Senior Care Records.

Facility Evaluation Report

Sunrise Home, San Jose06/20/2025Licence 435200234

Capacity6
Census6
Date signed06/20/2025 03:16:42 PM
Name of licensing program analystManuel Monter
Name of licensing program managerRomeo Manzano
The inspector’s account

Licensing Program Analyst Manuel Monter conducted an unannounced Case Management-Incident visit, regarding an incident report for the resident R1. LPA met with ADM Christia Vasquez.. LPA explained the purpose of the visit.

On June 20, 2025, the Department received an incident report for the resident R1. This incident Report stated the following " On Thursday around 4:30pm Sunrise staff noticed abrasions on the left side of R1's face; forehead, nose and above his/her lip. Upon body check they also noted a small abrasion on R1's right knee and redness on his/her left knee. Staff asked R1's 1on1 staff what happened to R1. The 1 on 1 staff said he did not know. R1 arrived home from day program at 1:36 pm and was received by Sunrise staff and no fall or any incidents from MITC day program were reported upon drop off. Staff did not observe any abrasions on R1's face when he/she took R1's hat off upon arrival and helped R1 to his/her chair. Staff stayed in the living room until R1's 1 on 1 arrived at 2pm. While R1 and R1's private care giver were outside in the patio area Sunrise staff noticed the abrasions on R1’s face and informed house manager, who went to check on R1. Staff asked the 1 on 1 care giver what happened to R1 and he/she said he/she doesn’t know. Staff asked the private care giver if R1 fell and he/she said no, he/she doesn’t know what happened. Basic first aid was rendered to R1."

LPA interviewed ADM and 1 staff member. ADM provided LPA with R1's IPP and physicians report.

LPA determined this event requires further investigation.

This report was reviewed with ADM Christia Vasquez. A copy of the report was provided.

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