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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435202775
Report Date: 01/09/2024
Date Signed: 01/09/2024 04:53:26 PM


Document Has Been Signed on 01/09/2024 04:53 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:WATERMARK AT ALMADEN, THEFACILITY NUMBER:
435202775
ADMINISTRATOR:RONALD ELLENICHFACILITY TYPE:
740
ADDRESS:4610 ALMADEN EXPRESSWAYTELEPHONE:
(669) 258-4567
CITY:SAN JOSESTATE: CAZIP CODE:
95118
CAPACITY:240CENSUS: 118DATE:
01/09/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Interim Executive Director, Brenda RitterTIME COMPLETED:
04:50 PM
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Licensing Program Analyst (LPA) Simi Rai arrived unannounced to conduct an annual visit and met with Interim Executive Director (IED) Brenda Ritter.

During visit, LPA toured the inside and outside of the facility. LPA observed a back-up generator placed on the side of the facility which is in use during visit and will be used until the generator on the premise is under repair. LPA observed the facilty common rooms and resident room temperatures to be noted at 70-74 degrees Fahrenheit. While the facility is using the back-up generator, the facility will submit daily updates of the facilty and any changes occurring during this time.

The facility common bathrooms had available soap, paper towels, and trash cans with lids. The showers had grab bars and textured floors with shower chairs. Fire extinguisher were observed and were inspected on March 2023. LPA inspected 8 random rooms and occupied resident rooms had available bedding, drawers, and functioning lights.

LPA will return another day to complete annual inspection.

This report was reviewed with Interim Executive Director (IED) Brenda Ritter. 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: 01/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/09/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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