The Stratford at Beyer Park

Allegation investigated: Staff did not follow infections diseases plan properly Staff did not ensure residents room was cleaned/infected properly

On 11/14/2025, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to deliver complaint findings. LPA met with Facility Designated Administrator (FDA), Nicole Rodriguez and explained the purpose of the visit. Current census was 81. A brief interview with FDA Rodriguez was conducted. Allegation: Staff did not follow infection diseases plan properly. It was alleged that the facility staff did not follow infection disease plan properly. During the course of this investigation, the department conducted interview and records review. Based on interviews conducted, it was learned that on 08/04/2025, Resident 1 (R1) reported experiencing skin irritation over their entire body. During a follow-up appointment, the physician prescribed a topical cream to address the symptoms. Further information obtained from the physician indicated that the facility implemented its infection control policy. Unsubstantiated On 08/05/2025, the facility received further guidance from the doctor indicating that quarantine was recommended as a precautionary measure. In response, the facility activated its infection control procedures. Throughout the implementation of these measures, there was no indication that the physician advised against isolation; rather, it was recommended due to suspicion of an infectious skin condition. Additionally, the LPA’s review of facility records confirmed that the facility complied with the doctor’s orders and maintained appropriate communication with the physician regarding R1’s care. Based on the information gathered, there is not sufficient evidence to prove that the facility staff are not following doctors orders. Allegation: Facility staff are not allowing resident access to personal belongings It was alleged that facility staff are not allowing resident access to personal belongings. During the course of this investigation, LPA conducted interviews and reviewed facility records. Based on interviews conducted, it was learned that on 08/05/2025,a resident was placed on the facility's infection control protocol as a precautionary measure for a suspected contagious skin infection. In accordance with this protocol, the facility implemented specific treatment and containment procedures, including bagging and laundering the resident’s clothing, cleaning and disinfecting common areas, vacuuming the resident’s room, and isolating personal belongings for 14 days. However, it was also learned that the facility ensured that the resident had sufficient amount of clothing and belongings to ensure that they had clean clothes. An interview with 3 facility staff members was conducted. 3 out 3 deny that the resident did not have access to their belongings. Based on the information gathered, there is not sufficient evidence to prove that the facility staff were not allowing resident access to personal belongings. Allegation: Facility staff are not meeting residents grooming needs It was alleged that the facility staff are not meeting residents grooming needs. During the course of this investigation, the LPA conducted interviews and reviewed facility records. Based on the information obtained, it was determined that R1 was offered showers in accordance with the doctor’s orders and the facility’s infection control protocol. However, R1 frequently refused to participate. A review of facility records confirmed that R1 consistently declined showers, and the facility respected this decision, recognizing it as R1’s personal right. Based on the information gathered, there is not sufficient evidence to prove that the facility staff were not meeting the residents grooming needs. According to records reviewed, this policy was activated as a precautionary measure in response to a suspected contagious skin infection. Based on the information gathered, there is not sufficient evidence to prove that the facility staff did not follow infection diseases plan properly. Allegation: Staff did not ensure residents room was cleaned/infected properly. It was alleged that the facility did not ensure residents room was cleaned or infected properly. During the course of this investigation, the department conducted interviews and records review. Based on interviews conducted, a resident was placed on the facility's infection control protocol as a precautionary measure for a suspected contagious skin infection. In accordance with this protocol, the facility implemented specific treatment and containment procedures, including bagging and laundering the resident’s clothing, cleaning and disinfecting common areas, vacuuming the resident’s room, and isolating personal belongings for 14 days. LPA Pascua interviewed staff members, who denied failing to clean or disinfect. Staff stated that cleaning procedures were initiated immediately upon receiving information from the physician. Based on information gathered, there is not sufficient evidence to prove that the facility staff did not ensure residents room was cleaned properly. As a result of this investigation, this Department found the allegation to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated meant that although the allegations may have happened or was valid, there was not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted and a copy of this report was provided to the facility at the end of this visit.the state’s words, verbatim · CDSS document, Nov 14, 2025 · control 27-AS-20250805101829

Allegation investigated: Facility staff are not following doctors orders Facility staff are not allowing resident access to personal belongings Facility staff are not meeting residents groomings needs Resident contracted communicable disease while in care

