Senior Care Records.

Facility Evaluation Report

Sangha House, San Bruno07/29/2025Licence 419210116

Capacity4
Census4
Date signed07/29/2025 03:40:41 PM
Name of licensing program analystMurial Han
Name of licensing program managerApril Cowan
The inspector’s account

On July 29, 2025, Licensing Program Analyst(LPA) Murial Han conducted an unannounced annual inspection. LPA was greeted by the administrator, Sally DeLa Cueva and explained the purpose of today's visit.

LPA toured facility and grounds. No accessible bodies of water or fire safety hazards observed. LPA toured the facility inside and outside including all of resident rooms, common areas, and kitchen area. The indoor and outdoor passageways were free of obstruction. Facility was overall clean and odor-free. Comfortable temperature is maintained and lighting is sufficient for comfort.

LPA observed four private resident rooms. Rooms were spacious and included all required furnishings. Two full bathrooms were observed to be clean and in operating condition. Hot water temperature was measured at 110 degrees F.

LPA observed medications, toxins and sharps to be locked and inaccessible to residents in care. 2 days for perishables and & 7 days non-perishable were observed to be present.

A review of (4) resident files was conducted and noted on the LIC 858.

A review of (3) staff files was conducted and noted on the LIC 859.

Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties.

This report is reviewed and discussed with the administrator. A copy is provided.

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