Senior Care Records.

Facility Evaluation Report

Evonne's Residential Care Home #1, San Jose06/29/2023Licence 435202392

Capacity6
Census5
Date signed06/29/2023 11:40:59 AM
The inspector’s account

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Case Management visit and met with Philomena Agbontaen. The purpose of the visit was to observe the new bedroom that was added to the facility bed capacity.

During visit, LPA Marrufo observed the new bedroom. The bedroom had working lighting, a smoke detector, functioning window blinds, and electrical outlets and cable connections on the walls.

LPA Marrufo toured the other 5 resident bedrooms and observed them to have beds, lighting, and smoke detectors.

No deficiencies were cited at this time as per California Code of Regulations Title 22.

This report was reviewed with Philomena Agbontaen and a copy of the report was provided.

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