Senior Care Records.

Facility Evaluation Report

Park Avenue Adult Residential Facilities, San Jose06/23/2026Licence 430707097

Capacity12
Census10
Date signed06/23/2026 05:02:48 PM
Name of licensing program analystDavid Marrufo
Name of licensing program managerChristine Kabariti
The inspector’s account

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Case Management visit and met with Administrator (ADM) Cecilia Eustaquio. While conducting a complaint investigation visit, LPA Marrufo observed that there are two facility staff who are not background cleared.

During visit, LPA Marrufo observed a staff bedroom in the house located at 1992 Park Avenue. LPA Marrufo asked staff S1 who was living in the staff bedroom. S1 stated S2 lives there.

LPA Marrufo interviewed ADM, who stated S2 has been working at the facility since 06/02/2025. ADM stated S2 helps clean, cook, and care for the residents.

LPA Marrufo observed that S3 was present at the facility during visit. S3 stated to have begun working at the facility since 06/21/2026. LPA Marrufo observed S3 to be cooking and cleaning in the kitchen. LPA Marrufo interviewed S3, who stated he/she provides care to residents, including by getting them items that they request and helping them back up if they fall. LPA Marrufo observed that S2 and S3 are not listed on the Guardian Employee Roster. LPA Marrufo confirmed that S2 is not background cleared. ADM stated during interview that she has not submitted a background clearance for S3.

A deficiency has been cited as per California Code of Regulations Title 22. See LIC809-D page for more information. Two immediate civil penalties have been issued due to staff not being background cleared. One penalty is $500 and the other is $300, totaling $800. See LIC421BG for more information. This report was reviewed with ADM Cecilia Eustaquio and a copy of this report and appeal rights were provided.

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