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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435201251
Report Date: 05/03/2022
Date Signed: 05/03/2022 04:22:38 PM


Document Has Been Signed on 05/03/2022 04:22 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
CCLD Regional Office, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131



FACILITY NAME:PRONTO CARE HOMEFACILITY NUMBER:
435201251
ADMINISTRATOR:DIANA NATIVIDADFACILITY TYPE:
740
ADDRESS:771 PRONTO DRIVETELEPHONE:
(408) 226-9838
CITY:SAN JOSESTATE: CAZIP CODE:
95123
CAPACITY:6CENSUS: 6DATE:
05/03/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:DIANA NATIVIDADTIME COMPLETED:
03:59 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) Steve Chang conducted an unannounced annual inspection visit, and met with Administrator (ADM) DIANA NATIVIDAD.

LPA toured the facility inside out with ADM. No COVID posters were observed at main entrance and in the facility. ADM stated the facility will put the COVID posters on at the main door and in facility in 3 days. Screening station was too small to hold all the masks, hand sanitizer, glove, thermometer and visitor log book at the main entrance. ADM stated the facility will put a bigger table as the screening station at the main entrance in 3 days. Kitchen, family room, dinning area and two restrooms were inspected. Some trash cans were observed without covers. ADM stated the facility will change all the trash cans with covers in 3 days. NO washing hands for 20 seconds posters were observed by the sinks. ADM statted the facility will put the washing hands for 20 second posters on in 3 days. Paper towels were observed with holder. Two single resident bedrooms, 2 shared resident bedrooms, and 1 staff live-in bedroom, and laundry area were inspected. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. Medication closet, knives closet, and cleaning product closet were observed locked. Room temperature was at 72 degree F, and hot water temperature was at 110 degree F in facility. Six residents and 2 staff were observed in facility.

Fire extinguisher was serviced on 04/01/2022. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Smoke detectors was tested by ADM, and were working fine. Front yard and backyard were inspected. There was no obstruction to block the walkways.

ADM stated all the residents and staff are fully vaccinated. No citation were noted today. Exit interview was conducted with ADM. This report was provided to ADM for signature.
SUPERVISOR'S NAME: Romeo ManzanoTELEPHONE: (408) 324-2112
LICENSING EVALUATOR NAME: Chihhsien ChangTELEPHONE: (408) 904-9843
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2022
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