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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 430701864
Report Date: 01/15/2025
Date Signed: 01/15/2025 01:48:05 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/13/2024 and conducted by Evaluator Kiran Jain
PUBLIC
COMPLAINT CONTROL NUMBER: 26-AS-20241213161119
FACILITY NAME:LYTTON GARDENS COMMUNITY CAREFACILITY NUMBER:
430701864
ADMINISTRATOR:ANAHI MCKANEFACILITY TYPE:
740
ADDRESS:649 UNIVERSITY AVENUETELEPHONE:
(650) 617-7338
CITY:PALO ALTOSTATE: CAZIP CODE:
94301
CAPACITY:55CENSUS: 42DATE:
01/15/2025
UNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Anahi McKane, ManagerTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff are not providing adequate food service for residents
Staff have not addressed roaches in the facility
INVESTIGATION FINDINGS:
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On January 15, 2025, at 12:15 PM, Licensing Program Analyst (LPA) Kiran Jain arrived at the facility to conduct a Complaint Investigation visit. Upon arrival, the LPA was greeted by the Manager, Anahi McKane. The LPA disclosed the purpose of the inspection. The Manager informed the LPA that there were (42) residents in care.

Regarding the allegation “Staff are not providing adequate food service for residents”, the Reporting Party (RP) stated “AL gets most of their servers through 'agency' who have never served food before and are not trained to serve in the dining hall. They don't know the basic health and food safety. Most of them don't wear gloves, they throw gloves in compost bins, don't know about temperature maintenance before serving food, leave refrigerated stuff on dining table for long causing the residents to complain about spoiled items. AL employees are eating food on the table the food to be served to the residents was placed. The employees keep their personal food in the same refrigerator where food for the residents is stored”.

Continued on 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: April Cowan
LICENSING EVALUATOR NAME: Kiran Jain
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 4
Control Number 26-AS-20241213161119
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME: LYTTON GARDENS COMMUNITY CARE
FACILITY NUMBER: 430701864
VISIT DATE: 01/15/2025
NARRATIVE
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LPA interviewed (3) residents (R1-R3). R1 stated they had not had any complaints about the quality, temperature, or hygiene of the food served at the facility, and if the food had not been warm, they had asked the staff to microwave it. R1 stated they had been given plenty of meal preferences, their requests had been met, and they had no complaints. R1 stated that the dining staff had worn gloves. R2 stated that the quality of the food had been fair but could have been better; sometimes the soup had been too hot, and the creamers and milk had not been spoiled. R2 stated that dining servers had worn gloves. R3 stated that the quality of the food had been alright and that they could customize options available from an alternate menu. R3 stated they had picked up food and brought it to their room, had warmed food in the microwave if necessary, and had never received any spoiled food. R3 stated they were not sure if staff had worn gloves in the dining area, as they had not eaten in the dining area.

LPA interviewed (3) staff members (S1-S3). S1 stated they had passed around the food, had not touched the food, had always worn gloves, and had thrown the gloves in the trash bin. S1 stated the food temperature had been checked by the server in the kitchen before it was put on the table in the kitchen, and they had served coffee as well. No resident had complained to them about the food quality, and they had checked the milk expiration date. S1 stated they had been placed at the facility by an agency and that they had held a CNA license. S2 stated they had been a caregiver, had helped in the dining area, had always worn gloves, and had thrown the gloves in the garbage. S2 stated the server from the kitchen had always checked the temperature and had put it on the counter when the food was hot and in a little cooler when the food was cold. S2 stated they had not made or handled food but had just served the food, and they had verified what residents had ordered before giving it to them. They had never heard from any resident about spoiled food. S3 stated the residents had been given a weekly menu and an alternative options menu, and the residents had received what they had ordered. If residents had changed their minds, they had tried to accommodate. S3 stated that they had used a third-party vendor to prepare food for the residents and that the server responsible for food quality and temperature checks had come from the vendor only. They had never had issues with the quality or the temperature of the food. S3 stated the staff had stored their food in the staff refrigerator and not in the resident-use refrigerator.

