxide detectors were observed to be in working condition. The fire alarm/carbon monoxide panel was observed to be fully operational. No Hazards nor obstructions were present in exterior terraces/patios, hallways or other areas of the facility. The facility has an evacuation chair on each floor. The facility also has the required 7 days of non-perishables and 2 days of perishables on site. No food in the main kitchen was expired. Food in the Assisted living dining room that was expired was removed and disposed of by Administrator, Terrence Tumbale in the presence of the LPA. A review of Centrally stored medications in Assisted Living 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 Calandra reviewed 5 resident files. All were observed to be complete. LPA to continue reviewing documents during continuation of Annual. This Annual will be completed at a later date. No deficiencies were cited during today's visit. This report was reviewed with Terrence Tumbale, Administrator and a copy of the report left at the facility.the state’s words, verbatim · CDSS document, May 23, 2024

Allegation investigated: - Resident sustained serious injuries from a fall - Resident not receiving nutritious meals from facility which made resident malnourished and weak

Based on investigation conducted by LPA Jeung of the Community Care Licensing Division of the CA Department of Social Services, these allegations are determined to be unfounded. This means that the allegations could not have happened and/or are without a reasonable basis. Client #1 resided independently in room 6K from 11/29/08 until 3/9/23, when she fell in her room. Client sustained serious injuries, but client attributed the fall to her house slippers. Resident was discharged from hospital on 3/15/23 to skilled nursing unit of facility--licensed by CA Dept. of Health Services. She has relocated permanently to the skilled nursing unit. According to executive director, there is one kitchen that provides meals for all residents in assisted living, memory care, and skilled nursing. A full-time registered dietician--qualified by formal training or experience--is responsible for the operation of the food service for the entire building. LPA obtained copies of the certification and job description. In January 2023--prior to March 2023 fall--client's primary care physician documented that client chronically complains about food, doctors, etc., and is allergic to garlic and legumes. Client told LPA that she is allergic to berries, as well. Following the fall, SNF staff documented that "resident was noted to have extensive food preferences," and she complained about food quality. Unfoundedthe state’s words, verbatim · CDSS document, Mar 14, 2024 · control 14-AS-20230522130802