Senior Care Records.

Facility Evaluation Report

Jackson House III, Union City10/06/2022Licence 015600045

Capacity6
Census0
Date signed10/06/2022 03:42:46 PM
The inspector’s account

On 10/6/2022 at 2:45PM, Licensing Program Analysts (LPAs) G. Luk and K. Nguyen conducted an announced Case Management visit to inspection the facility after completion of repairs related to fire damages. LPAs met with Administrator, Evelyn Marquez-Uy.

LPAs observed no clients at the facility. LPAs toured the facility including but not limited to bedrooms, bathrooms, common areas, kitchen, garage, and outdoor areas. LPAs observed that the facility sketch does not match the current floor plan. Therefore, LPAs are requesting a new facility sketch from the licensee and administrator to be submitted by 10/13/2022. LPAs will request fire inspector to inspect the facility once new facility sketch is received.

No deficiencies are being cited on this date.

Exit interview conducted and a copy of this report provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction