Inspection
No deficiencies recorded in this report
1ST PACIFIC COAST HOMES II
2585 ARDEE LANE, South San Francisco CA 94080
6 bedsLatest official report Apr 1, 2026Licensed
Additional info
- Telephone
- (650) 873-8635
- Licensee
- DEBORAH M. DAHLEN
- Administrator
- DEBORAH M. DAHLEN
- Contact
- DEBORAH M. DAHLEN
- License first date
- Apr 8, 2011
- License effective date
- Apr 8, 2011
- District office
- SAN BRUNO RO · (650) 266-8800
- Regional office
- 14
- Clients served
- 985 - RCFE / HOSPICE
Summary
The available records show 4 Type A and 5 Type B deficiencies for this facility.
- Most recent inspection
- Apr 1, 2026
- Most recent deficiency
- Apr 2, 2025
1 later report, on Apr 1, 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 150 San Mateo County facilities licensed for 6 or fewer beds.
In the available public five-year record, CCLD published 6 reports for this facility: 6 inspections, 0 complaint investigations, and 0 licensing or administrative records.
Those records contain 4 Type A and 5 Type B deficiencies.
0 deficiencies have explicit official correction or clearance evidence in the loaded records.
- Official inspections
- 6
- Recorded deficiencies
- 9
- Type A deficiencies
- 4
- Type B deficiencies
- 5
- Substantiated complaints
- 0
- Repeated topics
- 0
More than the typical 4
1 in the last 12 months
Well above the typical 4
0 in the last 12 months
More than the typical 1
0 in the last 12 months
More than the typical 2
0 in the last 12 months
Most this size also 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.
No topic repeats in the last 36 months
No deficiency topic appears in more than one report during that window. This does not establish that nothing repeated earlier in the five-year record, and it is not a statement about current conditions.
Official report history
All preserved reports from the most recent to the oldest, sortable by report type.
Inspection
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 87412(d)
- Regulation authority
- CCR
What the official deficiency says
(d) The licensee shall maintain documentation that an administrator has met the certification requirements specified in Section 87406, Administrator Certification Requirements or the recertification requirements in Section 87407, Administrator Recertification Requirements. This requirement is not met as evidenced by: Deficient Practice Statement Based on records review, the licensee did not comply with the section cited above due to Administrator not having an updated administrator certificate which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 04/09/2025 Plan of Correction Licensee to provide proof to LPA a continuing education schedule and to submit proof of payment upon submission to renew certificate.
Plan of correction recorded
Correction not verified in available records
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
Licensing and administrationType A
- Official classification
- Type A
- Official code
- 1569.618(c)(3)
- Regulation authority
- HSC
What the official deficiency says
(c) The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staff to provide CPR. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in 3 out of 3 persons does not have certificates for CPR and first aid which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 04/25/2023 Plan of Correction Licensee shall develop a plan to ensure that 3 out of 3 staff will receive training for CPR & First Aid by POC due date. Licensee shall submit training certificates to CCLD by 5 business days, 04/28/2023.
Plan of correction recorded
Correction not verified in available records
Staffing, personnel, and trainingType A
- Official classification
- Type A
- Official code
- 87412(f)
- Regulation authority
- CCR
What the official deficiency says
(f) All personnel records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the following requirements: This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in 3 out of 4 personnel records were not available upon inspection which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 04/25/2023 Plan of Correction Licensee shall submit a plan to explain how facility will have personnel records available when CCLD requests the files by POC due date.
Plan of correction recorded
Correction not verified in available records
Staffing, personnel, and trainingType A
- Official classification
- Type A
- Official code
- 87412(g)
- Regulation authority
- CCR
What the official deficiency says
(g) All personnel records shall be maintained at the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in 3 out of 4 personnel files were not maintained in the facility which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 04/25/2023 Plan of Correction Licensee shall provide a plan on how the facility will be able to maintain personnel records that would be readily available if CCLD requests for it by POC due date.
Plan of correction recorded
Correction not verified in available records
Staffing, personnel, and trainingType A
- Official classification
- Type A
- Official code
- 87411(c)(1)
- Regulation authority
- CCR
What the official deficiency says
(1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in 3 out of 3 persons does not have certificates for First Aid which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 04/25/2023 Plan of Correction Licensee shall develop a plan to ensure that 3 out of 3 staff will receive training for First Aid by POC due date. Licensee shall submit training certificates to CCLD by 5 business days, 04/28/2023.
Plan of correction recorded
Correction not verified in available records
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 87411(f)
- Regulation authority
- CCR
What the official deficiency says
(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure. A report shall be made of each screening, signed by the examining physician. The report shall indicate whether the person is physically qualified to perform the duties to be assigned, and whether he/she has any health condition that would create a hazard to him/herself, other staff members or residents. A signed statement shall be obtained from each volunteer affirming that he/she is in good health. Personnel with evidence of physical illness or emotional instability that poses a significant threat to the well-being of residents shall be relieved of their duties. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in 3 out o 4 staff did have health screening and TB test results which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 04/25/2023 Plan of Correction Licensee shall develop a plan to provide the files to CCLD by POC due date.
Plan of correction recorded
Correction not verified in available records
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 87411(c)(6)
- Regulation authority
- CCR
What the official deficiency says
(6) The licensee shall maintain documentation pertaining to staff training in the personnel records, as specified in Section 87412(c)(2). For on-the-job training, documentation shall consist of a statement or notation, made by the trainer, of the content covered in the training. Each item of documentation shall include a notation that indicates which of the criteria of Section 87411(c)(3) is met by the trainer. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in 3 out of 4 staff did not have documentations of training which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 04/28/2023 Plan of Correction Licensee shall submit the training documentations to CCLD by POC due date.
Plan of correction recorded
Correction not verified in available records
Health conditions and treatmentsType B
- Official classification
- Type B
- Official code
- 87633(h)(1)
- Regulation authority
- CCR
What the official deficiency says
(h) For each terminally ill resident receiving hospice services in the facility, the licensee shall maintain the following in the resident's record: (1) A written request for acceptance or admittance to or retention in the facility while receiving hospice services, along with any advance directive and/or request regarding resuscitative measures form executed by the resident or (in certain instances) the resident's Health Care Surrogate Decision Maker. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in 1out of 1 resident do not have Hospice agreement which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 04/28/2023 Plan of Correction Licensee shall submit a copy of the Hospice agreement to CCLD by POC due date.
Plan of correction recorded
Correction not verified in available records
Dementia careType B
- Official classification
- Type B
- Official code
- 87705
- Regulation authority
- CCR
What the official deficiency says
(k) The following initial and continuing requirements must be met for the licensee to utilize delayed egres devices on exterior doors or perimeter fence gates: (3) Fire and earthquake drills shall be conducted at least once every three months on each shift and shall include, at a minimum, all direct care staff. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above by not being able to provide an Emergency Disaster drill log which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 04/28/2023 Plan of Correction Licensee shall conduct an emergency disaster drill and submit to CCLD the emergency disaster log showing the drill uis completed and to submit a plan on when quarterly drills are to be held.
Plan of correction recorded
Correction not verified in available records
Inspection
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