Medication handling and storage
Cited in 2 reports, with 2 deficiencies in total.
BLOSSOM VALLEY CARE HOME, INC.
4387 SILVERBERRY DRIVE, San Jose CA 95136
6 bedsLatest official report Apr 3, 2026Licensed
Additional info
- Telephone
- (408) 489-9170
- Licensee
- BLOSSOM VALLEY CARE HOME, INC.
- Administrator
- RONNIE UBUNGEN
- Contact
- RONNIE UBUNGEN
- License first date
- Dec 7, 2007
- License effective date
- Dec 7, 2007
- District office
- SAN JOSE RO · (408) 324-2112
- Regional office
- 26
- Clients served
- 935 - ELDERLY
Summary
The available records show 2 Type A and 2 Type B deficiencies for this facility.
- Most recent inspection
- Jan 6, 2026
- Most recent deficiency
- Dec 23, 2025
2 later reports, from Jan 6, 2026 through Apr 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 185 Santa Clara County facilities licensed for 6 or fewer beds.
In the available public five-year record, CCLD published 9 reports for this facility: 5 inspections, 4 complaint investigations, and 0 licensing or administrative records.
Those records contain 2 Type A and 2 Type B deficiencies.
0 deficiencies have explicit official correction or clearance evidence in the loaded records.
- Official inspections
- 5
- Recorded deficiencies
- 4
- Type A deficiencies
- 2
- Type B deficiencies
- 2
- Substantiated complaints
- 1
- Repeated topics
- 1
About the same as most this size
2 in the last 12 months
More than the typical 3
2 in the last 12 months
More than the typical 1
2 in the last 12 months
About the same as most this size
0 in the last 12 months
Most this size 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
Facility condition and maintenanceType A
- Official classification
- Type A
- Official code
- 87303(e)(2)
- Regulation authority
- CCR
What the official deficiency says
87303 Maintenance and Operation (e) Water supplies and plumbing fixtures shall be maintained as follows: (2)Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C). This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by not maintaining the hot water temperature of not less than 105 deg F and not more than 120 deg F. Water temperature was measured with a digital thermometer at 140 deg F to 145 deg F for 2 bathroom and kitchen, which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 12/24/2025 Plan of Correction LIC and ADM stated that they will submit a written plan of correction to monitor the hot water temperature to ensure compliance with the regulation of 105 degree F to 120 degree F. LIC and ADM will submit written plan by the POC due date of 12/24/2025.
Plan of correction recorded
Correction not verified in available records
Medication handling and storageType A
- Official classification
- Type A
- Official code
- 87465(h)(2)
- Regulation authority
- CCR
What the official deficiency says
87465(h)(2) - Incidental Medical and Dental Care (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation the licensee did not comply with the section cited above by not ensuring medications for 3 residents were kept in a safe locked place that is not accessible to persons other authorized personnel. LPA observed 4 bottles of medication for 3 residents (R1 to R3) that were not locked in a safe secure place, which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 12/24/2025 Plan of Correction LIC and ADM stated that they will submit a written plan of correction to ensure that medication are kept in a safe secure place not accessible to persons other than authorized personnel or employees who are responsible for the supervision of the centrally stored medication. LIC and ADM stated the plan will be submitted to LPA by due date of 12/24/2025.
Plan of correction recorded
Correction not verified in available records
Inspection
Medication handling and storageType B
- Official classification
- Type B
- Official code
- 87465(h)
- Regulation authority
- CCR
What the official deficiency says
(h) The following requirements shall apply to medications which are centrally stored: 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 in that 2 Out of 3 resident files were observed not matched with their medications which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 12/13/2024 Plan of Correction Administrator stated to submit a plan of correction by the POC due date to ensure residents' centrally stored medication forms were well maintained, and to provide staff training for medications. Administrator agreed to submit the training log to CCL office.
Plan of correction recorded
Correction not verified in available records
Inspection
No deficiencies recorded in this report
Inspection
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