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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435202775
Report Date: 07/16/2024
Date Signed: 07/16/2024 03:56:24 PM


Document Has Been Signed on 07/16/2024 03:56 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: 149DATE:
07/16/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Executive Director, Corey Miller TIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Simi Rai conducted a case management visit to do a wellness check after power was restored at the facility. LPA Rai met with Executive Director, Corey Miller and stated the purpose of the visit.

LPA Rai interviewed Maintenance Director (MD) Wesley McKinley. The power went back online on June 28th, 2024 and no issues to report. PG&E and City of San Jose has conducted inspections and the facility passed the inspections. The maintainence team will conduct weekly and monthly checks on the facility's generator and power grid.

LPA Rai toured the facility and observed the facility's electrical grid and observe the power generator was removed from the premise.

LPA Rai observed random resident rooms and observed the room temperature within range, functioning lights and fridge/freezer in working condition.

No deficiencies were cited at this time as per California Code of Regulations, Title 22.

This report was reviewed with Executive Director, Corey Miller and 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: 07/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/16/2024
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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