Basic services and supervision
Cited in 5 reports, with 6 deficiencies in total.
MISSION VILLA SENIOR LIVING
995 E MARKET ST, Daly City CA 94014
60 bedsLatest official report Jul 23, 2026Licensed
Additional info
- Telephone
- (650) 756-1995
- Licensee
- PACIFICA DALY LLC AND DALY CITY 1 MGR. LLC.
- Administrator
- GHEISAR, SHAYAN
- Contact
- GHEISAR, SHAYAN
- License first date
- Jul 8, 2019
- License effective date
- Jul 8, 2019
- District office
- SAN BRUNO RO · (650) 266-8800
- Regional office
- 14
- Clients served
- 983 - RCFE / DEMENTIA
Summary
The available records show 17 Type A deficiencies for this facility.
- Most recent inspection
- Jul 23, 2026
- Most recent deficiency
- Jul 17, 2025
3 later reports, from Apr 17, 2026 through Jul 23, 2026, recorded no deficiencies, though the records do not say whether they were follow-ups.
What Type A and Type B mean
- Type A
- Violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
- Type B
- Violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care.
Both classifications are published by California CDSS and are shown as published. SeniorLivingFacts does not rename them or add a severity level of its own.
At a glance
Counts cover the five-year public record. Typical figures are the median for the 28 San Mateo County facilities licensed for 50 or more beds, except where too few exist to state one — those come from facilities with 7 or more beds.
In the available public five-year record, CCLD published 28 reports for this facility: 13 inspections, 13 complaint investigations, and 2 licensing or administrative records.
Those records contain 17 Type A and 0 Type B deficiencies.
0 deficiencies have explicit official correction or clearance evidence in the loaded records.
- Official inspections
- 13
- Recorded deficiencies
- 17
- Type A deficiencies
- 17
- Type B deficiencies
- 0
- Substantiated complaints
- 6
- Repeated topics
- 4
More than the typical 6
3 in the last 12 months
Well above the typical 4
0 in the last 12 months
Well above the typical 1
0 in the last 12 months
Fewer than the typical 1
0 in the last 12 months
Most this size have none
0 in the last 12 months
Last 36 months
Repeated topics
Topics cited in more than one report during the last 36 months. A repeat may show a pattern worth asking about. Each date opens its report below.
Admission, assessment, and eviction
Cited in 2 reports, with 2 deficiencies in total.
Fire safety and emergency preparedness
Cited in 2 reports, with 2 deficiencies in total.
Medical and dental care
Cited in 2 reports, with 2 deficiencies in total.
Official report history
All preserved reports from the most recent to the oldest, sortable by report type.
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Licensing recordNot an inspection of the operating facility
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Complaint
Allegations3 substantiated · 0 unsubstantiated · 0 unfounded · 3 cited
Basic services and supervisionType A
- Official classification
- Type A
- Official code
- 87464(f)(1)
- Regulation authority
- CCR
What the official deficiency says
87464 Basic Services: (f) Basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement is not met as evidenced by: Based on interviews and records reviewed, R1 was a fall risk, required two-persons transfer, escort assistance and close supervision, however despite staff being aware, facility staff did not assist a Vitas Healthcare hospice aide on 12/2/24, leaving the hospice aide alone with R1. In addition, R1 fell on 12/2/24, and based on medical records, R1 had a rotation to his/her left leg and a deformity to his/her left hip, an acute, mildly displaced fracture of the left iliac wing extending to the acetabulum with associated widening of the left femoroacetabular joint space; an acute, comminuted, mildly displaced fracture of the left inferior pubic ramus, and a mild presacral edema without a definite sacral fracture. A hematoma involving the left iliacus and left pelvic sidewall was also present. This poses an immediate health and safety risk to residents in care.
Official plan of correction
Licensee/administrator shall conduct an in-service to ensure staff are closely monitoring residents if they are identified to be a fall risk. An immediate $500 civil penalty is being assessed today as the facility did not provide adequate supervision resulting in R1 sustaining multiple fractures in care. A repeat civil penalty of $500 is being issued today due to the same violation being cited on 1/9/2025. Due to immediate civil penatly of $500 being cited and repeat civil penalty of $500 being issued, total civil penalty being assessed today is $1,000.
