Senior Care Records.

Facility Evaluation Report

Madison House LLC, the, San Jose06/19/2025Licence 435202796

Capacity6
Census5
Date signed06/19/2025 12:02:37 PM
Name of licensing program analystMarcela Yanez
Name of licensing program managerRomeo Manzano
The inspector’s account

Licensing Program Analyst (LPA) Marcela Yanez conducted an unannounced case management-other visit to conduct a change of ownership (Chow) insoection. LPA met with Ying Wang, Administrator (ADM) and Designated Administrator Tina Liu and announced the purpose of the visit. LPA observed 3 staff and 5 residents.

LPA observed Resident (R1) to have full bed rails and no exception on file. R1 moved into facility on 03/29/25. R1 has doctors order on file for full bed rails. Licensee did not submit an exception request for full bed rails to the department.

A deficiency was issued per California Code of Regulations Title 22. See LIC809D. An exit interview was conducted with designated administrator Tina Liu due to ADM had previous appointment, and a copy of this report was provided and appeal rights were provided.

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