Inspection Reports for Bonnevie Residence And Care
555 A McLaughlin Avenue, San Jose, CA 95116, CA, 95116
Back to Facility ProfileInspection Report Summary
Most inspections at this facility were clean, with no deficiencies cited in several visits including the most recent on August 19, 2025. Some earlier reports identified deficiencies related to safety hazards such as an unsafe metal latch on an exit door posing immediate risk, incomplete emergency drill documentation, and medication record issues. A substantiated complaint in September 2024 resulted in a $500 civil penalty for a staff member working without required criminal background clearance and training. Other deficiencies involved resident rights and financial handling policies, but these were addressed promptly through plans of correction. The facility’s record shows improvement over time, with the latest inspections clearing previous issues and no new deficiencies noted.
Deficiencies (last 4 years)
Deficiencies (over 4 years)
4.5 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
13% worse than California average
California average: 4 deficiencies/yearDeficiencies per year
12
9
6
3
0
Census
Latest occupancy rate
67% occupied
Based on a August 2025 inspection.
This facility has shown a decline in demand based on occupancy rates.
Census over time
Inspection Report
Plan of Correction
Census: 4
Capacity: 6
Deficiencies: 1
Date: Aug 19, 2025
Visit Reason
Licensing Program Analyst Manuel Monter conducted a Plan of Correction (POC) case management visit to clear deficiencies cited on August 13, 2025, during an annual inspection visit and to amend the previous report with additional information and an additional deficiency.
Findings
No deficiencies were cited during the visit. The previously cited Type A deficiency related to Personal Rights of Residents was cleared following receipt and approval of the plan of correction by the due date.
Deficiencies (1)
Type A deficiency related to Personal Rights of Residents in All Facilities (a)(1) cited on August 13, 2025, cleared by POC due date August 14, 2025.
Report Facts
Deficiencies cited: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Merclo Garcia | Administrator | Met with during inspection and named in report review |
| Manuel Monter | Licensing Program Analyst | Conducted the Plan of Correction case management visit |
| Romeo Manzano | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Follow-Up
Census: 4
Capacity: 6
Deficiencies: 1
Date: Aug 13, 2025
Visit Reason
Licensing Program Analyst Manuel Monter conducted a Plan of Correction (POC) case management visit to clear deficiencies cited on August 8, 2025, during an annual inspection visit and to amend the previous report with an additional deficiency.
Findings
The facility was cited for a new deficiency involving a metal latch on the living room exit door that posed an immediate health, safety, and personal rights risk to residents. The latch was removed during the visit. Previous deficiencies cited on August 8, 2025, were cleared based on submitted plans of correction.
Deficiencies (1)
Metal latch observed on the door exiting the living room posing an immediate health, safety, and personal rights risk to residents.
Report Facts
Capacity: 6
Census: 4
Plan of Correction Due Date: Aug 14, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Merclo Garcia | Administrator | Facility administrator involved in removal of metal latch and discussion of deficiencies |
| Manuel Monter | Licensing Program Analyst | Conducted the Plan of Correction visit and authored the report |
| Romeo Manzano | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 3
Date: Aug 8, 2025
Visit Reason
The inspection was an unannounced annual inspection visit conducted to evaluate compliance with licensing requirements for Bonnevie Residence and Care Facility.
Findings
The inspection found a Type A deficiency related to an unsafe metal latch on an exit door posing an immediate risk, and two Type B deficiencies related to incomplete emergency drill documentation and incomplete centrally stored medication records for residents.
Deficiencies (3)
Presence of a 'hook & eye' metal latch outside the living room door obstructing an exit, posing an immediate health, safety or personal rights risk.
Failure to conduct and document quarterly emergency drills for each shift with varied emergency scenarios as required.
Incomplete centrally stored medication records for residents, lacking multiple medications and fill dates for 2025.
Report Facts
Facility capacity: 6
Resident census: 4
Plan of Correction Due Date: Aug 9, 2025
Plan of Correction Due Date: Aug 15, 2025
Number of staff reviewed: 3
Number of resident medication records reviewed: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mercelo Garcia | Administrator | Met during inspection and involved in removal of metal latch and plans of correction |
| Manuel Monter | Licensing Program Analyst | Conducted the inspection and authored the report |
| Romeo Manzano | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Complaint Investigation
Census: 4
Capacity: 6
Deficiencies: 1
Date: Aug 4, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by an allegation of financial abuse of a resident by staff at Bonnevie Residence and Care Facility.
