Senior Care Records.

Facility Evaluation Report

Peninsula Elderly Care Home, San Mateo06/18/2026Licence 415600996

Capacity6
Census6
Date signed06/19/2026 12:21:19 PM
Name of licensing program analystJaime Vado
Name of licensing program managerApril Cowan
The inspector’s account

On 06/18/2026, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced case management - incident visit in response to an incident report received at Department regional office. LPA met with administrator Jennifer Tobias and explained the purpose of today's visit.

The Department received an incident report on 05/27/26 regarding a staff on client related report of possible physical harm. Report stated that around 05/24/26, staff person S1 observed the earlobes of resident R1 as being red with a little blood on them. R1 reported to S1 that staff person S2 "grabbed them" in reference as to why the residents earlobes were red showing some kind of injury. In response, on 05/28/26 the administrator Jennifer Tobias, and the licensee Neeru Verma, met with S2 in person. As a result, S2 was taken off the schedule and is no longer employed at the facility. LPA was informed during today's visit that photographs were taken of the injuries observed on R1. Those photos were forwarded to LPA during today's visit. LPA reviewed the photos with the administrator Jennifer Tobias and confirmed through the photographic evidence that there were injuries consistent with what R1 and S1 reported. Facility also informed the responsible party, the Long Term Care Ombudsman office, filed an SOC341, and informed the physician of R1.

Citation issued on the following LIC809D.

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