Fire safety and emergency preparedness
Cited in 2 reports, with 2 deficiencies in total.
ANDREA'S ELDERLY CARE FACILITY 1
804 HAMANN DRIVE, San Jose CA 95117
12 bedsLatest official report Feb 3, 2026Licensed
Additional info
- Telephone
- (408) 490-4758
- Licensee
- GIRON ROQUE ELDERLY CARE SERVICES, INC.
- Administrator
- VALLE, CATHERINE
- Contact
- VALLE, CATHERINE
- License first date
- Feb 14, 2023
- License effective date
- Feb 14, 2023
- District office
- SAN JOSE RO · (408) 324-2112
- Regional office
- 26
- Clients served
- 935 - ELDERLY, 983 - RCFE / DEMENTIA, 985 - RCFE / HOSPICE
Summary
The available records show 1 Type A and 4 Type B deficiencies for this facility.
- Most recent inspection
- Feb 3, 2026
- Most recent deficiency
- Jan 23, 2026
1 later report, on Feb 3, 2026, recorded no deficiencies, though the records do not say whether they were follow-ups.
What Type A and Type B mean
- Type A
- Violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
- Type B
- Violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care.
Both classifications are published by California CDSS and are shown as published. SeniorLivingFacts does not rename them or add a severity level of its own.
At a glance
Counts cover the five-year public record. Typical figures are the median for the 11 Santa Clara County facilities licensed for 7 to 15 beds, except where too few exist to state one — those come from facilities with 7 or more beds.
In the available public five-year record, CCLD published 6 reports for this facility: 4 inspections, 0 complaint investigations, and 2 licensing or administrative records.
Those records contain 1 Type A and 4 Type B deficiencies.
0 deficiencies have explicit official correction or clearance evidence in the loaded records.
- Official inspections
- 4
- Recorded deficiencies
- 5
- Type A deficiencies
- 1
- Type B deficiencies
- 4
- Substantiated complaints
- 0
- Repeated topics
- 1
Fewer than the typical 8
2 in the last 12 months
More than the typical 3
3 in the last 12 months
Fewer than the typical 2
1 in the last 12 months
More than the typical 1
2 in the last 12 months
Most this size also have none
0 in the last 12 months
Last 36 months
Repeated topics
Topics cited in more than one report during the last 36 months. A repeat may show a pattern worth asking about. Each date opens its report below.
Official report history
All preserved reports from the most recent to the oldest, sortable by report type.
Inspection
No deficiencies recorded in this report
Inspection
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 87412(a)
- Regulation authority
- CCR
What the official deficiency says
87412 Personnel Records (a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee...This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above, 1 out of 3 staff did not have the staff record at the facility, the designated administrator (DADM) stated that he/she took the file home to make a copy and did not return the record to the facility, which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 02/03/2026 Plan of Correction LIC & DADM stated that he/she will ensure that records will be maintained at the facility at all times and will send proof of correction by 02/03/2026.
Plan of correction recorded
Correction not verified in available records
Medical and dental careType B
- Official classification
- Type B
- Official code
- 87465(a)(6)
- Regulation authority
- CCR
What the official deficiency says
87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following: (6)When requested by the prescribing physician or the Department, a record of dosages of medications which are centrally stored shall be maintained by the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review of 4 Out of 4 resident records the licensee did not comply with the section cited above by not ensuring that the centrally stored medication record are maintained by the facility. LIC/ DADM stated that he/she takes the record home to get updated and is not available at the facility when requested by the LPA during inspection, which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 02/03/2026 Plan of Correction LIC & DADM staed that centrally stored medication record will be maintained at the facility and available for when requested by the prescribing physician and the Department. LIC & DADM stated that he/she will submit a plan of correction in writing and proof of correction by the correction due date of 02/03/2026 to LPA.
Plan of correction recorded
Correction not verified in available records
Fire safety and emergency preparednessType A
- Official classification
- Type A
- Official code
- 1569.695(c)
- Regulation authority
- HSC
What the official deficiency says
§1569.695 Emergency Plans (c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of residents is not required during a drill. While a facility may provide an opportunity for residents to participate in a drill, it shall not require any resident participation. Documentation of the drills shall include the date, the type of emergency covered by the drill, and the names of staff participating in the drill. This requirement is not met as evidenced by: Deficient Practice Statement This requirement is not met as evidenced by: Based on record review the license did not comply with the section cited above by not ensuring that quarterly drills for each shift and type of emergency is conducted. During today's record review the last emergency training was conducted on February 10, 2025 which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 01/24/2026 Plan of Correction Licensee (LIC) & Designated Administrator (DADM) will submit a written plan of correction by the POC due date when training will be conducted. lLIC & DADM stated that he/she will conduct the first quarter training by January 24, 2026 and will send proof of training to LPA by January 26, 2026.
Plan of correction recorded
Correction not verified in available records
Inspection
No deficiencies recorded in this report
Inspection
Basic services and supervisionType B
- Official classification
- Type B
- Official code
- 87466
- Regulation authority
- CCR
What the official deficiency says
The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs. When changes such as unusual weight gains or losses or deterioration of mental ability or a physical health condition are observed, the licensee shall ensure that such changes are documented and brought to the attention of the resident's physician and the resident's responsible person, if any. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review and interview, the licensee did not comply with the section cited above. LPA observed R1 and R3 did not have a weight record. Resident R2 is missing two months of weight record documentation. This poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 02/21/2024 Plan of Correction ADM stated she will send plan of action on how the facility will ensure residents changes of weight are observed. ADM stated she will create a weight record log and will send plan of action by POC date, 02/21/2024.
Plan of correction recorded
Correction not verified in available records
Fire safety and emergency preparednessType B
- Official classification
- Type B
- Official code
- 1569.695(c)
- Regulation authority
- HSC
What the official deficiency says
(c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of residents is not required during a drill. While a facility may provide an opportunity for residents to participate in a drill, it shall not require any resident participation. Documentation of the drills shall include the date, the type of emergency covered by the drill, and the names of staff participating in the drill. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review and interview, the licensee did not comply with the section cited above. LN stated the facility does conduct drills but did not document the drills. This poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 02/21/2024 Plan of Correction ADM stated she will create a disaster drill log. ADM stated she will send documentation to LPA that a drill has taken place by POC. ADM stated she will send plan of corrections by POC date, 02/21/2024.
Plan of correction recorded
Correction not verified in available records
Licensing recordNot an inspection of the operating facility
No deficiencies recorded in this report
Licensing recordNot an inspection of the operating facility
No deficiencies recorded in this report
Source and limits
California Department of Social Services, Community Care Licensing Division. Public facility history is described by the source as a five-year window. Older records and previous-licensee history may require a regional-office request. Type 741 RCFE-CCRCs, nursing homes, and other care settings are excluded from this page.
Read the data methodology