435294345-2-19-2025-26-AS-CKAI-DE2T8C-20250219133006

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 435294345
Report Date: 02/19/2025
Date Signed: 02/19/2025 01:30:17 PM

Document Has Been Signed on 02/19/2025 01:30 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
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME:	WESTMONT OF MORGAN HILL		FACILITY NUMBER:	435294345
ADMINISTRATOR/ DIRECTOR:	JOLIE HIGGINS		FACILITY TYPE:	740
ADDRESS:	1160 COCHRANE RD		TELEPHONE:	(408) 779-8490
CITY:	MORGAN HILL	STATE: CA	ZIP CODE:	95037
CAPACITY: 112	TOTAL ENROLLED CHILDREN: 0	CENSUS: 82	DATE:	02/19/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:10 AM
MET WITH:	Jolie Higgins		TIME VISIT/ INSPECTION COMPLETED:	01:35 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Christine Kabariti arrived unannounced to conduct the facility's annual required - 1 year inspection. LPA met with Executive Director (ED), Jolie Higgins and Resident Services Director Ria Hernandez. LPA toured Compass Rose (aka Memory Care) with ED to include 4 apartments (RM 138B, 133, 134, and 129), bathrooms, activity room, kitchen, dining room, and patio area. All fire exit routes were free and clear of obstruction. Delayed egress exit doors observed in working condition. Temperature maintained between 72 - 74 degrees F. Kitchen refrigerator temperature maintained at 26 degrees F. Freezer temperature maintained at 0 degrees F. Hot water temperature measured between 109.4 - 111.2 degrees F in RM 133 and 138B. Chemicals, disinfectants, and medications observed locked in Compass Rose. Activities calendar observed posted for the month. During visit, resident's observed participating in various activities. 2 resident files in Compass Rose was reviewed. 2 out of 2 resident files were complete and no issues noted. LPA inspected 2 resident's centrally stored medication and records with staff. 2 out of 2 resident medications were complete and no issues noted. LPA entered in the kitchen with the ED. The facility has at least 2 days worth of perishables and 7 days worth of non-perishable foods. Walk-in refrigerator temperature maintained at 36 degrees F. Walk-in freezer temperature maintained at 0 degrees F. Items inside the refrigerator and freezer observed covered and labeled. LPA observed a menu posted in the Compass Rose and Assisted Living section. See LIC809-C.

Jackie Jin	TELEPHONE: (714) 319-3786
Christine Kabariti	TELEPHONE: (408) 324-2112
	DATE: 02/19/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: WESTMONT OF MORGAN HILL	FACILITY NUMBER: 435294345
	VISIT DATE: 02/19/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

LPA toured Assisted Living with ED to include 4 resident apartments (RM 223, 219, 206, and 248). Hot water temperature was measured between 109.4 - 111.5 in RM 219 and 248. 2 residents file in Assisted Living was reviewed. 2 out of 2 resident's files were complete. LPA inspected 2 resident's centrally stored medication and records with staff. 2 out of 2 resident medications were complete and no issues noted.

4 staff files were reviewed and observed complete. 4 out of 4 staff members are fingerprint cleared. 4 out of 4 staff have over 20 hours of annual training.

Fire extinguishers observed throughout the facility, last service date was 06/28/2024. Facility has carbon monoxide and smoke detectors present. Facility has an emergency disaster plan and emergency non-perishable foods. LPA observed the facility has a box that contains emergency supplies to include (but not limited to) flash lights, batteries, radio, reflector vests, and band aids. Emergency drills are being completed monthly and the last drill was completed in January 2025. Elevator observed in working condition. LPA observed the facility has a first aid kit. 3 stairwells were observed with an evacuation chair.

Activities calendar posted in the elevator in assisted living. Based on resident interviews, the activity calendars are also provided to the residents weekly.

No deficiencies were cited per California Code of Regulations, Title 22. This report was reviewed with Executive Director, Jolie Higgins and Resident Services Director Ria Hernandez and a copy of the report was provided.

SUPERVISOR'S NAME: Jackie Jin	TELEPHONE: (714) 319-3786
LICENSING EVALUATOR NAME: Christine Kabariti	TELEPHONE: (408) 324-2112
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2025

LIC809 (FAS) - (06/04)

Page: 2 of 2