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Assisted Living

Evonne's Residential Care Home #1

2719 Penitencia Creek Rd., San Jose, CA 951327 bedsLicensed & Active
Source: CA CCLD — view official record

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Evonne's Residential Care Home #1 Assisted Living in San Jose, CA — Street View
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State Inspection History

State Inspections

Source: CA Community Care Licensing Division

9total
7deficiencies
3 Type A— immediate health risk
4 Type B— non-compliance
Feb 25, 2026Routine

The unannounced annual inspection revealed multiple significant deficiencies across medication management and resident record-keeping. Specifically, deficiencies were cited regarding unsecured medications, failure to update resident Needs and Services Plans, and incomplete central medication records. All cited deficiencies were classified as Type A, indicating an immediate risk to the health, safety, or personal rights of the residents in care.

Type A87465(h)(2)

The facility failed to keep centrally stored medications in a safe and locked place inaccessible to unauthorized persons. An unsecured half orange tablet was observed on the kitchen table.

Type A87463(a)

The facility failed to update resident Needs and Services Plans as required. Three out of three residents had plans that were not updated.

Type A87465(h)(6)

The facility failed to maintain records of centrally stored prescription medications for all residents. Three out of three residents had medications not listed on their centrally stored medication record.

Sep 12, 2025Other
CleanReport

The facility underwent an unannounced Case Management visit. The Licensing Program Analyst observed the facility and interviewed residents and the Administrator. All interviewed residents stated they like living at the facility and reported no recent changes or complaints. No deficiencies were cited in the provided report.

Jul 31, 2025Other
CleanReport

The facility underwent an office visit on July 31, 2025. The visit involved discussions regarding the property's sale and the potential for the licensee to add her daughter to the license for business loan purposes. No deficiencies were cited during this visit.

Feb 14, 2025Other

The facility underwent an unannounced Required 1 Year visit. The inspection noted several positive observations regarding facility safety and resident care areas. However, one deficiency was cited concerning the maintenance of complete personnel records for staff members.

Type B87412(a)

The licensee must ensure personnel records are maintained for the licensee, administrator, and each employee. This requirement was not met due to incomplete staff files missing required documents.

Dec 4, 2024Complaint
CleanReport

The facility underwent an unannounced collateral visit conducted to deliver a complaint. The report explicitly states that no deficiencies were cited at this time, according to the California Code of Regulations Title 22.

Apr 24, 2024Follow-up
CleanReport

The facility underwent an unannounced Case Management visit to verify a change in capacity. The Licensing Program Analyst met with the Administrator and noted that no deficiencies were cited during the visit.

Feb 14, 2024Routine

The unannounced annual inspection revealed several areas of non-compliance. Deficiencies were noted regarding the maintenance of resident weight records, the frequency of emergency drills, and the timely updating of medical assessments for residents with dementia. All cited deficiencies were classified as Type B, indicating non-compliance rather than an immediate health risk.

Type B87303(a)

The facility did not maintain a weight record log for residents as requested by the inspector. This poses a potential health, safety, or personal rights risk to persons in care.

Type B1569.695(c)

The facility's last fire/earthquake drill was on September 2, 2023, which does not meet the requirement for quarterly drills. This poses a potential health, safety, or personal rights risk to persons in care.

Type B87705(c)(5)

The facility failed to provide an annual medical assessment or reappraisal for a resident with dementia (R1), as the last report was dated September 6, 2022. This poses a potential health, safety, or personal rights risk to persons in care.

Jun 29, 2023Follow-up
CleanReport

The facility underwent an unannounced Case Management visit to observe a newly added bedroom. The inspector noted that the new bedroom, along with the other five resident bedrooms, appeared to have working lighting, smoke detectors, and functioning blinds. No deficiencies were cited at this time.

Ownership & Operations

Who Operates This Facility

Owner / Operator

Philomena Agbontaen

Administrator

PHILOMENA AGBONTAEN

Source: State licensing data

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References & Resources

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