Senior Care Records.

Facility Evaluation Report

Peninsula Elderly Care Home-laurel LLC, San Carlos11/06/2024Licence 415601034

Capacity12
Census7
Date signed11/06/2024 11:51:02 AM
The inspector’s account

On November 6, 2024, Licensing Program Analyst (LPA) John Calandra arrived at the facility at 8:40 AM to conducted an unannounced Case Management visit. Purpose of visit is due to a self reported incident that was reported on 10/26/2024. LPA met with Administrator, Jennifer Tobias and explained the purpose of the visit. Neeru Verma, Head of Operations arrived later during the visit.

The incident occurring on 10/26/2024, involved a resident (R1) striking and spitting on a staff member, S1. The incident was reported to CCLD and confirmed based on the incident report and interview with Administrator, Jennifer Tobias.

During the visit, LPA Calandra interviewed 4 residents, staff, and Administrator.

No deficiencies were cited during today's visit.

An exit interview was conducted. This report was reviewed with Jennifer Tobias, Administrator and a copy of the report left at the facility.

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