<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435201057
Report Date: 07/27/2024
Date Signed: 07/27/2024 05:37:01 PM


Document Has Been Signed on 07/27/2024 05:37 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131



FACILITY NAME:SARATOGA RETIREMENT COMMUNITYFACILITY NUMBER:
435201057
ADMINISTRATOR:SARAH STELFACILITY TYPE:
741
ADDRESS:14500 FRUITVALE AVENUETELEPHONE:
(408) 741-7100
CITY:SARATOGASTATE: CAZIP CODE:
95070
CAPACITY:418CENSUS: 290DATE:
07/27/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Administrator, Sarah Stel and Health Care Administrator, Sangeetha Narasimhan TIME COMPLETED:
05:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Simi Rai conducted an unannounced Required 1 Year visit. LPA met with Administrator (ADM) Sarah Stel and Health Care Administrator, Sangeetha Narasimhan stated the purpose of today's visit.

During visit, LPA Rai toured the inside and outside of the facility to include the assisted living unit and memory care unit. When touring the outside area of the facility, the exits were cleared of obstruction. LPA Rai toured the facility kitchen and observed food supply of at least 2 days of perishable food and at least 7 days of nonperishable food. LPA Rai observed the temperature of the freezer at 0 degrees F and the temperature of the fridge at 37 degrees F.

LPA Rai randomly toured resident bedrooms and they had available bedding, drawers, and functioning lights. The facility bathrooms had available soap, paper towels, and trash cans with lids. The water temperature in the bathroom sinks ranged from 110.9 degrees F - 116.6 degrees F.

Fire extinguisher was observed and inspected on 09/14/2023. Facility is equipped with interconnected smoke detectors and carbon monoxide detectors.The last disaster drill was conducted on 06/14/2024 and 04/17/2024.

LPA Rai reviewed facility records for 10 staff and 10 residents. LPA Rai reviewed at random resident current medications and central stored medication records.

No deficiencies were cited per California Code of Regulations, Title 22. This report was reviewed with Administrator (ADM) Sarah Stel and Health Care Administrator, Sangeetha Narasimhan a copy of the report was provided.
SUPERVISOR'S NAME: Romeo ManzanoTELEPHONE: (650) 388-2297
LICENSING EVALUATOR NAME: Simranjit RaiTELEPHONE: (408) 324-2112
LICENSING EVALUATOR SIGNATURE:
DATE: 07/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/27/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1