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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 435200727
Report Date: 08/21/2026
Date Signed: 08/21/2026 11:13:27 AM

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
07/31/2026 and conducted by Evaluator Manuel Monter
COMPLAINT CONTROL NUMBER: 26-AS-20260731113322
FACILITY NAME:CARLTON PLAZA OF SAN JOSEFACILITY NUMBER:
435200727
ADMINISTRATOR:SHANTELA YADAOFACILITY TYPE:
740
ADDRESS:380 BRANHAM LANETELEPHONE:
(408) 972-1400
CITY:SAN JOSESTATE: CAZIP CODE:
95136
CAPACITY:183CENSUS: DATE:
08/21/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Administrator Shantela YadaoTIME COMPLETED:
11:20 AM
ALLEGATION(S):
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Staff did not follow infection control protocols.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Monter conducted an unannounced complaint inspection to deliver the findings on the above allegations. LPA met with Administrator Shantela Yadao.

On July 31, 2026, the Department received a complaint alleging Staff did not follow infection control protocols.

On August 04, 2026, Licensing Program Analyst Manuel Monter interviewed staff S1-S12. 12 Out of 12 staff (S1-S12) stated staff are following infection control protocols by: isolating covid positive residents, using PPE when interacting with covid positive residents, cleaning high traffic/common areas, and having hand sanitizer readily available in the dinning area and on each floor of the facility. S12 stated they placed PPE and a cart outside the covid positive apartments to don and doff their PPE after entering a covid positive resident bedroom. Page 1 Out of 3.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2026
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 3
Control Number 26-AS-20260731113322
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: CARLTON PLAZA OF SAN JOSE
FACILITY NUMBER: 435200727
VISIT DATE: 08/21/2026
NARRATIVE
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On August 4, 2026, Licensing Program Analyst Manuel Monter interviewed Administrator (ADM) Shatela Yadao. ADM stated for every resident that is covid positive, they have a station outside that residents bedroom with PPE for staff to use when entering said bedroom. ADM stated the facility’s nurses do their checks daily and testing as well. ADM stated they are testing the covid positive residents every 3 days. ADM stated they are quarantining the residents who are covid positive. ADM stated the facility is delivering meals to the covid positive residents.

ADM stated they have been cleaning/sanitizing high touch / traffic areas. ADM stated hand sanitizer is available for residents as well. ADM stated the facility recommends that residents who test positive for covid limit visitors during their quarantine period. ADM stated that if visitors must enter the apartment of a covid positive resident, they are instructed to use personal protective equipment (PPE). ADM stated that visitors of residents who are not covid positive are asked to reschedule their visit if they are feeling unwell. ADM reported that residents may otherwise visit with their guests as they choose. ADM stated that masks and hand sanitizer are available for anyone who requests them.

ADM stated that an email was sent to families notifying them that there are active COVID 19 cases in the facility. ADM she contacted the Department of Public Health for guidance. ADM stated the facility is following their infection control protocol.

On August 4, 2026, Licensing Program Analyst Manuel Monter interviewed Residents R1-R3. 3 Out of 3 residents (R1-R3) stated they have seen staff wearing masks and gloves. 3 Out of 3 residents (R1-R3) stated they have observed the facility providing hand sanitizer in each floor. 3 Out of 3 residents (R1-R3) stated they have observed the facility staff cleaning the high traffic / high touch areas. 3 Out of 3 residents (R1-R3) stated they do not have any concern regarding the facility’s response to covid.

On August 19, 2026, Licensing Program Analyst Manuel Monter interviewed residents R4-R8. 5 Out of 5 residents (R4-R8) stated they have observed facility staff cleaning high traffic areas, wearing masks and wearing gloves as well. 5 Out of 5 residents (R4-R8) stated they have also seen the facility place stations of PPE outside the rooms of residents who are covid positive. 5 Out of 5 residents (R4-R8) stated they have seen the facility providing hand sanitizer in the common areas of the facility including the dinning area.
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SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 26-AS-20260731113322
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: CARLTON PLAZA OF SAN JOSE
FACILITY NUMBER: 435200727
VISIT DATE: 08/21/2026
NARRATIVE
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On August 21, 2026, Licensing Program Analyst Manuel Monter interviewed staff S13-S16. 4 Out of 4 staff (S13-S16) stated staff are following infection control protocols which includes: isolating covid positive residents, using PPE when interacting with covid positive residents, cleaning high traffic/common areas, and having hand sanitizer readily available in the dinning area and on each floor of the facility.

On August 21, 2026, LPA interviewed ADM Shantela Yadao. ADM stated as of today, August 21, 2026, the facility does not have any residents who are Covid 19 Positive / showing symptoms.

On August 4, 2026, the Department received 2 incident report from the facility noting there was 5 residents who tested positive for Covid 19.

On August 7, 2026, the Department received an incident report noting there was an additional case of Covid 19 at the facility.

The Department reviewed the facility’s training records. On July 30 and 31, 2026, the facility conducted COVID/infection control and PPE training for staff.

The Department reviewed the facility's Infection Control Plan, dated July 8, 2026. The plan states the following procedures will be followed when there are one or more residents are diagnosed with a contagious disease. The procedures include the following but not limited to actions: Cleaning to maintain a safe and sanitary environment to prevent, contain and mitigate the transmission. Staff providing direct care to residents who has a contagious disease shall wear PPE to prevent exposure to infectious agents. The facility will consult with local health Department. The facility will provide additional training to staff regarding the specific contagious disease and infection control measures. Residents who are positive for the infectious disease will be quarantined.

The Department has completed the investigation of the above allegations. Based on interviews conducted and records review, the department has found that the above allegations were UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis.

Page 3 Out of 3. End of Report.
SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3