Facility Evaluation Report

Success RCF 1, San Jose09/25/2025Licence 435202567

Capacity32
Date signed09/25/2025 12:13:44 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 Required 1 Year visit and met with Rejoice Amas, Designated Administrator (DAM). LPA announced the purpose of the visit.

During visit, LPA toured the facility inside and out and pantry area with food storage and laundry area as well as dining area. The facility grounds are maintained. LPA observed a shaded area for residents to use.

LPA observed the kitchen area and observed locked cabinets for medications, sharp objects, and cleaning supplies. LPA observed perishable food supply of at least two days and a non-perishable food supply of at least seven days.

LPA toured 11 resident bedrooms. Each bedroom had available bedding and clothing storage areas as well as functioning lights. ADM tested the smoke detector and found the smoke detector to function properly when tested. LPA toured 4 resident bathrooms. Each bathroom had available soap and paper towels and functioning lights. At 10:15 AM water temperature measured at 130 degrees F. During visit the bathroom sink water was lowered and water temperature regulated between 105-120 degrees F

LPA toured the outside area and found the exits to be clear of obstructions. LPA observed fire extinguisher was last serviced on 05/27/25 and Facility Pull Fire alarm was last serviced on 09/24/25. LPA reviewed Fire and Earthquake log. Last disaster drill conducted on 09/18/25

LPA reviewed resident records for 5 residents including P&I and Centrally Stored Medication. LPA reviewed 3 staff records.

No deficiency were cited as per California Code of Regulations Title 22. This report was reviewed with DAM Rejoice Amas and a copy of this report and appeal rights were provided.

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