The Terraces at Los Altos

Type of visit: Required - 1 Year

On 7/1/2026, Licensing Program Analyst(LPA) John Calandra arrived at the facility to conduct the Annual 1-year required inspection. LPA Calandra was greeted by Joni Tsukimura, Director of Assisted Living and Andrii Skyrypkar, Health Services Administrator and explained the purpose of the visit. LPA reviewed 5 resident files. All were observed to be complete. The Annual will be completed at a later date. No deficiencies cited during today's visit. An exit interview was conducted and a copy of the report was provided.the state’s words, verbatim · CDSS document, Jul 1, 2026

Type of visit: Case Management - Other

On December 26, 2025, Licensing Program Analyst (LPA) Komal Curley conducted a Case Management-Other visit to the facility. LPA met with Administrator, Inderpreet Kaur and explained the purpose of the visit. The purpose of this visit is to follow up on a "Decision and Order" for the exclusion of Staff 1 (S1). According to the administrator, S1 does not work at the facility and a copy of an LIC500 was provided to LPA. No citations are issued during the visit. Report is reviewed with Administrator and a copy is provided.the state’s words, verbatim · CDSS document, Dec 26, 2025

Type of visit: Case Management - Incident

On 9/17/2025, Licensing Program Analyst(LPA) John Calandra arrived at the facility to conduct a Case Management visit in regards to an incident that was reported to the Department via an Incident Report received on 8/18/2025. LPA Calandra was greeted by Preet Kaur, Executive Director and explained the purpose of the visit. Joni Tsukimura, Director of Assisted Living and Anne Tabin, LVN, Nurse Supervisor joined the visit later. During the visit, LPA conducted interviews. Based on interviews, S1 poured medications for R1 and R2 and gave R1's medication to R2. Poison control was contacted immediately and R2 was observed for any change in condition. R2 has remained stable since the incident occurred. LPA received a copy of the fax cover sheet during the visit. A Type A citation was provided for the medication error. A Type B citation was provided for not submitting a written report to the licensing agency within seven days of the occurrence. Deficiencies are cited under the California Code of Regulations, Title 22. Failure to correct the deficiencies by the due date may result in civil penalties. An exit interview was conducted. This report was reviewed with facility representatives and a copy of the report provided.the state’s words, verbatim · CDSS document, Sep 17, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87464(a)(4) · Plan of correction due date: Sep 18, 2025

87464(a)(4): Incidental Medical and Dental: A plan for incidental medical and dental care shall be developed...The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Based on interview and document review, the Licensee did not assist R2 with self-administered medication when R1’s medication was provided to R2, which is an immediate health, safety, or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 17, 2025

Plan of correction: Licensee conducted a training on 8/10/2025, with staff and provided a copy of the training content reviewed and a list of all attendees during visit. Deficiency cleared during visit.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87211(a)(1) · Plan of correction due date: Sep 26, 2025

87211(a)(1): Reporting Requirements: Each licensee shall furnish …A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence. This requirement is not met as evidenced by: Based on document review and interview, Licensee submitted a written report of the occurrence to the Department eight days after the occurred, which is a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 17, 2025

Plan of correction: Licensee has submitted written report to the Dpeartment and will conduct a training. Content of training and a list of attendees will be sent to the Department by the POC due date.

Type of visit: Case Management - Other

On 9/15/2025, LPA Grace Donato conducted a Case Management-Other visit to the facility. LPA met with Assisted Living Director Joni Tsukimura and explained the purpose of the visit. The visit is regarding about the stipulation order sent to the facility and to confirm that the staff member (S1) mentioned in the order is no longer working in the facility. No deficiencies cited today. Report is reviewed and a copy is provided.the state’s words, verbatim · CDSS document, Sep 15, 2025

Type of visit: Required - 1 Year

On June 18, 2025, Licensing Program Analyst (LPA) Kiran Jain arrived unannounced at the facility to conduct a Required 1-Year Annual inspection. LPA met with the Assisted Living Director (ALD), Joni Tsukimura, and disclosed the purpose of the inspection. Executive Director (ED), Preet Kaur joined shortly after. The facility consisted of seven (7) buildings from one to three floors each. There was one (1) building with a combination of Assisted Living unit (Lodge) and Memory support unit (Health Center) and six (6) buildings for Independent living units (Redwood, Cedar, Magnolia, Maple, Birch, and Willow). The ALD informed the LPA that the facility had 172 residents in care at the time, including 31 in Assisted Living, 15 in memory support, and 126 in Independent Living. At 9:50 AM, LPA initiated a walk-through of the facility, accompanied by ALD. LPA inspected randomly selected eight (8) resident rooms in Assisted Living and Memory Care units. The rooms were found to be clean, well-lit, and equipped with the required furniture. Emergency pull cords were observed to be functioning in the resident rooms with an average response time of 1 minute. LPA inspected the private bathrooms in random rooms. The bathrooms contained soap, grab bars, towels, a trash can, and non-slip flooring. The hot water temperature at the sink faucets measured between 110.3°F to 113.6°F. “Oxygen in Use” signs were observed posted outside the residents’ room where oxygen was administered. LPA inspected the Assisted Living and Memory Support kitchen and found it clean. The refrigerator, freezer, and pantry cabinets were checked, and there was a sufficient supply of fresh perishable food for two (2) days and nonperishable staples for seven (7) days. Continued on LIC809-C No expired food items were found. Open food items were wrapped and dated. The dining rooms in Assisted Living and Memory Care were inspected and were found to be clean, with all furniture in good repair. A weekly food menu and menu with alternate food options are available to the residents. LPA inspected activity areas, library, media room, fitness center, arts and crafts room, and living room areas. LPA observed residents watching TV and engaged in recreational programs and activities. Monthly activity calendar was available for the residents. All common areas were free from obstructions, and hallways were well-lit. Evacuation chairs were observed in the stairwells. LPA inspected locked laundry stations in Memory support and Assisted Living and observed washer and dryer units. Sharp objects, detergents, and chemicals were observed to be locked and inaccessible to persons in care. LPA observed locked centrally stored medication carts in the Assisted Living and Memory Support units. Medications were organized separately for each resident. Narcotics were locked. All medication bottles and bubble packs were properly labeled. Centrally Stored Medication Records were reviewed and found to be complete. LPA inspected the first aid kit in the medication room and found it fully stocked. LPA toured the outside courtyard and patio areas and found passageways in good condition, free of obstructions, and without any blocking or tripping hazards. These areas had patio tables, chairs, and umbrellas for residents’ use. Delayed egress was observed on emergency exits. LPA inspected the fire extinguishers mounted on the hallway walls in Assisted Living and Memory Care and found them fully charged, with the last service tag dated 12/09/2024. The fire alarm, smoke detector, and fire sprinkler systems are tested annually by a third-party vendor, Battalion One Fire Protection. A staff member tested the carbon monoxide detector in one of the resident’s in LPA’s presence, and it was found to be functional. Emergency Drill Logs were reviewed, and it was observed that Emergency Disaster (Fire and Earthquake) Drills were conducted quarterly, with the most recent drill completed on 04/10/2025. LPA reviewed six (6) staff personnel records and five (5) resident records. The LPA observed that 5 of 5 residents had the Admission Agreement, Physician's Report, Appraisal Needs and Services Plan, Personal Rights, and Consent forms. LPA observed that 6 of 6 staff members had LIC 508 Criminal Record Statements and LIC 503 Health Screening and confirmed that 6 of 6 staff members were associated with the facility. Continued on LIC809-C The following updated forms are requested to be submitted to CCLD by 06/25/2025: LIC 500: Personnel Report LIC 308: Designation of Facility Responsibility Certificate of Liability Insurance Administrator Certificate(s) No deficiencies were cited during today's visit. An exit interview was conducted with the Executive Director. A copy of this report was provided to the Executive Director, Preet Kaur, whose signature on this form confirms receipt of the report.the state’s words, verbatim · CDSS document, Jun 18, 2025

