Senior Care Records.

Facility Evaluation Report

Gretchen Residential Care Home, INC., San Jose10/28/2024Licence 435202942

Capacity6
Census4
Date signed10/28/2024 02:11:18 PM
The inspector’s account

Facility Type: Residential Care Facility for the Elderly (RCFE)

Application Type: Change in Ownership (CHOW)

COMP II Participants: Daisy Estoesta, Administrator/Applicant

On October 28, 2024 at 1:00 PM, Applicant/Administrator participated in COMP II. Identification of the Applicant/Administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, Applicant/Administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained.

During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas:

1. Facility Operation: License type, client/resident populations, and program.

4. Restrictive/Prohibited Health Conditions

Exit interview conducted with Applicant. Report sent via email and informed to return sign copy to CAB by end business day.

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