Inspection
No deficiencies recorded in this report
ST. ANNE'S HOME FOR ELDERLY
790 LAKEBIRD DRIVE, Sunnyvale CA 94089
6 bedsLatest official report Jul 29, 2026Licensed
Additional info
- Telephone
- (408) 744-1752
- Licensee
- BANAAG, MELINDA M.
- Administrator
- BANAAG M., MANALO MAYLENE
- Contact
- BANAAG M., MANALO MAYLENE
- License first date
- Jul 28, 2006
- License effective date
- Jul 28, 2006
- District office
- SAN JOSE RO · (408) 324-2112
- Regional office
- 26
- Clients served
- 935 - ELDERLY
Summary
The available records show 1 Type A and 5 Type B deficiencies for this facility.
- Most recent inspection
- Jul 29, 2026
- Most recent deficiency
- Jul 22, 2025
1 later report, on Jul 29, 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 5 reports for this facility: 4 inspections, 0 complaint investigations, and 1 licensing or administrative record.
Those records contain 1 Type A and 5 Type B deficiencies.
0 deficiencies have explicit official correction or clearance evidence in the loaded records.
- Official inspections
- 4
- Recorded deficiencies
- 6
- Type A deficiencies
- 1
- Type B deficiencies
- 5
- Substantiated complaints
- 0
- Repeated topics
- 0
Fewer than the typical 5
1 in the last 12 months
More than the typical 3
0 in the last 12 months
About the same as most this size
0 in the last 12 months
More than the typical 2
0 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.
No topic repeats in the last 36 months
No deficiency topic appears in more than one report during that window. This does not establish that nothing repeated earlier in the five-year record, and it is not a statement about current conditions.
Official report history
All preserved reports from the most recent to the oldest, sortable by report type.
Licensing recordNot an inspection of the operating facility
No deficiencies recorded in this report
Inspection
Admission, assessment, and evictionType B
- Official classification
- Type B
- Official code
- 87204(b)
- Regulation authority
- CCR
What the official deficiency says
(b) Resident rooms approved for 24-hour care of ambulatory residents only shall not accommodate nonambulatory residents. Residents whose condition becomes nonambulatory shall not remain in rooms restricted to ambulatory residents. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, and record review, the licensee did not ensure that 2 of 5 non-ambulatory residents (R4 and R5) were living in rooms (Room #5 and Room #2 respectively) that had approved non-ambulatory fire clearance, which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 07/29/2025 Plan of Correction The licensee stated they will apply for non-ambulatory fire clearance for Room #2 for R5 and will contact R4's physician to get correct ambulatory status for R4 and will submit the evidence of approved/denied fire clearance and R4's correct ambulatory status to CCLD by 07/29/2025.
Plan of correction recorded
Correction not verified in available records
Admission, assessment, and evictionType B
- Official classification
- Type B
- Official code
- 87463(h)
- Regulation authority
- CCR
What the official deficiency says
(h) The licensee shall request that all residents receive an annual routine visit with a licensed medical professional once every twelve months, either in person or by video appointment. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, and record review, the licensee did not ensure that 3 of 5 residents (R1-R3) received an annual routine visit with their physician, either is person or video appointment, which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 07/29/2025 Plan of Correction The licensee stated they will contact the physicians of these three Residents (R1-R3) to schedule annual visit and will submit the evidence of their appointment and physician reports to CCLD by 07/29/2025.
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 observation, interview and record review, the Licensee did not ensure that the Emergency Disaster Drills logs are conducted quarterly at the facility, which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 07/29/2025 Plan of Correction The Licensee stated they will conduct Emergency disaster drills once every quarter and will submit a evidence of latest drill conducted to CCLD by 07/29/2025.
Plan of correction recorded
Correction not verified in available records
Medication handling and storageType A
- Official classification
- Type A
- Official code
- 87465(h)(6)(C)
- Regulation authority
- CCR
What the official deficiency says
87465 Incidental Medical and Dental Care (h) The following requirements shall apply to medications which are centrally stored: (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: (C) The drug name, strength and quantity. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, and record review, the Administrator did not ensure that a medication ‘Atorvastatin 80MG’ that was administered to 1 of 5 residents (R1)’s was entered in the Centrally Stored Medication Records, which poses/posed an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 07/23/2025 Plan of Correction The Licensee stated that they will review R1's medications, update Centrally Stored Medication Record for R1, and submit the evidence of corrected Centrally Stored Medication Record to CCLD by 07/23/2025.
Plan of correction recorded
Correction not verified in available records
Inspection
Medical and dental careType B
- Official classification
- Type B
- Official code
- 87465(e)(1)
- Regulation authority
- CCR
What the official deficiency says
87465 Incidental Medical and Dental Care: e) For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician, on a prescription blank, maintained in the residents file, and a label on the medication. Both the physician's order and the label shall contain at least all of the following information. (1) The specific symptoms which indicate the need for the use of the medication. (2) The exact dosage. (3) The minimum number of hours between doses. (4) The maximum number of doses allowed in each 24-hour period. This requirement is not met as evidenced by: Deficient Practice Statement *Amended on 08/01/2024 to provide more detail to the Deficient Practice Statement * Based on record review, the licensee did not comply with the section cited above in 2 out of 4 Centrally Stored Medication and Destruction Records, which poses a potential health risk to persons in care.
Official plan of correction
POC Due Date: 07/09/2024 Plan of Correction Licensee agrees to audit all resident Centrally Stored Medication and Destruction Record and ensure that all prescription and nonprescription PRN medications have been entered into each resident's Centrally Stored Medication and Destruction Record and then submit a statement of completion by POC date to CCL.
Plan of correction recorded
Correction not verified in available records
Records and plan of operationType B
- Official classification
- Type B
- Official code
- 87506(b)(16)
- Regulation authority
- CCR
What the official deficiency says
87506 Resident Records (b) Each resident’s record shall contain at least the following information: (16) Records of resident's cash resources as specified in Section 87217, Safeguards for Resident Cash, Personal Property, and Valuables. This requirement is not met as evidenced by: Deficient Practice Statement Based on records review, the licensee did not comply with the section cited above in 2 out of 5 resident records which were missing the Safeguard for Property and Valuables form, which poses/posed a potential personal rights risk to persons in care.
Official plan of correction
POC Due Date: 07/09/2024 Plan of Correction Licensee agrees to submit copies of the Safeguard for Property and Valuables form for the two residents who were misisng those forms to CCL by POC date.
Plan of correction recorded
Correction not verified in available records
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