Senior Care Records.

Complaint Investigation Report

Carlton Plaza of San Jose, San Jose10/31/2024Licence 435200727

Census93
Date signed10/31/2024 04:49:51 PM
The inspector’s account

The facts provided in the 30 day eviction notice for a resident is without foundation or merit:

The allegation is that resident R1 denied the a ccusation specified on the 30 days eviction letter issued by the facility .

Resident R1 was accused that on 4/18/2024, R1 made an inappropriate comment stating to push facility staff out of the window and pulled an Swiss knife out and pretended to stab facility staff.

Resident R1 was accused on 5/7/2024, around 12:30PM, R1 lit something on fire in R1's bathroom, creating a large fire to set off the facility sprinkler system which resulted in serious water damage to the facility. The fire threatened the health and safety to the residents and staff at the facility.

On 5/30/2024, LPA interviewed staff S1. S1 stated on 4/18/2024, he/she and staff S2 went to R1's room to fix R1's internet problem. S1 stated R1 stated “I wonder what would happen if you would fall from the window”. S1 stated R1 took out an Swiss army knife and took off the knife part of the Swiss army knife.

LPA interviewed staff S2. S2 stated he/she went with S1 to fix R1's internet problem. S2 stated he/she heard R1 stated something about throwing something over the window. S2 stated R1 had a little knife, and then gestured his knife close to S1. S2 stated the knife was too close to S1.

Based on the review of the incident report dated 5/9/2024, on 5/7/2024 around noon time, the facility fire alarm was activated. The fire panel indicated the source from room #337 of resident R1. Water was pouring out, flowing to the hallway. Fire fighters came in the facility and stated that it seems as if R1 was burning paper and got out of control and sprinkler was activated. Resident rooms next door as well as below on second floor and first floor were all affected as water leaked below.

On 5/10/2024, LPA toured the facility. LPA observed R1's room #337 door frame in the bathroom and walls were black due to smoke. R1's apartments next door as well as below on 2nd and 1st floor were all affected as water leaked below and hallways. LPA toured the affected rooms 121B, 251, 334, 337 and 339. The rooms were used fans to dry out the water.

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