Senior Care Records.

Facility Evaluation Report

California Residential Facility, San Jose01/16/2025Licence 435202081

Capacity6
Census6
Date signed01/16/2025 09:38:23 AM
The inspector’s account

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced annual inspection visit, and met with Administrator Sashi Lata Kumar (ADM). During the visit, LPA observed 0 residents and 2 staff. LPA explained the purpose of the visit.

LPA toured the facility inside out with ADM which included the Living room, kitchen, dining room, 3 restrooms and 3 residents bedrooms. The staff area of the facility was also inspected. The front yard and backyard were inspected. There was no obstruction to block the walkways.

Two-day perishable food supplies and seven day nonperishable food supplies were observed. LPA observed the medication storage area, knives storage area, and cleaning product storage area as locked and inaccessible to residents in care. Room temperature was at 70 degrees F, and hot water temperature was measured at 112 degrees F in both resident bathrooms.

Fire extinguisher was serviced in February 13, 2024. The facility was equipped with smoke and carbon monoxide detectors. Smoke detectors was tested by ADM, and were functional. LPA observed facility first aid kit and facility fire/earthquake drill log. The facility's last drill was on November 18, 2024.

LPA reviewed facility records for 3 staff and 3 residents. LPA reviewed 3 resident medications and centrally stored medication records. Residents were attending day program during LPA's visit.

No deficiencies cited during today's visit. This report was reviewed with Administrator Sashi Lata Kumar and a copy of the signed report was provided.

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