On 11/14/2025, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to deliver complaint findings. LPA met with Facility Designated Administrator (FDA), Nicole Rodriguez and explained the purpose of the visit. Current census was 81. A brief interview with FDA Rodriguez was conducted. Allegation: Facility staff are not following doctors orders. It was alleged that facility staff are not following doctors orders. During the course of this investigation, LPA conducted interview and review facility records. Based on interviews conducted, it was learned that on 08/04/2025, R1 visited the doctor’s office to address a medication concern, which resulted in a contagious diagnosis. Upon returning to the facility, no additional information regarding the diagnosis was initially communicated to staff. The facility subsequently sought clarification from the physician to ensure proper protocols were implemented and that all medical orders were followed. Unsubstantiated Allegation: Resident contracted communicable disease while in care It was alleged that the resident contracted a communicable disease while in care. During the course of this investigation, the LPA conducted interviews and reviewed facility records. Based on interviews conducted, it was confirmed that no residents contracted a communicable disease while in care. Additional information indicated that the facility had received documentation from a recent doctor’s visit recommending that staff toilet the resident frequently and keep the resident’s incontinence brief off as much as possible to allow skin irritation to subside. However, on 10/15/2025, it was reported that Resident 1 (R1) was not complying with the recommendations provided by the physician, facility staff, and emergency personnel, and it was determined that R1 needed to be transported to the hospital. R1 initially refused transport, and a family member ultimately took the resident to the hospital. Approximately one week later, it was reported that R1 had received an updated physician’s report indicating an infection. There is no evidence or documentation indicating that the infection was contracted at the facility. Furthermore, no reports were submitted to the Local Public Health Office or to the Department regarding any communicable diseases that could pose a risk to the health and safety of other residents in care. Based on the information gathered, there is not sufficient evidence to prove that the resident contracted communicable disease while in care. As a result of this investigation, this Department found the allegations to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated meant that although the allegations may have happened or was valid, there was not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted and a copy of this report was provided to the facility at the end of this visit.the state’s words, verbatim · CDSS document, Nov 14, 2025 · control 27-AS-20250820093721

Type of visit: Required - 1 Year

On 11/25/2024, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA met with Facility Designated Administrator (FDA), Nicole Rodriguez and explained the purpose of the visit. The purpose of this visit was to conduct an annual visit. Current census was 86. 65 current resident in assisted living and 21 residents in Memory Care. A brief interview with FDA Rodriguez was conducted. This facility is licensed to served 60 elderly residents, of which, all my be non-ambulatory. This facility has a fire clearance for delayed egress and has a hospice waiver for 10. It was learned that this facility has LPA reviewed 5 resident files and 5 staff files. All of which were complete and up to date. The facility administrator has an active administrator certificate #7000291740 expires on 04/30/2027. All rooms designated as activity areas and common areas for resident use were toured. Furniture and furnishings were observed to be present and sufficient to meet the needs of the residents at this time. Office rooms and other areas intended for resident use were toured. Kitchen area was toured. Facility freezer and refrigerator units were toured. LPA reviewed the food storage supply to make sure that there was always a 2-day perishable and 7-day nonperishable food quantities on site at all times. Knives were observed to be locked and made inaccessible to the residents at this time. It was observed in that the facility has cafe areas equipped with a microwave and addition refrigerator present to cool, heat, and warm up food of the residents if necessary. Storage area for chemicals and cleaning supplies were observed to be locked and made inaccessible to the residents at this time. A tour of the facility resident bedrooms was conducted. Furniture and furnishings were observed to sufficient and able to meet the needs of the residents at this time. A tour of the resident restrooms was conducted. Grab bars and non skid mats were observed to be present and in good repair at this time. Hot water temperatures were taken and measured to make sure that they were within the allowed range of 105-120 degrees. Laundry area was toured. Laundry detergent, bleach, and all other cleaning supplies were observed to be locked and made inaccessible to the residents at this time. Additional incontinent supplies were also identified. Medication cabinet was reviewed. It was learned that narcotics and all other medications were housed in medication carts that were used to store and dispense medications to the residents at this time. This facility has an electronic Medication Administration Record system. A brief interview was conducted with facility staff responsible for handling, dispensing, and documentation of the medications at this time. First aid kit was observed to be present and contained all of the required components at this time. First aid kit was observed to be present and contained all of the required components at this time. A tour of the facility memory care unit was conducted. Exterior grounds of this facility was toured. Perimeter fence and gates were observed to be functional and in good repair at this time. Delayed egress and other safety measures were observed to be functional at this time. Fire extinguishers, located and placed throughout the facility, were observed to have been annually inspected on 3/5/2026 by the local fire extinguisher company noted as Silicon Valley Fire and in compliance at this time. All smoke and carbon monoxide detectors were present and working at this time. The following forms and documents were requested to be updated and submitted into CCL: -LIC 308 -LIC 400 -LIC 500 -LIC 610e As a result of this visit, no deficiencies were observed or cited during this annual visit. An exit interview was conducted and copy of the 809 and 809-C was provided to Facility Designated Administrator, Nicole Rodriguez.the state’s words, verbatim · CDSS document, Nov 14, 2025

