Senior Care Records.

Facility Evaluation Report

Jackson House III, Union City08/24/2023Licence 015600045

Capacity6
Census4
Date signed08/24/2023 04:40:54 PM
The inspector’s account

On this day at around 2 PM, Licensing Program Analyst (LPA) Luisa Fontanilla arrived unannounced to conduct annual required inspection and met with staff Mary Grace Rentoria. Administrator Evelyn Uy was not available but was informed about the visit by telephone.

The facility is a Level 4 home vendored by the Regional Center of the East Bay (RCEB). The facility has an approved fire clearance for all ambulatory clients only.

LPA inspected the facility inside and out including but not limited to client rooms, dining area, bathrooms, kitchen and backyard. Hot water in the kitchen measured at 120 degrees Fahrenheit.

The following deficiencies were observed:

both passageways were observed with empty boxes, garbage bins and wood planks

refrigerators were observed with food spills and freezer with strong odor

refrigerator temperature in the garage was observed at 79.9 degrees Fahrenheit

chain saw observed unlocked in the backyard

Deficiencies are cited per Title 22 California Code of Regulations (refer to Lic 809D).

Exit interview was conducted and Appeal Rights was provided to Rentoria.

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