Senior Care Records.

Facility Evaluation Report

Peninsula Del Rey, Daly City04/15/2025Licence 415601070

Capacity150
Census106
Date signed04/15/2025 12:54:49 PM
Name of licensing program analystKomal Charitra
Name of licensing program managerApril Cowan
The inspector’s account

On April 15, 2025, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual visit. LPA met with Administrator, Katherine Tazawa and explained the purpose of the visit.

LPA toured the facility inside and outside including a random sample of resident rooms, common areas & kitchen. The indoor and outdoor passageway was free of obstruction. LPA observed a hot-tub but the gates were observed to be locked. There were no fire safety hazards observed. This is a four story facility; assisted living (AL) on 1st, 2nd, and a portion of the 3rd floor and independent living (IL) on the rest of 3rd floor and all of the 4th floor.

Rooms observed were clean, odor-free with all required furniture. Each resident room has it's own bathroom. Bathrooms observed were observed to be clean, equipped with liquid soap, toilet paper and paper-towels.

Water temperature throughout the facility measured between 117-118 degrees F. Extra linen was observed to be present. First aid kit was observed to be complete. Dining room was observed free from tripping hazards. Residents were observed to be having lunch in the dining room. A comfortable temperature is maintained and lighting is sufficient for comfort. LPA observed two day perishables and seven day non-perishables. Extra food supply was observed to be present. Medications, sharps, and chemicals were observed locked an inaccessible to residents in care.

Carbon monoxide monitors are working properly. All fire extinguishers have been checked and current as of

July 2024. Emergency drills are logged and done every month. LPA reviewed 5 resident records and 5 staff records. Resident records are updated, complete and signed. Staff records are complete, with training logs that have met the basic requirement. Medication review was done, and all medications are accounted for, and centrally stored medication records are updated.

No citations are issued during the visit. Report is reviewed with Administrator and a copy is provided.

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