Type of visit: Case Management - Incident

On February 19, 2025, at 12:40 PM, Licensing Program Analyst (LPA) Kiran Jain arrived at the facility to conduct a Case Management – Other inspection visit for an suspected elder abuse incident, reported by the facility through SOC 341. Upon arrival, the LPA was greeted by the Assisted Living Director (ALD), Joni Tsukimura. The LPA disclosed the purpose of the visit. The ALD informed the LPA that there were (30) residents in Assisted Living care and total facility census was 169. On 01/27/2025, the resident (R1) reported an incident to staff member (S2). R1 stated that on 01/25/2025, around 9:00 PM, staff member (S1) assisted them with the shower. After that, S1 helped them to stand at the side of the shower so that R1 could hold onto the rails facing the wall, and S1 then proceeded to dry R1 with a towel. R1 stated that S1 brushed their hand with the towel against R1’s breast. R1 mentioned that it happened a second time and felt more deliberate, so they asked S1 to leave. On 02/19/2025, at 1:13 PM, LPA interviewed ALD. ALD stated that R1 was not able to describe the person. When ALD initially talked to R1, ALD didn’t have the schedule with them as they were not sure who was working on the Saturday night. ALD stated that they asked R1 to describe the person who could have given them the shower, but R1 was still not able to identify the staff. ALD added that they didn’t go back with a picture to help R1 identify the staff. ALD confirmed that the facility notified the Los Altos Police Department. An officer called back and talked to R1 in the presence of R1’s family member (FMD). The police officer didn’t come to the facility, and no police report or complaint was made. R1 didn’t want to file a police complaint. R1’s family (FM1) was aware of this incident. On 02/19/2025, at 1:36 PM, LPA interviewed R1’s family member (FMD). FMD stated that R1 was anxious to talk about this incident with the LPA and that R1 had anxiety, with many things for R1 being anxiety-based. FMD mentioned that the staff was amazing and that R1 had built a good rapport with them. Continued on LIC809-C FMD stated that R1 never felt that S1’s actions while assisting them with the shower were inappropriate and that, in R1’s mind, they weren’t thinking they were reporting something inappropriate. FMD added that R1 was taken aback when this incident was reported to the police, as it was never an issue that R1 was concerned about. FMD explained that at times, R1’s Parkinson’s-related anxiety took over and that they helped R1 process and dissect the incident, considering it one of those moments. FMD stated that it was just a case of R1 getting used to a new person helping them. There was never anything inappropriate with what S1 did, and according to FMD, S1 had their own style within appropriate boundaries. No deficiencies were cited during today's visit. An exit interview was conducted with the Assisted Living Director. A copy of this report was left with the Assisted Living Director, Joni Tsukimura, whose signature on this form confirms receipt of the report.the state’s words, verbatim · CDSS document, Feb 19, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required 1 Year visit and met with Preet Kourl, Administrator. During visit, LPA Marrufo toured the facility inside and out. LPA Marrufo toured the facility 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 Marrufo observed the first aid kit and found it to be complete. LPA Marrufo toured 7 resident living units. Each living unit had working lights and available bedding and storage areas for clothing. LPA Marrufo toured the bathrooms in the 7 toured resident living units and two hallway bathrooms and observed each bathroom had working lights and available soap and paper towels. The water temperatures in the bathrooms ranged from 110 F to 119 F. LPA Marrufo reviewed the Centrally Stored Medication and Destruction Records (CSMDR) for residents R1-R7. R1's CSMDR had one missing medication, one medication entered with the wrong prescription number, and four medications with no start date. R2's CSMDR had a medicatoin with the incorrect expiration date. R4's CSMDR had a medication with an incorrect expiration date. R6's CSMDR had a medication with the wrong prescription number. R7 had two medications that were missing a start date. LPA Marrufo reviewed 7 resident records and 7 staff records and found them to be complete. The facility maintenance record indicates the last smoke detector testing occurred on 11/09/2023. The last emergency disaster drill was conducted on 03/18/2024. A deficiency was cited as per California Code of Regulations Title 22. See LIC809-D for more information. This report was reviewed with Administrator Preet Kourl and a copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Jun 18, 2024