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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435202780
Report Date: 01/17/2024
Date Signed: 01/17/2024 12:00:01 PM


Document Has Been Signed on 01/17/2024 12:00 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:SONNET HILLFACILITY NUMBER:
435202780
ADMINISTRATOR:LATU, JASMINEFACILITY TYPE:
740
ADDRESS:429 MERIDIAN AVETELEPHONE:
(408) 731-0019
CITY:SAN JOSESTATE: CAZIP CODE:
95126
CAPACITY:80CENSUS: DATE:
01/17/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Administrator Jasmine LatuTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Manuel Monter arrived to the facility unannounced to conduct a case management visit regarding an exception request for resident R1. LPA met with Administrator (ADM) Jasmine Latu. LPA explained the purpose of the visit.

LPA requested documents to process the exception request for Resident R1. The facility provided R1's physician report and needs & Services plan. S1 stated R1 is his/her own power of attorney. ADM stated the facility would send LPA a letter of support from R1.

ADM stated the reason for the delay was due to staff not being available because of the holidays. ADM also stated the delay was due to staff getting sick as well.

LPA advised ADM to collaborate with Community Care Licensing in the future, to process exception requests.

No deficiencies were cited per California Code of Regulations, Title 22. Advisory note provided. This report was reviewed with Administrator Jasmine Latu and a copy of the report was provided.
SUPERVISOR'S NAME: Romeo ManzanoTELEPHONE: (408) 388-2297
LICENSING EVALUATOR NAME: Manuel MonterTELEPHONE: (408) 324-2112
LICENSING EVALUATOR SIGNATURE:
DATE: 01/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/17/2024
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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