Medication handling and storage
Cited in 2 reports, with 3 deficiencies in total.
2575 FOREST AVENUE, San Jose CA 95117
6 bedsLatest official report May 19, 2026Licensed
The available records show 4 Type A and 9 Type B deficiencies for this facility.
No later report is available, so the records do not show what happened afterward.
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.
Counts cover the five-year public record. Typical figures are the median for the 185 Santa Clara County facilities licensed for 6 or fewer beds.
In the available public five-year record, CCLD published 6 reports for this facility: 6 inspections, 0 complaint investigations, and 0 licensing or administrative records.
Those records contain 4 Type A and 9 Type B deficiencies.
0 deficiencies have explicit official correction or clearance evidence in the loaded records.
More than the typical 5
1 in the last 12 months
Well above the typical 3
2 in the last 12 months
More than the typical 1
0 in the last 12 months
Well above the typical 2
2 in the last 12 months
Most this size also have none
0 in the last 12 months
Last 36 months
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.
Cited in 2 reports, with 3 deficiencies in total.
All preserved reports from the most recent to the oldest, sortable by report type.
87465(h)(6) The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained for at least one year... This requirement is not met as evidenced by: Based on record review, Licensee did not ensure 3 medications which were centrally stored had start dates or recorded on the Centrally Stored Medication Record which poses/posed a potential health, safety or personal rights risk to persons in care.
Administrator stated to submit a written plan of action understanding regulation and will ensure resident's centrally stored prescription medication are recorded on the Centrally Stored Medication log by POC due date. Administrator agreed and understood.
Deadline recorded: May 26, 2026. A deadline is not proof that correction was completed.
87203 All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. This requirement is not met as evidenced by: Based on observation, there is 1 fire extinguisher at the facility which was last inspected on 12/27/2024, which poses/posed a potential health, safety or personal rights risk to persons in care.
Administrator stated to submit a written plan of action understanding regulation and will ensure fire extinguisher is inspected or purchased new and placed at the facility by POC due date. Administrator agreed and understood.
Deadline recorded: May 26, 2026. A deadline is not proof that correction was completed.
87411 Personnel Requirements - General (c)(1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross. This requirement was not met as evidenced by: Based on record review and interview, S1's file did not contain first aid training on 5/2/2024 and S1 provides direct care to residents which poses/posed a potential health, safety or personal rights risk to persons in care.
Licensee/Administrator stated to submit a written plan of action understanding regulation and will ensure staff who provide care to residents receive first aid training before certification expires. The written plan is due by POC due date. Licensee/Administrator agreed and understood. During today's visit, LPA Rai observed S1's file contained first aid training which was conducted on 5/3/2024.
Deadline recorded: May 15, 2024. A deadline is not proof that correction was completed.
87412 Personnel Records (a)The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. This requirement was not met as evidenced by: Based on record review and interview, S2's file did not contain TB test results with the health screening and on 5/2/2024 staff file was incomplete at the facility which poses/posed a potential health, safety or personal rights risk to persons in care.
Licensee/Administrator stated to submit a written plan of action understanding regulation and will ensure staff files are maintained at the facility by POC due date. Licensee/Administrator agreed and understood. During today's visit, LPA Rai observed S2's file contained the TB test result.
Deadline recorded: May 15, 2024. A deadline is not proof that correction was completed.
87463 Reappraisals (a) The pre-admission appraisal shall be updated...The reappraisals shall document changes in the resident's physical, medical, mental, and social condition. This requirement was not met as evidenced by: Based on record review, 2 out of 2 resident files (R1-R2) did not contain Appraisal/Needs and Services Plan which poses/posed a potential health, safety or personal rights risk to persons in care.
Licensee/Administrator stated to submit a written plan of action understanding regulation and will ensure R1 and R2 have completed Appraisal/Needs and Services Plan in resident's file by POC due date. Licensee/Administrator agreed and understood.
Deadline recorded: May 15, 2024. A deadline is not proof that correction was completed.
87608 Postural Supports (a)(5)(A) A bed rail that extends from the head half the length of the bed and used only for assistance with mobility shall be allowed. This requirement is not met as evidenced by: Based on record review, 1 ouf of 2 resident files (R2) did not contain a physician's order to use half-bed rail for mobility and R2 is not receiving hospice services which poses/posed a potential health, safety or personal rights risk to persons in care.
