Senior Care Records.

Facility Evaluation Report

Evergreen Guest Home #2, San Jose10/16/2024Licence 430707505

Capacity6
Census6
Date signed10/16/2024 03:12:47 PM
The inspector’s account

Licensing Program Analyst (LPA) Manuel Monter arrived unannounced to conduct a case management to amend a complaint investigation LIC9099 and LIC9099-C issued on September 28, 2024

LPA explained the purpose of the visit. The complaint (26-AS-20230310144550) is being amended to add additional information and change the findings from UNFOUNDED to UNSUBSTANTIATED.

LPA met with Administrator Evelyn Canonizado. ADM stated she had a prior appointment and stated she could not stay at the facility. ADM stated Staff S1, Robert Foronda, could sign on her behalf.

No deficiencies cited. A copy of the report was provided to Staff, Robert Foronda.

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