Deadline recorded: Jul 18, 2025. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Jul 18, 2025
Correction not verified in available records
Medical and dental careType A
- Official classification
- Type A
- Official code
- 87465(a)(1)
- Regulation authority
- CCR
What the official deficiency says
87465 Incidental Medical and Dental Care: (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care... (1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents. This requirement is not me as evidenced by: Based on documentation reviewed, R1 had a fall on 12/2/24 at 7am and was treated by the hospice nurse. However, it was noted that later in the evening of 12/2/24, R1 was constantly yelling for help. Based on staff interviews, on 12/3/2024, R1 was complaining of pain when changing R1’s diaper and reported it to the med-tech and constantly yelling for help. It was not until the following evening on 12/4/24 that R1 was sent out to the hospital after staff noted R1 complaining of left hip pain. Staff interviewed were unable to state why R1 was not sent out to the hospital earlier which poses an immediate health and safety risk to residents in care.
Official plan of correction
Licensee/administrator shall conduct an in-service training to ensure staff notify families regarding any changes of condition. Training shall include, notifying physician and sending resident out when there is a change of condition. An immediate $500 civil penalty is being assessed today as staff did not seek medical attention to resident in a timely manner.
Deadline recorded: Jul 18, 2025. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Jul 18, 2025
Correction not verified in available records
Admission, assessment, and evictionType A
- Official classification
- Type A
- Official code
- 87463(f)
- Regulation authority
- CCR
What the official deficiency says
87463 Reappraisals: (f) The licensee shall immediately, or as soon as reasonably possible, communicate with the resident and, if applicable, the resident's representative, about any significant change in condition and the recommendation... This regulation is not met as evidenced by: Based on R1's charting notes reviewed, although the facility did reach out to R1's responsible party on 12/2/24 after the fall and later in the evening, the facility failed to communicate with R1's responsible party on 12/3/24 when R1 was constantly yelling for help and the facility documented a change in R1's condition which poses an immediate health and safety risk to residents in care.
Official plan of correction
Licensee/administrator shall conduct an in-service training to ensure staff notify families and any required parties regarding a change of resident condition. .
Deadline recorded: Jul 18, 2025. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Jul 18, 2025
Correction not verified in available records
Licensing recordNot an inspection of the operating facility
No deficiencies recorded in this report
Complaint
Allegations1 substantiated · 5 unsubstantiated · 0 unfounded · 1 cited
Admission, assessment, and evictionType A
- Official classification
- Type A
- Official code
- 1569.652(c)
- Regulation authority
- HSC
What the official deficiency says
1569.652 Termination of admission agreement upon death of resident; removal of resident’s property; refund of fees paid; notice of contract termination and refunds : (c) A refund of any fees paid in advance covering the time after the resident’s personal property has been removed from the facility shall be issued to the individual...responsible for the fees ...within 15 days after the personal property is removed. This requirement is not met as evidenced by: Based on the admission agreement reviewed and the copy of check provided for review, R1 moved out of the facility on 11/2/24 and all personal belongings were removed, however facility did not issue a refund check until 12/17/24.
Official plan of correction
Licensee/administrator shall submit a plan in writing regarding how to ensure refund checks are provided in a timely manner to meet both facility's admission agreement and comply with HSC 1569.652(c).
Deadline recorded: Feb 25, 2025. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Feb 25, 2025
Correction not verified in available records
Complaint
Allegations1 substantiated · 2 unsubstantiated · 0 unfounded · 1 cited
Facility condition and maintenanceType A
- Official classification
- Type A
- Official code
- 87303(b)
- Regulation authority
- CCR
What the official deficiency says
87303 Maintenance and Operation: (b) A comfortable temperature for residents shall be maintained at all times. This requirement is not met as evidenced by: Based on interviews conducted, it was acknowledged that the facility does not have a functioning heating unit on both floors of the facility and the facility is using portable heaters in common areas. In addition, based on observations, LPA observed residents at the facility wearing heavy jackets and wrapped in blankets.
Official plan of correction
Licensee/Administrator shall submit a plan in writing indicating how to ensure a comfortable temperature is maintained at the facility.
Deadline recorded: Feb 12, 2025. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Feb 12, 2025
Correction not verified in available records
Inspection
Records and plan of operationType A
- Official classification
- Type A
- Official code
- 87506(a)
- Regulation authority
- CCR
What the official deficiency says
87506: Resident Records: (a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff This regulation is not met as evidenced by: Based on R1's file reviewed, there were no completed reappraisals, no service plans, pre-admission appraisal, functional capacilities in the file.
