MISSION DE LA CASA

2501 ALVIN AVENUE
SAN JOSE, CA, 95121
4082389751
CCN: 555487
2
Overall
1
Health
5
Staffing
5
Quality
Special FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
Ownership
NameRole%
NGUYEN, NGAI5% OR GREATER DIRECT OWNERSHIP INTEREST100%
NGUYEN, NGAICORPORATE DIRECTORNOT APPLICABLE
NGUYEN, NGAICORPORATE OFFICERNOT APPLICABLE
EVANS, JOYOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
GUPTA, ATINOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
HEDGER, JOSHOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
LUC, HAOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
LUCAS, ALETHEAOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
NGUYEN, ANHOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
NGUYEN, KYMOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
NGUYEN, NGAIOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
PEREZ, ANGELICAOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
RABARA, ROSANAOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
TSE, DANIELOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
VETSA, SUREKHAOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
EIETA, JULIEOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
AOAY, NORIEOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Penalties (1)
DateTypeAmount
2025-08-21Fine$52K
Health Deficiencies (35)
2025-08-21 · Health
D
F925 · Environmental Deficiencies
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
D
F908 · Environmental Deficiencies
Keep all essential equipment working safely.
K
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
F
F814 · Nutrition and Dietary Deficiencies
Dispose of garbage and refuse properly.
F
F813 · Nutrition and Dietary Deficiencies
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
F
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
F803 · Nutrition and Dietary Deficiencies
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
F
F802 · Nutrition and Dietary Deficiencies
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
F
F801 · Nutrition and Dietary Deficiencies
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
D
F800 · Nutrition and Dietary Deficiencies
Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.
D
F740 · Quality of Life and Care Deficiencies
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
E
F700 · Quality of Life and Care Deficiencies
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
E
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
E
F657 · Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
E
F656 · Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
D
F645 · Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
2024-06-27 · Health
F
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
F759 · Pharmacy Service Deficiencies
Ensure medication error rates are not 5 percent or greater.
D
F645 · Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
2024-04-18 · Health
G
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
2024-03-28 · Health
D
F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
2021-07-12 · Health
D
F881 · Infection Control Deficiencies
Implement a program that monitors antibiotic use.
E
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
D
F813 · Nutrition and Dietary Deficiencies
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
D
F801 · Nutrition and Dietary Deficiencies
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
D
F761 · Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
D
F698 · Quality of Life and Care Deficiencies
Provide safe, appropriate dialysis care/services for a resident who requires such services.
D
F690 · Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
D
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
F677 · Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
F658 · Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
D
F644 · Resident Assessment and Care Planning Deficiencies
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
D
F637 · Resident Assessment and Care Planning Deficiencies
Assess the resident when there is a significant change in condition
D
F558 · Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
D
F557 · Resident Rights Deficiencies
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day
4.45
3.68
RN Hrs/Resident/Day
0.67
0.54
LPN Hrs/Resident/Day
0.74
0.81
CNA Hrs/Resident/Day
3.05
2.33
PT Hrs/Resident/Day
0.07
0.12
Data as of 2026-03-01