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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435202917
Report Date: 03/12/2025
Date Signed: 03/12/2025 03:55:19 PM

Document Has Been Signed on 03/12/2025 03:55 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:ELLIE REESE CARE HOME LLCFACILITY NUMBER:
435202917
ADMINISTRATOR/
DIRECTOR:		OVISO, PORTIAFACILITY TYPE:
735
ADDRESS:3175 SYLVAN DRTELEPHONE:
(408) 891-7016
CITY:SAN JOSESTATE: CAZIP CODE:
95148
CAPACITY: 6CENSUS: 6DATE:
03/12/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:15 PM
MET WITH:Portia Oviso, Administrator TIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On 03/12/2025 Licensing Program Analyst Marcela Yanez conducted an unannounced Case Management visit regarding an AWOL incident for a resident. LPA explained the purpose of the visit. LPA observed 3 residents 4 staff.

On March 7, 2025 the Department received an incident report, regarding resident R1. The incident report stated that on March 6/2025 at 6:20 PM, staff noted that the R1 was in the restroom and upon checking to see if R1 was done using the restroom and realized R1 was no longer in the bathroom. Staff immediately conducted a census of the facility to account for the whereabouts of R1. Staff went to look for resident for 1/2 a mile distance from the facility. R1 was located at the local 7 eleven store.

On 03/12/2025 LPA interviewed Administrator and 1 staff.


LPAs determined that the above incident requires further investigation. No deficiencies were cited at this time as per California Code of Regulations Title 22.

This report was reviewed with Administrator Portia Oviso and a copy of the report was provided.
SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Marcela Yanez
LICENSING EVALUATOR SIGNATURE: DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/12/2025
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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