Senior Care Records.

Facility Evaluation Report

Belmont Village Los Gatos, San Jose07/11/2025Licence 435202856

Capacity175
Census130
Date signed07/11/2025 11:55:11 AM
Name of licensing program analystDavid Marrufo
Name of licensing program managerMaria Partoza
The inspector’s account

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Case Management - Incident visit and met with Administrator (ADM) Radhika Martinez. The purpose of the visit was to respond to an Unusual Incident/Injury Report (IR) submitted to the department by the facility on 07/03/2025. The IR stated that on 07/01/2025, a visitor who is a family member of both residents R1 and R2 reported to staff that R1 grabbed R2's hand, resulting in R2's hand being scratched. R1 and R2 are married to one another. The IR states that staff separated R1 and R2 and provided first aid care to R2. The IR stated R1 will begin programming in the Memory Care unit and will be prescribed anti-anxiety medications.

During visit, LPA Marrufo reviewed the Physician's Reports of R1 and R2. R1 and R2's Physicians Reports both state that neither have sundowning or wandering behaviors. R1's Physician's Report indicates R1 has a diagnosis of Mild Cognitive Impairment and R2 has a dementia diagnosis.

R1's Service Plan was updated on 07/02/2025 to include programming in Day Programming.

During visit, LPA Marrufo interviewed ADM. ADM stated that both R1 and R2 will visit their physician today and be prescribed anti-anxiety medications. The physician may also update R1's Physician's Report to include a dementia diagnosis. During visit, LPA Marrufo conducted a wellness check on both R1 and R2.

No deficiencies were cited at this time as per California Code of Regulations, Title 22. This report was reviewed with Administrator Radhika Martinez and a copy of this report was provided.

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