Senior Care Records.

Facility Evaluation Report

Sacred Haven Care Home INC., Gilroy03/23/2024Licence 435202241

Capacity6
Census5
Date signed03/23/2024 12:02:24 PM
The inspector’s account

At 9:00 a.m. of 3/23/2024, Licensing Program Analyst (LPA) Maria (Mita) Partoza arrived at the facility and conducted an unannounced required 1 year inspection and met with administrator/house manager (HM) Alma Buclatin, administrator (ADM) Edna Oribello was not available during the time of visit per HM, ADM was on scheduled time off.

ADM/HM stated they have 5 residents in the facility and 3 staff.

At 9:05 a.m. LPA toured the facility to include the dining room, kitchen, living room, resident bedrooms, bathrooms, garage, and backyard. All fire exits and passageways were free and clear of obstruction. All staff present and live-in staff are fingerprint cleared and associated to the facility.

Facility's kitchen equipped with clean plates, cups, bowls, utensils, and cooking supplies. Sharp objects observed locked. Disinfectants and chemicals stored in a separate area away from the food. Hot water temperature is within range of 105 to 120 degree F. Facility's refrigerator and freezer is equipped with thermometer and temperature is maintained at 38 degree F and 0 degree F respectively. LPA observed the facility's reusable containers were covered with lids and properly labeled. Facility has at least seven days worth of non-perishable foods and two days worth of perishables foods. The bathroom hot water temperature measured between 105 to 120 degree F.

Facility temperature maintained between 68 to 71 degree F. Bedrooms supplied with proper linens and furniture to include beds, dressers, night stands, and lamps. Bathrooms supplied with hygiene products and hand washing sign.

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