Official plan of correction
Licensee/administrator shall submit a plan in writing on how to ensure all residents' files are completed and current. Plan in writing shall include; audits, who will review the files, how often they will be reviewed.
Deadline recorded: Jan 10, 2025. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Jan 10, 2025
Correction not verified in available records
Complaint
Allegations1 substantiated · 5 unsubstantiated · 0 unfounded · 1 cited
Basic services and supervisionType A
- Official classification
- Type A
- Official code
- 87464(f)(1)
- Regulation authority
- CCR
What the official deficiency says
87464 Basic Services: (f) Basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement is not met as evidenced by: Based on medical records reviewed, the resident was found to have a diganosis of dehydration and UTI when admitted to the hospital which resulted in the resident needing multiple doses of IV fluids while at the hospital. This finding poses an immediate health a safety risk to the resident in care.
Official plan of correction
Licensee/Administrator shall conduct in-service training regarding the importance of hydration and how to ensure residents are hydrated. Training shall include being able able to identify when a resident is dehydrated and intervening. In service training shall be submitted to CCL by 1/10/25 A civil penalty of $250.00 will be issued on 1/9/2025 for a repeat violation within the last 12 months. The same violation was cited on 11/6/2024
Deadline recorded: Jan 10, 2025. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Jan 10, 2025
Correction not verified in available records
Inspection
Background checksType A
- Official classification
- Type A
- Official code
- 87355(e)(1)
- Regulation authority
- CCR
What the official deficiency says
Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or... This requirement was not met as evidenced by: Based on filed reviewed, LPA was unable to locate S1's fingerprint clearance and facility association documentation for S1. In addition, the resident care director and the business office manager were unable to provide LPA with confirmation or documentation of S1's fingerprint clearance and/or S1's facility association documentation
Official plan of correction
S1 no longer is employed at the facility, however licensee/administrator shall conduct an audit to ensure all staff that are currently employed at the building have fingerprint clearance and are associated to the facility A civil penalty of $500 is being issued during the visit today; $100 a day for 5 days = $500.
Deadline recorded: Nov 7, 2024. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Nov 7, 2024
Correction not verified in available records
Complaint
Allegations2 substantiated · 1 unsubstantiated · 0 unfounded · 2 cited
Basic services and supervisionType A
- Official classification
- Type A
- Official code
- 87464(f)(1)
- Regulation authority
- CCR
What the official deficiency says
87464 Basic Services: (f) Basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement is not met as evidenced by: Based on documents reviewed and interviews conducted, R1 was fell and was found on the bathroom floor and facility staff failed to ensure care and supervision was provided as documents reviewed identified R1 as fall risk, however there was no individualized fall prevention place for R1. In addition, based on staff interviewed, due to short staffing, there was a lack of supervision.
Official plan of correction
Licensee/administrator shall submit a plan in writing on how to ensure staff provide proper care and supervision to all residents. Plan must include training, staffing, observation of resident, addressing changes in condition. Plan shall be submitted to CCLD by 11/7/24. AN IMMEDIATE CIVIL PENALTY OF $500 WAS ASSESSED FOR VIOLATIONS THAT RESULTED IN SICKNESS OR INJURY TO A RESIDENT IN CARE.
Deadline recorded: Nov 7, 2024. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Nov 7, 2024
Correction not verified in available records
Medical and dental careType A
- Official classification
- Type A
- Official code
- 87465(a)
- Regulation authority
- CCR
What the official deficiency says
87465 Incidental Medical and Dental Care - (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care. This requirement is not met as evidenced by: Licensee failed to perform care and supervision to the resident to address the care need of a resident who fell and had a change in condition. According to staff interviews, R1 was experiencing pain in his/her right leg or hip, and called R1’s responsible party, however, did not feel that calling 911 was necessary due to R1’s old age even though staff observed R1 moaning and grimacing in pain when R1 moved his/her leg. Furthermore, based on interviews conducted and file reviewed, it was noted that R1 was at fall risk and med-techs interviewed indicated that 911 should have been called but they did not. Nevertheless, R1 was complaining and observed by staff of having pain and the facility did not seek medical attention for R1 which poses an immediate health risks to residents in care.
