Senior Care Records.

Facility Evaluation Report

Warner Home #1, San Jose06/04/2025Licence 435202774

Capacity6
Census6
Date signed06/04/2025 02:53:52 PM
Name of licensing program analystJohn Calandra
Name of licensing program managerAndrea Medlin
The inspector’s account

On 6/4/2025, Licensing Program Analyst(LPA) John Calandra arrived at the facility to conduct the 1-year required Annual Inspection. LPA Calandra was greeted by Elena Butaya, House Manager and explained the purpose of the visit. Licensee, Pam Sloan and Teresita Dela Pena, Lead Staff arrived later during the visit.

LPA Calandra toured the physical plant. This is a 1-story building with 3 bedrooms, 2 and a half bathrooms, a living room, dining room, kitchen, laundry room, garage, front and back yards, and office. All bedrooms had the required furniture and sufficient lighting. No accessible bodies of water or hazards were observed in hallways or the backyard. Hot water temperature was measured within the required 105-120 degrees Fahrenheit. The facility's fire alarms and Carbon Monoxide detector were observed to be in working order. The facility's first aid kit was observed to have all required items. The facility had the required 7 days of non perishables and 2 days of perishables on site. No food was expired. The facility was maintained at a comfortable temperature of 70 degrees Fahrenheit. The facility's fire extinguishers were observed to be fully charged.

All sharp objects, soap, detergents, and poisons were observed to be locked and in-accessible to persons in care.

LPA reviewed 5 resident files and 5 staff files. All were observed to be complete.

A review of Centrally stored medications indicated that medications for residents were properly labeled with instructions on dosage and times of day and matched the Centrally Stored Medication records kept at the facility.

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