LPA reviewed S4's certification and in-service records. S4 had a ServSafe California certificate that had been issued on 12/27/2024 and was valid for three years, a Food Safety and Quality Assurance in-service training dated 9/19/2024, a Food Handling and Temperature in-service training dated 10/7/2024, an Associate Food Safety in-service training dated 10/16/2024, a Hand Washing in-service training dated 10/31/2024, and a Hand Hygiene in-service training dated 11/22/2024.

Continued on 9099-C

SUPERVISORS NAME: April Cowan
LICENSING EVALUATOR NAME: Kiran Jain
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 26-AS-20241213161119
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME: LYTTON GARDENS COMMUNITY CARE
FACILITY NUMBER: 430701864
VISIT DATE: 01/15/2025
NARRATIVE
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On 12/19/2024, LPA observed the dining area during lunchtime service, where the server (S4) had been standing behind the counter, putting food on the counter for the staff to serve. Two staff members (S1 and S2) were observed serving the food. S1 and S2 had been wearing gloves while serving food to the residents at the dining tables in the dining area. Residents were observed eating and enjoying their lunch. LPA observed a standing refrigerator in the dining area that contained milk and juices for the residents. LPA also observed and a freezer in the dining area that contained ice creams for the residents.

Regarding the allegation “Staff have not addressed roaches in the facility”, the Reporting Party (RP) stated, “have roaches (they know about it and have pasted pictures regarding that too)”.

LPA interviewed (3) residents (R1-R3). R1 stated they had not seen roaches too often and that bugs had been present when it was hot. R2 stated that a roach had been found in their closet the previous week, pest control had come and taken care of it, and they had not seen any roaches afterward. R3 stated that German roaches had started about seven months earlier, and a new pest control company had been hired by the facility. R3 further stated they had not seen a single roach in the last 10 days and that the facility had finally solved the problem.

LPA interviewed (3) staff members (S1-S3). S1 stated they did not remember seeing any roaches. S2 stated they had roaches before, but not currently, as the company had come and sprayed. S3 stated the pest control company had been coming every two weeks, had last come on 12/11/2024, and had put traps on the floors.

LPA reviewed pest control reports for the past two months. The Ecolab Pest Eliminator invoice number 6995717, for a service date of 12/11/2024, with the Service Program of Cockroach/Rodent Program and Outside-In Large Fly Program, indicated the following Conditions Found/Action Taken: “No rodent activity was noted during the inspection and/or service, no ant activity was noted during the inspection and/or service, and cockroaches were noted in one apartment.” For invoice number 6790324, for a service date of 11/14/2024, with the Service Program of Cockroach/Rodent Program and Outside-In Large Fly Program, the Conditions Found/Action Taken indicated: “No rodent activity was noted during the inspection and/or service, no fly activity was noted during the inspection and/or service, and no cockroach activity was noted during the inspection and/or service.”

Continued on 9099-C

SUPERVISORS NAME: April Cowan
LICENSING EVALUATOR NAME: Kiran Jain
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 26-AS-20241213161119
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME: LYTTON GARDENS COMMUNITY CARE
FACILITY NUMBER: 430701864
VISIT DATE: 01/15/2025
NARRATIVE
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On 12/19/2024, LPA visited three residents' (R1-R3) rooms and observed baits had been placed in R3’s room. No roaches were seen in any of these three rooms. LPA observed the dining area during lunchtime service, where baits had been placed, no roaches were seen, and no posted pictures regarding roaches were observed at the facility.

Based on observations, interviews conducted, and records reviewed, the department has determined that the allegations may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred. Therefore, the allegations are UNSUBSTANTIATED.

No deficiencies were cited under the California Code of Regulations, Title 22.

An exit interview was conducted with the Manager. A copy of this report was discussed and left with the Manager, Anahi McKane, whose signature on this form confirms receipt of this report.

SUPERVISORS NAME: April Cowan
LICENSING EVALUATOR NAME: Kiran Jain
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4