Allegation investigated: Staff mismanaged resident's medication Staff did not safeguard resident's personal items

On 08/25/2025, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct a complaint visit. LPA met with Facility Designated Administrator (FDA), Nicole Rodgriuez and explained the purpose of the visit. The purpose of this visit to deliver complaint findings for the allegations above. Current census was 82. A brief interview with FDA Rodriguez was conducted. Allegation: Staff mismanaged resident's medication It was alleged that staff mismanaged resident's medication. During the course of this investigation, the department conducted interviews and reviewed facility records. Through staff interviews, it was determined that Resident 1 (R1) frequently experienced medical conditions that could impair their ability to understand the medications being administered. A review of the resident's records further confirmed that R1's diagnosis may contribute to confusion regarding their medications. Unsubstantiated Additionally, a review of the resident’s Medication Administration Record (MAR) was conducted. LPA Pascua did not find any discrepancies indicating that facility staff mismanaged the resident’s medication. Based on the information gathered, there is not sufficient evidence to prove that the facility mismanaged the resident's medication. Allegation: Staff did not safeguard resident's personal items It was alleged that the staff did not safeguard resident's personal items. During the course of this investigation, the department conducted interviews and reviewed facility records. Based on interviews conducted, it was denied that the facility staff did not safeguard resident's personal items. Staff stated that a resident inventory list is provided to residents, documenting the items kept at the facility. In addition, if incontinent supplies are one of the items, these are not shared with any other residents. An interview with 5 residents were conducted. 5 out 5 residents deny that the facility does not safeguard the resident's personal items. Based on the information gathered, there is not a sufficient evidence to prove that the facility staff did not safeguard resident's medication. As a result of this investigation, this Department found the allegation to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated meant that although the allegations may have happened or was valid, there was not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted and a copy of this report was provided to the facility at the end of this visit.the state’s words, verbatim · CDSS document, Aug 25, 2025 · control 27-AS-20250711131606

Allegation investigated: Staff did not dispense medication to resident as prescribed.

On 06/16/2025, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct a complaint visit. LPA was met by Facility Designated Administrator (FDA), Nicole Rodriguez and explained the purpose of the visit. The purpose of this visit was to deliver complaint findings for the allegations above. Current census was 80. A brief interview with FDA Rodriguez was conducted. Allegation: Staff did not dispense medication to resident as prescribed. It was alleged that staff failed to administer medication to a resident (R1) as prescribed. During the investigation, the Licensing Program Analyst (LPA) conducted staff interviews and reviewed facility records. According to staff interviews, on January 26, 2025, R1 contacted the facility to report they would be late in returning for their scheduled medication. Upon R1’s return, facility staff declined to administer the medication, citing that more than one hour had passed since the scheduled time. Substantiated Based on the information gathered, staff did not administer the medication to the resident as prescribed. Based on observations, review of records and information gathered through interviews, the above allegations were SUBSTANTIATED meaning that there was a preponderance of evidence to prove that the allegations occurred as alleged. The following deficiencies were cited per Title 22 Division 6 of the California Code of Regulation. An exit interview was conducted, a copy of this report and appeals rights were provided to the facility at the end of this visit. Allegation: Staff is not following resident’s care plan. It was alleged that staff are not following resident’s care plan. During the course of this investigation, LPA conducted interviews and reviewed facility records. Based on staff interviews conducted it was denied that staff do not follow resident’s care plans. It was stated by 5 staff that they conduct staff meetings regarding updates with all residents. In addition, care plans are reviewed on an as needed basis. An interview with 5 residents was conducted, 5 out 5 residents deny that they are not receiving care and supervision. Based on the information gathered, there is not sufficient evidence to prove that staff are not following resident’s care plan. As a result of this investigation, this Department found the allegation to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated meant that although the allegations may have happened or was valid, there was not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted and a copy of this report was provided to the facility at the end of this visit. Based on the information gathered, staff did not administer the medication to the resident as prescribed. Based on observations, review of records and information gathered through interviews, the above allegations were SUBSTANTIATED meaning that there was a preponderance of evidence to prove that the allegations occurred as alleged. The following deficiencies were cited per Title 22 Division 6 of the California Code of Regulation. An exit interview was conducted, a copy of this report and appeals rights were provided to the facility at the end of this visit.the state’s words, verbatim · CDSS document, Jun 16, 2025 · control 27-AS-20250128085931

