Senior Care Records.

Facility Evaluation Report

North Star Residential Care Home, San Jose09/08/2023Licence 435202760

Capacity6
Date signed09/08/2023 03:34:12 PM
The inspector’s account

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced annual inspection visit, and met with Administrator (ADM) Arlene Lira.

LPA toured the facility inside out which included; the Living room, kitchen, dinning room, activity room, two bathrooms, laundry area and 4 residents bedrooms. Front yard and backyard were inspected. There was no obstruction to block the walkways.

Two day perishable food supplies and seven day nonperishable food supplies were observed. LPA observed the locked medication cabinet, locked knives drawer, and cleaning product storage area as locked and inaccessible to residents in care. Room temperature was at 77 degree F, and hot water temperature was measured to range from 108 F to 110 F in the facility restrooms.

Fire extinguisher was serviced in September 7 2023. The facility has smoke and carbon monoxide detectors. Smoke detectors was tested by facility staff, and were functional. LPA observed facility first aid kit and facility fire/earthquake drill log. The facility's last fire drill was conducted on 09/04/2023 and the last earthquake drill was conducted on 09/05/2023.

LPA reviewed facility records for 2 staff and 2 residents. LPA reviewed 2 resident medications and centrally stored medication records. LPA reviewed two residents P & I money. LPA conducted interviews with 2 staff (S1 to S2) and 2 residents (R1-R2).

No deficiencies cited during today's visit. This report was reviewed with Administrator Arlene Lira and a copy of the signed report was provided.

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