Licensee/Administrator stated to submit a written plan of action understanding regulation and will ensure physician's order for half-bed rail is in R2's resident file by POC due date. Licensee/Administrator agreed and understood.
Deadline recorded: May 15, 2024. A deadline is not proof that correction was completed.
87465 Incidental Medical and Dental Care (h) (5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. This requirement was not met as evidenced by: Based on recored review, observation and interview,LPA Rai osberved a medication bottle containing two different types of medication different than the one on the bottle label which poses/posed an immediate Health, Safety, or Personal Rights risk to persons in care.
Licensee/Administrator stated to submit a written plan of action understanding regulation and will ensure medications are stored in its original container by POC due date. Licensee/Administrator agreed and understood.
Deadline recorded: May 9, 2024. A deadline is not proof that correction was completed.
87411 Personnel Requirements - General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This requirement is not met as evidenced by: Based on record review, interview and observation R1's 1 out of 3 meds not administered to R1 as prescribed by the MD and R2's 4 out of 4 meds were not administered to R2 as prescribed by the MD which poses an immediate Health, Safety, or Personal Rights risk to persons in care.
Licensee/Administrator stated to submit a written plan of action understanding regulation and will ensure staff receive medication training by POC due date. Licensee/Administrator agreed and understood.
Deadline recorded: May 9, 2024. A deadline is not proof that correction was completed.
87207 False Claims No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility. This requirement is not met as evidenced by: Based on record review, interview and observation, R1-R2 e MARs noted medications administered but LS stated R1 requested for PRN medication and R2 refused medication, which poses an immediate Health, Safety, or Personal Rights risk to persons in care.
Licensee/Administrator stated to submit a written plan of action understanding regulation and will ensure staff are trained in accurate record keeping which reflects the medication administed to the residents in care by POC due date. Licensee/Administrator agreed and understood.
Deadline recorded: May 9, 2024. A deadline is not proof that correction was completed.
87405 Administrator - Qualifications and Duties (d) The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7). If the licensee is also the administrator, all requirements for an administrator shall apply. This requirement is not met ad evidenced by: Based on interview, record review and observation, ADM did not adequate provide attention to the management & administration of the facility by conforming to the applicable laws, rules and regulations which poses/posed an immediate Health, Safety, or Personal Rights
Licensee/Administrator stated to submit a written plan of action understanding regulation by POC due date. Licensee/Administrator agreed and understood. (con't) risk to persons in care.
Deadline recorded: May 9, 2024. A deadline is not proof that correction was completed.
87465 Incidental Medical and Dental Care (h)(6)The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained for at least one year and includes. This requirement is not met as evidenced by: Based on interview and record review, R2's Centrally Stored Medication Record is not accurate as stated by Lead Staff (LS). LS stated R2's medication was started on 4/10/2024, when the log states 4/9/2024 which poses/posed a potential health, safety or personal rights risk to persons in care.
Licensee/Administrator stated to submit a written plan of action understanding regulation and will ensure Centrally Stored Medication Record is accurate and maintained for R2 by POC due date. Licensee/Administrator agreed and understood.
Deadline recorded: May 15, 2024. A deadline is not proof that correction was completed.
87465 Incidental Medical and Dental Care (b)If the resident's physician has stated in writing that the resident is able to determine and communicate his/her need for a prescription or nonprescription PRN medication... This requirement is not met as evidenced by: Based on record review, R2's physician has not stated in writing that the resident is able to determine and communicate his/her need for PRN medication which poses/posed a potential health, safety or personal rights risk to persons in care.
Licensee/Administrator stated to submit a written plan of action understanding regulation and will ensure resident file is complete with necessary documents from physician to administer PRN medication by POC due date. Licensee/Administrator agreed and understood.
Deadline recorded: May 15, 2024. A deadline is not proof that correction was completed.
87507 Admission Agreements (a) The licensee shall complete an individual written admission agreement, as defined in Section 87101(a), with each resident or the resident's representative, if any. This requirement is not met as evidenced by: Based on interview and record review, R2's file did contain an Admission Agreement but it was not for the current facility where R2 resides which poses/posed a potential health, safety or personal rights risk to persons in care.
Licensee/Administrator stated to submit a written plan of action understanding regulation and will ensure resident's Admission Agreement is accurate to where the resident is currently residing by POC due date. Licensee/Administrator agreed and understood.
Deadline recorded: May 15, 2024. A deadline is not proof that correction was completed.
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.
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