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(a)(4) · Plan of correction due date: Jul 16, 2025

The licensee shall assist residents with self-administered medications as needed. This is not met as evidenced by: Based on record review and interview, the licensee did not ensure that R1 was provide medication as prescribed. It was learned that R1 was out of the facility and requested their medication at the time of return however was not provided the medication. This poses a potential health, safety, and personal rights risks to persons in care.the state’s words, verbatim · CDSS document, Jun 16, 2025

Plan of correction: The facility provide a statement of correction and acknowledgement to the LPA by the POC Date.

Type of visit: Required - 1 Year

On 11/25/2024, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA met with Facility Designated Administrator (FDA), Nicole Rodriguez and explained the purpose of the visit. The purpose of this visit was to conduct an annual visit. Current census was 86. 65 current resident in assisted living and 21 residents in Memory Care. A brief interview with FDA Rodriguez was conducted. This facility is licensed to served 60 elderly residents, of which, all my be non-ambulatory. This facility has a fire clearance for delayed egress and has a hospice waiver for 10. LPA reviewed 5 resident files and 5 staff files. All of which were complete and up to date. The facility administrator has an active administrator certificate #7000291740 expires on 04/30/2025. All rooms designated as activity areas and common areas for resident use were toured. Furniture and furnishings were observed to be present and sufficient to meet the needs of the residents at this time. Office rooms and other areas intended for resident use were toured. Kitchen area was toured. Facility freezer and refrigerator units were toured. LPA reviewed the food storage supply to make sure that there was always a 2-day perishable and 7-day nonperishable food quantities on site at all times. Knives were observed to be locked and made inaccessible to the residents at this time. It was observed in that the facility has cafe areas equipped with a microwave and addition refrigerator present to cool, heat, and warm up food of the residents if necessary. Storage area for chemicals and cleaning supplies were observed to be locked and made inaccessible to the residents at this time. A tour of the facility resident bedrooms was conducted. Furniture and furnishings were observed to sufficient and able to meet the needs of the residents at this time. A tour of the resident restrooms was conducted. Grab bars and non skid mats were observed to be present and in good repair at this time. Hot water temperatures were taken and measured to make sure that they were within the allowed range of 105-120 degrees. Laundry area was toured. Laundry detergent, bleach, and all other cleaning supplies were observed to be locked and made inaccessible to the residents at this time. Additional incontinent supplies were also identified. Medication cabinet was reviewed. It was learned that narcotics and all other medications were housed in medication carts that were used to store and dispense medications to the residents at this time. This facility has an electronic Medication Administration Record system. A brief interview was conducted with facility staff responsible for handling, dispensing, and documentation of the medications at this time. First aid kit was observed to be present and contained all of the required components at this time. First aid kit was observed to be present and contained all of the required components at this time. A tour of the facility memory care unit was conducted. Exterior grounds of this facility was toured. Perimeter fence and gates were observed to be functional and in good repair at this time. Delayed egress and other safety measures were observed to be functional at this time. Fire extinguishers, located and placed throughout the facility, were observed to have been annually inspected on 12/11/2023 by the local fire extinguisher company noted as Assured and in compliance at this time. All smoke and carbon monoxide detectors were present and working at this time. The following forms and documents were requested to be updated and submitted into CCL: -LIC 308 -LIC 400 -LIC 500 -LIC 610e As a result of this visit, no deficiencies were observed or cited during this annual visit. An exit interview was conducted and copy of the 809 and 809-C was provided to Facility Designated Administrator, Nicole Rodriguez.the state’s words, verbatim · CDSS document, Nov 25, 2024