Official plan of correction
Licensee/administrator shall submit a plan in writing addressing how to seek timely medical attention. Plan shall include staff training, staffing, reassessments, individualized care plans for residents. Civil penalty in the amount of $500 is being assessed today as the failure to arrange medical treatment for Resident 1 (R1) after an incident that resulted in a fractured hip.
Deadline recorded: Nov 7, 2024. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Nov 7, 2024
Correction not verified in available records
Inspection
Fire safety and emergency preparednessType A
- Official classification
- Type A
- Official code
- 1569.69(a)(5)
- Regulation authority
- HSC
What the official deficiency says
1569.69 Employees assisting residents with self-administration of medication; training requirements (a) Each residential care facility for the elderly licensed under this chapter shall ensure that each employee of the facility who assists residents with the self-administration of medications meets all of the following training requirements: (5) To complete the training requirements set forth in this subdivision, each employee shall pass an examination that tests the employee’s comprehension of, and competency in, the subjects listed in paragraph (4). This requirement has not been met as evidenced by: Based on a complaint investigation conducted in relation to complaint # 14-AS-20240514090937, it was discovered that the memory care director was passing medications to residents in care but did not pass the examination regarding med-tech training. This poses an immediate health and safety risk to residents in care.
Official plan of correction
The facility shall develop a plan of correction to show how that the facility will have all staff handing out medications fully trained who pass out medications and have competed the examination regarding such training. Plan shall be submitted to the department by due date.
Deadline recorded: Sep 24, 2024. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Sep 24, 2024
Correction not verified in available records
Complaint
Allegations2 substantiated · 2 unsubstantiated · 0 unfounded · 3 cited · investigated over 2 visits
Basic services and supervisionType A
- Official classification
- Type A
- Official code
- 87101(c)(3)(H)
- Regulation authority
- CCR
What the official deficiency says
87101(c)(3)(H) " Care and Supervision " means those activities which if provided shall require the facility to be licensed. It involves assistance as needed with activities of daily living and the assumption of varying degrees of responsibility for the safety and well-being of residents. " Care and Supervision " shall include, but not be limited to, any one or more of the following activities provided by a person or facility to meet the needs of the residents: (H) Monitoring food intake or special diets. This regulation has not been met as evidenced by: Based on documentation reviewed, the resident lost weight while at the facility. It is not apparent that regular food intake records were being made to track any changes in food intake. Some meals may have been missed or the resident not receiving enough food caused the resident to lose weight at the facility from 120lbs to 111lbs at time of weighing at the emergency room. This finding poses an immediate health a safety risk to the resident in care.
Official plan of correction
Licensee shall conduct staff training and submit a written plan outlining how this violation would be avoided in the future. Must be submitted to the licensing office by due date, failure to correct this deficiency by due date may result in a civil penalty.
Deadline recorded: Sep 17, 2024. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Sep 17, 2024
Correction not verified in available records
Basic services and supervisionType A
- Official classification
- Type A
- Official code
- 87464(f)(5)
- Regulation authority
- CCR
What the official deficiency says
87464 Basic Services(f)(5) - (f) Basic services shall at a minimum include: (5) Regular observation of the resident's physical and mental condition, as specified in Section 87466, Observation of the Resident. This regulation has not been met as evidenced by: Based on records reviewed, the resident was found to have a condition as a result of dehydration which resulted in the resident needing fluids provided intravenously while at the hospital. Additionally there was a change in the resident's mental condition also found at the hospital . This finding poses an immediate health a safety risk to the resident in care.
Official plan of correction
Licensee shall conduct staff training and submit a written plan outlining how this violation would be avoided in the future. Must be submitted to the licensing office by due date, failure to correct this deficiency by due date may result in a civil penalty.
Deadline recorded: Sep 17, 2024. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Sep 17, 2024
Correction not verified in available records
Inspection
Hazardous items and storageType A
- Official classification
- Type A
- Official code
- 87309(a)
- Regulation authority
- CCR
What the official deficiency says
87309 Storage Space - (a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. This requirement has not been met as evidenced by: Based on interviews conducted, a cleaning solution was left in a resident's room where they were able to access it, open it, and had some of the solution on their face. This poses an immediate health and safety risk to residents in care.
Official plan of correction
The facility shall provide a plan of correction in writing identifying how the facility will prevent this regulation from not being met in the future. The written plan shall be received by the due date identified.
