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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 385601116
Report Date: 02/27/2025
Date Signed: 02/27/2025 03:44:17 PM

Document Has Been Signed on 02/27/2025 03:44 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:COTERIE CATHEDRAL HILLFACILITY NUMBER:
385601116
ADMINISTRATOR/
DIRECTOR:		DEBORAH SUAREZFACILITY TYPE:
740
ADDRESS:1001 VAN NESS AVENUETELEPHONE:
(415) 915-6615
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94109
CAPACITY: 260CENSUS: 193DATE:
02/27/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:13 AM
MET WITH:Matt Turner, General ManagerTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
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On 2/27/2025, Licensing Program Analysts (LPA) Tobola conducted an unannounced Annual Required – 1 yr. inspection for this facility and was greeted by General Manager, Matt Turner. The facility currently provides care for 193 residents, 6 of which are receiving hospice services along with a designated memory care unit. LPA continued with a tour of the facility with staff, facility found to be clean and at a comfortable temperature with all exits free from obstruction. Resident’s bedrooms, common spaces and kitchen and food storage areas were inspected. Fire Extinguishers located throughout the building were found to be charged. Smoke and carbon monoxide detectors and fire safety systems are interconnected with last fire safety inspection completed October 2024 with all corrections completed.

Cleaning supplies and other toxins are safely stored in locked closets throughout the facility, and housekeeping/maintenance rooms all of which were secured upon inspection. There was a supply of hygiene products and paper products available for residents. All resident’s bedrooms were found to be in a clean and comfortable condition with lighting & appropriate furnishings and bedding items.

Residents were observed to be out in the community during the inspection, interacting with staff, fellow residents and visitors in the common areas, or in their bedrooms resting. The facility encourages regular family visits and utilizes a wide variety of activities with LPA observing staff engaging continuously with residents, offering a unique variety of activities and outings based on individualized preferences and capabilities. A wide selection of activity supplies and amenities including a gym, pool, large outdoor patio and guest performances are all provided. LPA found that staff and resident engagement is well practiced with activity calendars developed on a monthly basis with residents observed to have a positive and personable relationship with staff and General Manager.

Continued onto LIC809-C
Andrea Medlin
Dominic Tobola
DATE: 02/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/27/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: COTERIE CATHEDRAL HILL
FACILITY NUMBER: 385601116
VISIT DATE: 02/27/2025
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LPA conducted a sample file review for several residents and found all items to be on file including Needs & Service Plans and Medical Assessments to be current. Upon a spot check of staff files, LPA found that caregiver staff have current first aid and annual training, health screenings and TB results on file. Lastly, a spot check of medications was conducted and found that all medication counts and records are in order.

Administrator, Deborah Suarez's Administrator Certificate 7008093740 is valid through 5/15/2025
General Manager, Matthew Turner's Administrator Certificate 6074366740 is valid through 1/28/2027

LPA requested the following documents be sent to CCL by COB 3/13/2025:

LIC 308 Designated Facility Responsibility
LIC 500 Personnel Summary
LIC 610 Emergency Disaster Plan
Liability Insurance

No deficiencies cited during today's visit
SUPERVISOR'S NAME: Andrea Medlin
LICENSING EVALUATOR NAME: Dominic Tobola
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2025
LIC809 (FAS) - (06/04)
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