Senior Care Records.

Facility Evaluation Report

Blossom Valley Care Home, INC., San Jose01/06/2026Licence 435294278

Capacity6
Census6
Date signed01/06/2026 04:56:02 PM
Name of licensing program analystMaria Partoza
Name of licensing program managerRomeo Manzano
The inspector’s account

Licensing Program Analyst (LPA) Maria (Mita) Partoza conducted an unannounced Plan of Correction (POC) visit and met with Licensee/ADM Ronnie Ubungen

During POC visit, LPA verified the water temperature and secure medications based on the written plan of action that facility has provided to CCLD on 12/23/2025.

LPA advised ADM to continue to monitor water temperature and monitor staff that they are securing medications after passing and administering prescription medication to residents.

POC reviewed and cleared the Type A deficiency cited on 12/23/2025 under California Code of Regulation (CCR) Title 22 87303(e)(2) and 87465(h)(2) on site and provided a copy of POC Clearance Letter to administrator Ronnie Ubungen.

No deficiency cited during today's inspection. Exit interview conducted with administrator Ronnie Ubungen and a copy of the report was provided.

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