Deadline recorded: Aug 31, 2024. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Aug 31, 2024
Correction not verified in available records
Complaint
Part of the complaint whose outcome is recorded on Sep 16, 2024 · Control 14-AS-20240514090937
Basic services and supervisionType A
- Official classification
- Type A
- Official code
- 87464(f)(1)
- Regulation authority
- CCR
What the official deficiency says
87464 Basic Services (f) Basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requriement has not been met as evidenced by: Based on documentation reviewed, the resident lost weight going from 120lbs to 111lbs during the resident's stay at the facility of approximately 5 weeks, additionally the resident was found to have a condition as a result of dehydration which resulted in the resident needing fluids provided intervenously while at the hospital. These finding pose an immedate health a safety risk to the resident in car.
Official plan of correction
Licensee shall conduct staff training and submit a written plan outlining how this violation would be avoided in the future. Must be submitted to the licensing office by due date, failure to correct this deficiency by due date may result in a civil penalty.
Deadline recorded: Aug 21, 2024. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Aug 21, 2024
Correction not verified in available records
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
Staffing, personnel, and trainingType A
- Official classification
- Type A
- Official code
- 87411(a)
- Regulation authority
- CCR
What the official deficiency says
87411 Personnel Requirements - General - (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. In facilities licensed for sixteen or more, sufficient support staff shall be employed to ensure provision of personal assistance and care as required in Section 87608, Postural Supports. Additional staff shall be employed as necessary to perform office work, cooking, house cleaning, laundering, and maintenance of buildings, equipment and grounds. The licensing agency may require any facility to provide additional staff whenever it determines through documentation that the needs of the particular residents, the extent of services provided, or the physical arrangements of the facility require such additional staff for the provision of adequate services. This regulation has not been met as evidenced by: Based on observations made and interviews conducted, there currently is only one med-tech handling AM and PM medications as well as 4 caregivers assiting residents at LPAs arrival. Per interviews and staffing schedule observed there is also only 1 med-tech for AM and PM for the next day, and 3 caregivers for AM and PM shfit for 57 residents. This violation poses a health and safety risk to residents in care.
Official plan of correction
The licensee shall provide a plan in writing to address and indicate how they well meet this regulation at all times. POC to be received by the date indcated.
Deadline recorded: May 11, 2024. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline May 11, 2024
Correction not verified in available records
Fire safety and emergency preparednessType A
- Official classification
- Type A
- Official code
- 1569.69(a)(1)
- Regulation authority
- HSC
What the official deficiency says
§1569.69 Employees assisting residents with self-administration of medication; training requirements (a) Each residential care facility for the elderly licensed under this chapter shall ensure that each employee of the facility who assists residents with the self-administration of medications meets all of the following training requirements: (1) In facilities licensed to provide care for 16 or more persons, the employee shall complete 24 hours of initial training. This training shall consist of 16 hours of hands-on shadowing training, which shall be completed prior to assisting with the self-administration of medications, and 8 hours of other training or instruction, as described in subdivision (f), which shall be completed within the first four weeks of employment. This regulation has not been met as evidenced by: Based on file review, the memory care director's file showed that she is not fully trained at this time and has passed out medications to residents as a reulst of the facility not having enough med-tech's on duty or on the schedule. This violation poses a health and safety risk to residents in care.
Official plan of correction
The licensee shall provide a plan in writing to address and indicate how they well meet this regulation at all times. POC to be received by the date indcated.
Deadline recorded: May 11, 2024. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline May 11, 2024
Correction not verified in available records
Complaint
Allegations0 substantiated · 5 unsubstantiated · 0 unfounded
No deficiencies recorded in this reportComplaint
Allegations0 substantiated · 6 unsubstantiated · 0 unfounded
No deficiencies recorded in this reportComplaint
Allegations0 substantiated · 1 unsubstantiated · 0 unfounded
No deficiencies recorded in this reportComplaint
Allegations0 substantiated · 5 unsubstantiated · 3 unfounded
No deficiencies recorded in this reportComplaint
Allegations0 substantiated · 0 unsubstantiated · 1 unfounded
No deficiencies recorded in this reportInspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Complaint
No deficiencies recorded in this report
Source and limits
California Department of Social Services, Community Care Licensing Division. Public facility history is described by the source as a five-year window. Older records and previous-licensee history may require a regional-office request. Type 741 RCFE-CCRCs, nursing homes, and other care settings are excluded from this page.
Read the data methodology