Senior Care Records.

Facility Evaluation Report

Belmont Village San Jose, San Jose06/25/2025Licence 435202350

Capacity150
Census117
Date signed06/25/2025 03:19:12 PM
Name of licensing program analystGrace Donato
Name of licensing program managerJackie Jin
The inspector’s account

On 6/25/2025, LPA Grace Donato made an unannounced annual visit to the facility. LPA met with Administrator, Rachel Brown. LPA explained the purpose of the visit.

LPA toured the facility including a random sample of resident rooms, common areas, activity rooms and kitchen area. LPA observed some residents were at different activity rooms. While touring the facility it was observed that the temperature was at 74 deg F. Hot water was also tested in the resident rooms and the temperature was at 110 deg F. All personal belongings are intact inside residents rooms. Facility has sprinkler system. All fire extinguishers have been checked and current. Resident bedrooms and bathrooms were observed to be in good repair equipped with grab bars and non-skid floors. Resident call buttons were checked and functioning. There is adequate amount of food, 2 days for perishables and & 7 days non-perishable. Emergency drills are done every month.

Five resident records and five staff records were reviewed. Resident records are updated, complete and signed. Staff records are complete, with training logs. Medication review was done, and all medications are accounted for, and centrally stored medication records are updated.

LPA received the following documents, LIC610D and copy of Administrator Certificate.

No deficiencies are cited at this time. Report is reviewed and a copy is provided.

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