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Facility Evaluation Report

Trinity RCF, INC.- Williams, San Jose07/15/2025Licence 435202373

Capacity6
Census6
Date signed07/15/2025 01:35:47 PM
Name of licensing program analystChihhsien Chang
Name of licensing program managerRomeo Manzano
The inspector’s account

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced case management visit and met with Administrator (ADM) Ini Uboh.

The purpose of today's visit is to deliver a notice to immediately remove staff S1 from the facility.

LPA observed a resident (R1) and 3 staff (S2, S3,S4) in the facility.

LPA read the "Criminal Record Exemption Needed" letter to Administrator that staff S1 cannot work or be present in a licensed facility unless a criminal record exemption is granted.

A "Criminal Record Exemption Needed" letter, a "CONFIRMATION OF REMOVAL" form for S1, and a "REFERENCE REQUEST" form for S1 were delivered to ADM.

ADM stated he/she will submit a updated LIC-500 to CCL office.

Exit interview was provided to ADM. The report was provided to ADM for review and signature. A copy of the report was provided to ADM.

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