Complaint Details
The complaint alleged financial abuse of a resident who gave $500 cash to a staff member to gamble at a casino. The investigation found the money was a loan repaid the next day. The resident felt pressured to give money and was told to buy food for others. The allegation was substantiated based on evidence including interviews and financial transaction reviews.
Findings
The investigation substantiated that a resident loaned money to a staff member without a written agreement outlining repayment terms, which is prohibited. The staff member accepted the loan and repaid it the next day. The facility lacked a written agreement regarding handling resident finances and loaning money, posing health, safety, and personal rights risks.
Deficiencies (1)
Failure to have a written agreement regarding handling resident's finances and loaning money from residents, violating HSC 1569.269(29)(E).
Report Facts
Capacity: 6
Census: 4
Deficiency count: 1
Plan of Correction Due Date: Aug 6, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Simranjit Rai | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Romeo Manzano | Licensing Program Manager | Oversaw the complaint investigation |
| Merclo Garcia | Licensee/Administrator | Facility administrator interviewed during investigation |
Inspection Report
Census: 4
Capacity: 6
Deficiencies: 0
Date: Apr 11, 2025
Visit Reason
The visit was an unannounced case management inspection conducted to amend a previously created report that was issued in error on 04/09/2025.
Findings
No deficiencies were cited during the visit based on California Code of Regulation (CCR) Title 22. The Licensing Program Analyst explained the correction to the Licensee/Administrator and conducted additional interviews with staff and residents.
Report Facts
Capacity: 6
Census: 4
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Merclo Garcia | Administrator / Director | Licensee/Administrator present during the visit and involved in discussion about the amended report |
| Maria Partoza | Licensing Program Analyst | Conducted the unannounced visit and interviews |
| Romeo Manzano | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Census: 4
Capacity: 6
Deficiencies: 0
Date: Apr 9, 2025
Visit Reason
An unannounced case management visit was conducted to follow up on Type A and Type B deficiencies cited on 10/31/2024 and to verify compliance with the fire clearance.
Findings
No deficiencies were cited during this visit. The facility was found to be in compliance with regulations including fire clearance, resident and staff records, and safety standards.
Report Facts
Food pantry non-perishable food supply: 7
Food pantry perishable food supply: 2
Water temperature: 119
Water temperature: 121
Fire clearance approval date: Mar 27, 2025
Disaster training date: Sep 21, 2024
Upcoming disaster training date: Apr 13, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Merclo Garcia | Administrator | Met with Licensing Program Analyst during inspection and discussed visit purpose |
| Maria Partoza | Licensing Program Analyst | Conducted the unannounced case management visit |
| Romeo Manzano | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Follow-Up
Census: 5
Capacity: 6
Deficiencies: 0
Date: Dec 19, 2024
Visit Reason
Unannounced case management visit to follow up on previously cited Type A and Type B deficiencies from 10/31/2024.
Findings
No deficiencies were cited during this visit. Observations included secure storage of sharps, chemicals, and medications, appropriate hot water temperature, clean windows and screens, and adequate food supply. Fire clearance is still pending further review.
Report Facts
Staff observed: 4
Residents observed: 4
Hot water temperature: 110.8
Perishable food supply: 2
Non-perishable food supply: 7
Administrator presence hours: 20
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Merclo Garcia | Administrator | Met with Licensing Program Analysts during visit and discussed facility operations |
| Marcela Yanez | Licensing Program Analyst | Conducted the inspection visit and observations |
| Simi Rai | Licensing Program Analyst | Conducted the inspection visit and discussed facility supervision requirements |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 9
Date: Oct 31, 2024
Visit Reason
The inspection was an unannounced required 1-year visit to evaluate compliance with licensing regulations and facility conditions.
Findings
The inspection identified multiple deficiencies including excessively high hot water temperatures, unlocked storage of toxic materials and medications, lack of resident appraisal and service plans, inadequate medication logs, insufficient food supplies, facility maintenance issues such as loose floorboards and unclean appliances, and improper destruction of medications for former residents. The facility was advised to submit plans of correction by specified due dates.
