Facility Evaluation Report

Licensing Program Analyst (LPAs) Marcela Yanez and Mita Partoza. Licensing Program Manager (LPM) Romeo Manzano conducted an unannounced Required 1 Year visit and met with Merclo Garcia Administrator, 3 staff-Bienvenido (Ben) and Ramiro Custodio (brothers), and Mary Wacheke and met with 5 residents (R1 to R5).

During inspection LPAs observed a total of 7 bedrooms (1 of which is the upstairs office converted into a room which is not being utilized as a staff bedroom). Based on physical floor plan submitted to the department and during initial application, there are only 2 bedrooms on the first floor (#1 & #2) and 2 bedrooms on second floor (bedroom#3 and caregiver bedroom (no designated number) adjacent to the second floor stairway next to the bathroom. A review of the approved 3 STD 850 dated on 11/7/13 and 11/18/2013 are approved for 2 ambulatory and 4 non-ambulatory and on 12/4/2013, fire clearance change from 2 ambulatory, 3 non-ambulatory and 1 bedridden clearance in bedroom #2 on 1st floor. An overall analysis of the facility fire clearance, the facility is currently approved for 2 Ambulatory and 3 Non-Ambulatory and 1 bedridden clearance (as it states #1 and #2 on first floors are either ambulatory and/or non-ambulatory) and Bedroom #3 is ambulatory only and an office on the second floor.

On 7/1/2024, Mr. Merclo Garcia was elected by the officers of the corporation the corporation as the new president/Administrator and Ramiro Custodio, a corporate member. Mr. Merclo stated that the former board members (Edralyn Lanzi and Rochelle Basco) stated that when they took over of the facility in 2013 from the previous licensee, the facility bedrooms already existed which is contrary to the submitted floor plan and fire clearances on file by Ms. Lanzi and Ms. Basco.

Mr. Garcia will contact the former board members for additional information about the facility physical floor plan including the landlord and to contact the San Jose Fire Marshal to obtain history and building permits of the facility property building.

The Department did not issue a citation on the discrepance of the fire clearance but advised to immediately contact SJFD and to submit a new fire clearance and updated new/updated floor plan request to CCLD before COB 11/1/2024. Page 1 of 3