Senior Care Records.

Facility Evaluation Report

Twelveacres Bucknall Home, San Jose05/21/2024Licence 435201889

Capacity6
Census4
Date signed05/21/2024 04:45:26 PM
The inspector’s account

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required 1 Year visit and met with Elizabeth Macharia.

During visit, LPA Marrufo toured the facility inside and out. LPA Marrufo toured the facility kitchen area and observed there to be locked drawers and storage areas for sharps and cleaning supplies. The facility first aid kit was inspected and found to be complete. LPA Marrufo observed the food supplies in the kitchen and food storage areas and found there to be a perishable food supply of at least two days and a non-perishable food supply of at least 7 days.

LPA toured two out of two resident bathrooms and found the water temperatures to be 110 F. Each bathroom had working lights and available soap and paper towels.

LPA Marrufo toured three out of three bedrooms. Each bedroom had functioning lights and beds with available bedding and clothing storage areas. LPA Marrufo tested the smoke detectors in each bedroom, in the hallway, and in the living room areas and found each smoke detector to function properly when tested. The carbon monoxide detector functioned properly when tested.

LPA toured the outside area and found the outdoor exits to be clear of obstructions. The Emergency Disaster Drill Log states the last drill was conducted on 04/19/2024.

LPA Marrufo reviewed resident and staff records during visit.

No deficiencies were cited at this time as per California Code of Regulations Title 22. This report was reviewed with Elizabeth Macharia and a copy of this report was provided.

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