Type of visit: Case Management - Other

On 05/24/2024, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to conduct a case management visit. LPA met with Facility Designated Administrator (FDA), Nicole Rodriguez and explained the purpose of the visit. The purpose of this visit was to follow up on an eviction notice that was to be served to a current resident due to non-payment. LPA reviewed the eviction notice to ensure that all components to the eviction were included based on Title 22 regulations. No deficiencies were observed or cited during the course of this visit. An exit interview was conducted and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, May 24, 2024

Type of visit: Required - 1 Year

On 11/15/2023, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to conduct an annual visit. LPA met with Business Office Director (BOD), Anna Jones and explained the purpose of the visit. LPA asked that BOD Jones call the Facility Designated Administrator, Nicole Rodriguez and inform her that CCL was present at this time. Shortly after, LPA met with FDA Rodriguez and explained the purpose of the visit. The current census to this facility was 83. 69 resident reside in assisted living and 14 residents in Memory Care. This facility is licensed to served 60 elderly residents,of which, all my be non-ambulatory. This facility has a fire clearance for delayed egress and has a hospice waiver for 10. A tour of the facility was conducted with BOD, Jones. All rooms designated as activity areas and common areas for resident use were toured. Furniture and furnishings were observed to be present and sufficient to meet the needs of the residents at this time. Office rooms and other areas intended for resident use were toured. Kitchen area was toured. Facility freezer and refrigerator units were toured. LPA reviewed the food storage supply to make sure that there was always a 2-day perishable and 7-day nonperishable food quantities on site at all times. Knives were observed to be locked and made inaccessible to the residents at this time. It was observed in that the facility has cafe areas equipped with a microwave and addition refrigerator present to cool, heat, and warm up food of the residents if necessary. Storage area for chemicals and cleaning supplies were observed to be locked and made inaccessible to the residents at this time. Additional incontinent supplies were also identified. A tour of the facility resident bedrooms was conducted. Furniture and furnishings were observed to sufficient and able to meet the needs of the residents at this time. A tour of the resident restrooms was conducted. Grab bars and non skid mats were observed to be present and in good repair at this time. Hot water temperatures were taken and measured to make sure that they were within the allowed range of 105-120 degrees. Laundry area was toured. Laundry detergent, bleach, and all other cleaning supplies were observed to be locked and made inaccessible to the residents at this time. Additional incontinent supplies were also identified. Medication cabinet was reviewed. It was learned that narcotics and all other medications were housed in medication carts that were used to store and dispense medications to the residents at this time. This facility has an electronic Medication Administration Record system. A brief interview was conducted with facility staff responsible for handling, dispensing, and documentation of the medications at this time. First aid kit was observed to be present and contained all of the required components at this time. First aid kit was observed to be present and contained all of the required components at this time. A tour of the facility memory care unit was conducted. Exterior grounds of this facility was toured. Perimeter fence and gates were observed to be functional and in good repair at this time. Delayed egress and other safety measures were observed to be functional at this time. Fire extinguishers, located and placed throughout the facility, were observed to have been annually inspected on 12/07/2022 by the local fire extinguisher company noted as Assured and in compliance at this time. All smoke and carbon monoxide detectors were present and working at this time. LPA Pascua reviewed 8 resident files and 5 staff files. 8 out 8 resident files were current and up to date. 5 out 5 staff files were current and up to date. The following forms and documents were requested to be updated and submitted into CCL: -LIC 308 -LIC 400 -LIC 500 -LIC 610 Technical assistance is being provided today for 87465(h)(5) As a result of this visit, no deficiencies were observed or cited during this annual visit. An exit interview was conducted and copy of the 809 and 809-C was provided to Facility Designated Administrator, Nicole Rodriguez.the state’s words, verbatim · CDSS document, Nov 15, 2023