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Facility Evaluation Report

Pacifica Senior Living Union City, Union City10/04/2023Licence 019200509

Capacity110
Census66
Date signed10/04/2023 05:47:19 PM
The inspector’s account

On 10/4/2023 at 4:30PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a case management visit. LPA met with Executive Director, Robert Roby.

While LPA G. Luk was at the facility for a complaint investigation (#15-AS-20230925101546), the following deficiencies were observed.

After touring the kitchen, LPA observed chemicals for floor repairs were stored in the kitchen area. Staff removed the chemicals and put them with other cleaning supplies room.

At around 4:45PM, LPA observed a tray of bacon was stored in the walk-in refrigerator without any covering/wrapping. LPA observed other containers with loosely covered wrappings. Staff discard bacon during inspection.

The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct deficiencies may result in civil penalties.

Exit interview conducted. A copy of this report and appeal rights provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction