Sunnyvale Care Home II

Type of visit: Required - 1 Year

On 12/04/2025 at 3:30 PM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Team Lead, Mark Flancia, and explained the purpose of the visit. Mark phoned Licensee/Administrator, Isabelita Puruganan, to inform. Isabelita Puruganan arrived shortly at the facility. The facility’s fire clearance was approved for six (6) residents. In which all may be non-ambulatory. There is a approved hospice waiver for five (5) residents and one (1) bedridden in bedroom #3. Isabelita had to leave and gave Mark authorization to sign report. LPA toured facility with caregivers Mark and Judith Banaag including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of six (6) total bedrooms which five (5) bedrooms are occupied by the residents. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 75 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 110 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. LIC809-C Continued... LIC809-C (Page 2) Smoke and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 05/23/2025. Emergency Disaster Plan was not updated. First aid kit was observed to be complete. Emergency disaster drills were not updated. LPA reviewed five (5) residents records. LPA reviewed seven (7) staff records and 7 of 7 have current first aid training and associated to the facility. LPA reviewed a sample of resident’s medications. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 12/11/2025: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Current Administrator’s Certificates - Reviewed No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Dec 4, 2025

The state marks this report as 10 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 12/20/2024 at 12:10 AM, Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Isabelita Puruganan and explained the purpose of the visit. LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 74 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 109 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of non-perishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 05/29/2024. Emergency Disaster Plan was last posted on 10/30/2024. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 11/23/2024. LPA reviewed 5 residents records and 5 staff records; all were complete. LPA also reviewed a sample of resident’s medications.The following documents were reviewed during the visit:LIC 308 Designation of Administrative Responsibility ,LIC 500 Personnel Report, LIC 610E Emergency Disaster Plan,Liability Insurance, Current Administrator’s Certificate's renewal documents. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Dec 20, 2024

Type of visit: Required - 1 Year

On 01/17/2024 at 1:45PM, Licensing Program Analysts (LPAs) L. Alexander and T. Syess-Gibson arrived unannounced to conduct 1-Year Annual Required inspection. LPAs met with Administrator, Isabelita Puruganan and explained the purpose of the visit. The facility’s fire clearance was approved for capacity of 6 non-ambulatory. One (1) bedridden in room #3. Hospice waiver for five (5) residents. Administrator Certificate #6014623740 Expires 06/12/2024. LPAs toured facility with Isabelita including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 7 total bedrooms which 6 bedrooms are occupied by the residents and 1 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 75 degrees Fahrenheit. LPAs observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 109.9 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detector were in operating condition during visit. LIC809 Continued.... LIC809-C Continued... Fire extinguisher was last serviced on 05/26/2023. Emergency Disaster Plan was last posted on 11/29/2023. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 11/29/2023. LPAs reviewed 6 residents records. LPAs reviewed 5 staff records and 5 of 5 have current first aid training and associated to the facility. LPAs reviewed a sample of resident’s medications. Updated copies of the following documents were requested for facility file and are to be submitted to CCL 01/24/2024: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jan 17, 2024

The state marks this report as 4 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.