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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435202775
Report Date: 12/10/2021
Date Signed: 12/10/2021 02:48:57 PM

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:ATRIA ALMADENFACILITY NUMBER:
435202775
ADMINISTRATOR:WESLEY WHITTEMOREFACILITY TYPE:
740
ADDRESS:4610 ALMADEN EXPRESSWAYTELEPHONE:
(669) 258-4567
CITY:SAN JOSESTATE: CAZIP CODE:
95118
CAPACITY:240CENSUS: 72DATE:
12/10/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:26 PM
MET WITH:Wesley WhittemoreTIME COMPLETED:
03:00 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) David Marrufo conducted an unannounced Required 1 Year visit and met with Adminstrator Wesley Whittemore.

During visit, LPA Marrufo toured the facility inside and out. LPA Marrufo observed the facility visitor screening area that included symptom screening questions and temperature check. LPA Marrufo observed resident bathrooms had available soap and paper towels as well as hand washing posters. COVID-19 posters were observed throughout the facility hallways. LPA Marrufo observed a perishable food supply of at least 3 days and a non-perishable food supplies of at least 7 days. A PPE supply of at least 30 days was observed. LPA Marrufo observed the employee break room to have COVID-19 related posters.

LPA Marrufo toured the outside of the facility and observed the exits to be clear of obstructions.

No deficiencies were cited as per California Code of Regulations Title 22.

This report was reviewed with Administrator Wesley Whittemore and a copy of the report was provided.
SUPERVISOR'S NAME: Jackie JinTELEPHONE: (714) 319-3786
LICENSING EVALUATOR NAME: David MarrufoTELEPHONE: (650) 380-0519
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2021
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