Administrator qualifications
Cited in 2 reports, with 2 deficiencies in total.
5836 ETTERSBERG DRIVE, San Jose CA 95123
6 bedsLatest official report Mar 10, 2026Licensed
The available records show 7 Type A deficiencies for this facility.
5 later reports, from Sep 30, 2024 through Mar 10, 2026, recorded no deficiencies, though the records do not say whether they were follow-ups.
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 11 reports for this facility: 7 inspections, 4 complaint investigations, and 0 licensing or administrative records.
Those records contain 7 Type A and 0 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
More than the typical 3
0 in the last 12 months
Well above the typical 1
0 in the last 12 months
Fewer than the typical 2
0 in the last 12 months
Most this size 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 2 deficiencies in total.
All preserved reports from the most recent to the oldest, sortable by report type.
87355 All individuals...pursuant to Health and Safety Code Section 1569.17(b) shall prior to working... in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department. This requirement is not met as evidenced by Based on interview Licensee/ADM stated that he hired a staff that does not have a fingerprint or criminal background clearance prior to working at the facility, which pose/poses an immediate health, safety and personal rights risk to residents in care.
Licensee/ADM stated that all staff prior to working at the facility have criminal background and fingerprint clearance prior to working at the facility. Licensee will have staff fingerprinted and ensure that residents are protected from any harm. Licensee/ADM will provide a written plan of action by POC due date. LIC/ADM agreed and understood.
Deadline recorded: Apr 29, 2024. A deadline is not proof that correction was completed.
87468.2 Additional Personal Rights of Residents in privately owned facilities (a)(4)To care, supervision...that meet their..needs and are delivered by staff that are sufficient in qualifications...This requirement is not met as evidenced by: Based on interview and observation, Licensee/ADM did not provide care & supervision to residents by leaving the resident unattended and with a person who is a minor, which pose/poses an immediate health, safety and personal rights risk to persons in care.
Licensee/ADM stated that staff will have sufficient qualification to provide care & supervision that meets the needs of the persons in care, by providing training and guidance to staff. Licensee/ADM will provide a written plan of action by POC due date. LIC/ADM agreed and understood.
Deadline recorded: Apr 29, 2024. A deadline is not proof that correction was completed.
87705 Care of Person with dementia. (f) The following shall be stored inaccessible to residents with dementia: (1) Knives...(2)Over-the counter medication... supplements... toxics... such as... cleaning supplies...This requirement was not met as evidenced by: Based on observation, Licensee/ADM did not ensure that toxics, medications & knives located in the kitchen and three bathroom sink cabinets are inaccessible to persons with dementia, which pose/poses an immediate health, safety and personal right risk to persons in care.
Licensee/ADM stated to ensure that cleaning supplies and knives are locked at all times to ensure the safety of persons in care. Licensee/ADM will submit a written plan of action by the POC due date. Licensee/ADM agreed and understood.
Deadline recorded: Apr 29, 2024. A deadline is not proof that correction was completed.
87465 Incidental Medical and Dental Care Services (h)(2) Centrally stored medications shall be kept in a safe locked place that is not accessible to persons other than employees responsible for the supervision of the medication. This requirement is not met as evidenced by: Based on observation Licensee/ADM did not lock the upper kitchen cabinet and resident's prescription medication were accessible, which pose/poses an immediate health, safety and personal risks to persons in care.
Licensee/ADM stated that prescription and over-the counter medications is not accessible to persons in care. Licensee/ADM will submit a written plan of action by the POC due date. Licensee/ADM agreed and understood.
Deadline recorded: Apr 29, 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 as evidenced by: Based on observation, interview & record review, Licensee/ADM did not provide, care and supervision, did not ensure knives,toxics and medication are inaccessible to residents with dementia, and did not ensure staff has obtained a California criminal record clearance before providing direct care
LIcensee/ADM stated that a letter of understanding regarding Title 22 regulation by POC due date. Licensee/ADM agreed and undestood. (con't) to residents, which pose/poses an immediate health, safety and personal risks to persons in care. *87405(d)(1-7)
Deadline recorded: Apr 29, 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.
Read the data methodology