Senior Care Records.

Facility Evaluation Report

Campbell Village, Campbell08/13/2025Licence 435294224

Capacity90
Census65
Date signed08/13/2025 04:31:05 PM
Name of licensing program analystMarcella Tarin
Name of licensing program managerJin Jackie
The inspector’s account

Licensing Program Analyst (LPA) Marcella Tarin conducted an unannounced Case Management to conduct a Non-Compliance Plan Quarterly Visit and met Administrator (ADM) Geralyn De Ocampo. LPA stated the purpose of the visit.

The purpose of the visit is to ensure the facility is adhering to the Compliance Plan submitted to Community Care Licensing (CCL) after an informal meeting held on October 22, 2024.

LPA toured the facility inside and out with ADM. LPA observed all exits and passageways were free and clear of obstruction.

LPA toured 5 random resident rooms and did not observe any obstructions in the passageways.

ADM tested all 5 delayed egress doors. LPA observed all 5 delayed egress doors were working properly and free from any obstructions in both memory care and assisted living when tested by ADM.

LPA reviewed staff training such as, but not limited to: Dementia and Elopement completed on 8/11/2025. LPA also reviewed staff training on Delayed Egress completed on 8/7/2025.

The facility is adhering to the facility Compliance Plan.

No deficiencies cited per California Code of Regulations, Title 22. An exit interview was conducted with ADM Geralyn De Ocampo and a copy of this report was provided.

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