435202895-12-4-2025-26-AS-RMAO-DQNVM4-20260125153257

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435202895
Report Date: 12/04/2025
Date Signed: 12/04/2025 04:59:29 PM

Unfounded

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
09/17/2025 and conducted by Evaluator Chihhsien Chang

COMPLAINT CONTROL NUMBER: 26-AS-20250917161223

FACILITY NAME:	MORNINGSTAR ASSISTED LIVING OF WEST SAN JOSE		FACILITY NUMBER:	435202895
ADMINISTRATOR:	HALL, STEPHANIE		FACILITY TYPE:	740
ADDRESS:	1380 S DEANZA BLVD		TELEPHONE:	(669) 295-6500
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95129
CAPACITY:	149	CENSUS: 110	DATE:	12/04/2025
		UNANNOUNCED	TIME BEGAN:	02:55 PM
MET WITH:	April Princesa		TIME COMPLETED:	04:29 PM

ALLEGATION(S):

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Facility kitchen has cockroaches and/or rodents.
The facility refrigerator's maximum temperature of 40 degrees F (4 degrees C) and/or freezer temperature of 0 degrees F or below is not maintained.
All utensils used for eating and drinking and in preparation of food and drink are not cleaned and sanitized after each usage.
Food items are not stored, prepared in a safe and healthful manner.
Staff engaged in food preparation and service were not observing personal hygiene and food services sanitation practices which protect the food from contamination.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Steve Chang conducted an unannounced investigation visit to deliver the investigation finding and met with Operations Specialist April Princesa (OS).

On 09/17/2025, the Department received a complaint with the above allegations.

On 09/25/2025, the Department conducted an initial investigation visit.

LPA, with 3 county vector control staff toured the facility including kitchen, dining room, memory care unit small kitchen, memory care unit dining room, boiling room, trash room, a resident room in assist living unit, a resident room in memory care unit, and exterior of the building.

LPA interviewed previous Executive Director (PED), cooks, servers and Maintenance Director
Continue on LIC9099-C. Page 1 of 4..

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Chihhsien Chang
LICENSING EVALUATOR SIGNATURE:	DATE: 12/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025

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-20250917161223

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: MORNINGSTAR ASSISTED LIVING OF WEST SAN JOSE	FACILITY NUMBER: 435202895
	VISIT DATE: 12/04/2025

NARRATIVE

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Facility kitchen has cockroaches and/or rodents:
On 09/26/2025, LPA with 3 county vector control staff toured and inspected the facility including kitchen, dining room, memory care unit small kitchen, memory care unit dining room, boiling room, trash room, resident room in assist living unit, resident room in memory care unit, and exterior of the facility building.

There were no cockroaches or rodents found in the facility and no signs of cockroaches or rodents existing in the facility.

LPA interviewed staff S1. S1 stated he/she never saw rodents or cockroaches in the facility. S1 stated the facility has pest control company come to check every week. LPA interviewed the facility Maintenance Director (S2).S2 stated the facility does not have cockroaches or rodents.

LPA interviewed previous Executive Director (PED). PED stated he/she have the confident that the facility does not have cockroaches or rodents.

Based on the review of the report of county vector control staff, There were no cockroaches or rodents found in the facility.

The facility refrigerator's maximum temperature of 40 degrees F (4 degrees C) and/or freezer temperature of 0 degrees F or below is not maintained:

On 09/26/2025, LPA checked the temperature of the freezer and the refrigerator in the kitchen. The temperature of the freezer was observed at --17 degree F and the temperature of the refrigerator was observed at 25 degree F.

LPA interviewed staff S1. S1 stated the temperature of the freezer is always kept below 0 degree F and the temperature of the refrigerator is always kept below 40 degree F.

Based on the review of the temperature log in the kitchen, the temperature of the freezer is always kept below 0 degree F and the temperature of the refrigerator is always kept below 40 degree F.
Continue on LIC9099-C. Page 2 of 4.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Chihhsien Chang
LICENSING EVALUATOR SIGNATURE:	DATE: 12/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 26-AS-20250917161223

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: MORNINGSTAR ASSISTED LIVING OF WEST SAN JOSE	FACILITY NUMBER: 435202895
	VISIT DATE: 12/04/2025

NARRATIVE

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All utensils used for eating and drinking and in preparation of food and drink are not cleaned and sanitized after each usage:
On 09/26/2025, LPA toured and inspected the kitchen. LPA did not observed unwashed/soiled utensils in the kitchen.

LPA interviewed staff S1. S1 stated all the utensils are washed through the washing machine after usage and are ready/available before the next meal.

LPA interviewed staff S3. S3 stated he/she rinses dishes and put in the washing machine after meals. S3 stated the facility washes utensils after each meal and always are available before the next meal.

LPA interviewed 2 servers. Both stated they delivers food to dining room and resident rooms if needed. Both stated they collect the dishes from dining room and resident rooms and put in kitchen to wash through the washing machine. Both sated all utensils are washed before the next meal and always before 8:00PM every day.

Food items are not stored, prepared in a safe and healthful manner:
Staff engaged in food preparation and service were not observing personal hygiene and food services sanitation practices which protect the food from contamination:

On 09/26/2025, LPA toured and inspected the kitchen. All people are required to wear caps to enter the kitchen. LPA observed kitchen workers were wearing masks, gloves aprons, and hats. The kitchen workers clothes were observed neat and clean. The temperature of the freezer was observed at -17 degree F and the temperature of the refrigerator was observed at 35 degree F. The temperature logs were maintained for the freezer and refrigerators. The environment of the kitchen was observed in hygiene condition. No food were observed left unattended.

LPA interviewed staff S1. S1 stated no food are left unattended overnight. S1 stated he/she received the training of food handling/preparation. S1 showed his/her training certificate. S1 stated staff follow the standard practices to prepare food.

Continue on LIC9099-C. Page 3 of 4.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Chihhsien Chang
LICENSING EVALUATOR SIGNATURE:	DATE: 12/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 26-AS-20250917161223

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: MORNINGSTAR ASSISTED LIVING OF WEST SAN JOSE	FACILITY NUMBER: 435202895
	VISIT DATE: 12/04/2025

NARRATIVE

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LPA interviewed staff S3. S3 stated he/she received the training of food handling/preparation. S3 showed his/her training certificate. S3 stated he/she follows the standard practices of handling/preparing food.

The Department has investigated the above allegations. Based on the investigation, records reviewed, and interviews conducted, the Department found that the above allegation is UNFOUNDED, meaning that the allegation is false, could not have happened and/or is without a reasonable basis.

No citations noted at today’s compliant investigation visit. Exit interview conducted with OS. This report was provided to review and for signature. A copy of this report was provided to OS.

Page 4 of 4.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Chihhsien Chang
LICENSING EVALUATOR SIGNATURE:	DATE: 11/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2025

LIC9099 (FAS) - (06/04)

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