Senior Care Records.

Facility Evaluation Report

Evergreen Home Living, San Jose09/15/2021Licence 435202663

Capacity6
Census3
Date signed09/15/2021 03:42:39 PM
The inspector’s account

Licensing Program Analyst (LPA) Steve Nguyen conducted an inspection of facility with Administrator Sashi Kumar. LPA observed the windows and wall from one of the bedroom to be broken. LPA advised Licensee and Administrator that the window and wall needs to be fixed. Licensee acknowledged and confirmed understanding. Licensee gave the fix date as 9/20/2021 and will provide Department with pictures and/ or pictures with receipts upon completion.

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