Deficiencies (9)
Hot water temperature in resident bathrooms measured above the allowed maximum (145.7°F, 130.1°F, 141.1°F).
Toxic materials such as car wax, cleaning supplies, lighter fluid, and garden fertilizer were accessible to residents in unlocked areas.
Residents did not have required appraisal needs and service plans in their files.
Medication logs for centrally stored prescription medications were incomplete; September 2024 refills for three residents were not documented.
Insufficient supplies of nonperishable and perishable foods were maintained on premises.
Facility was not clean or in good repair: loose floorboard, cobwebs, holes in window screens, greasy kitchen appliances, stained carpets, and dusty furniture.
Medication belonging to a former hospice resident was found unlocked and not properly destroyed.
Centrally stored medicines were found in an unlocked closet accessible to residents, posing immediate risk.
Residents' OTC medications were stored unlocked without proper physician orders or labels.
Report Facts
Hot water temperature: 145.7
Hot water temperature: 130.1
Hot water temperature: 141.1
Census: 5
Total capacity: 6
Food cans observed: 20
Fire extinguisher last inspection date: 202306
Fire and Earthquake drill last conducted: Jul 15, 2024
Number of residents without appraisal needs and service plans: 5
Number of residents with undocumented medication refills: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Ramiro Custodio | Administrator | Facility administrator named in relation to findings and plans of correction |
| Merclo Garcia | President/Administrator | Newly elected president/administrator involved in facility oversight and discussions of findings |
| Bienvenido Custodio | Facility representative who signed the report and discussed deficiencies | |
| Marcela Yanez | Licensing Program Analyst | Conducted inspection and signed report |
| Romeo Manzano | Licensing Program Manager | Supervised inspection and signed report |
Inspection Report
Complaint Investigation
Census: 4
Capacity: 6
Deficiencies: 0
Date: Sep 26, 2024
Visit Reason
Unannounced case management visit was conducted due to an incident involving the reported unknown death of a resident on 09/17/2024.
Complaint Details
Investigation was triggered by a complaint regarding an unknown death of a resident. The death report was found to be mistaken and not confirmed by the coroner's office.
Findings
The investigation revealed that the reported death was a mistake and not a coroner's report. The case management remains open for further investigation due to lack of information.
Report Facts
Census: 4
Total Capacity: 6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Ramiro Custodio | Administrator/Director | Met during the inspection and involved in follow-up on death report |
| Merclo Garcia | Met during the inspection | |
| Mita Partoza | Licensing Program Analyst | Conducted the unannounced case management visit |
| Romeo Manzano | Licensing Program Manager | Named in the report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 5
Capacity: 6
Deficiencies: 2
Date: Sep 15, 2024
Visit Reason
The visit was an unannounced case management deficiency inspection conducted to address issues related to staff fingerprint/criminal background clearance and training compliance at the facility.
Complaint Details
The visit was complaint-related, focusing on the lack of fingerprint/criminal record clearance and training for staff member S1. The deficiency was substantiated and a civil penalty was assessed.
Findings
The inspection found that one staff member (S1) was residing and providing care at the facility without the required fingerprint and criminal background clearance, and that this staff member had not received the required training for care and supervision of residents. A civil penalty of $500 was assessed for these deficiencies.
Deficiencies (2)
Failure to obtain California criminal background clearance for staff member residing and providing care at the facility.
Failure to provide initial and annual training to staff assisting residents with personal activities of daily living.
Report Facts
Civil penalty amount: 500
Staff count: 5
Plan of Correction due date: Type A deficiency due date 09/14/2024, Type B deficiency due date 09/27/2024.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Ramiro Custodio | Administrator/Director | Licensee named in relation to deficiencies and interview. |
| Merclo Garcia | Licensee | Licensee met during inspection and exit interview. |
| Maria Partoza | Licensing Program Analyst | Conducted the inspection and authored the report. |
| Marcella Tarin | Licensing Program Analyst | Participated in the inspection visit. |
Inspection Report
Census: 5
Capacity: 6
Deficiencies: 1
Date: Sep 13, 2024
Visit Reason
An unannounced case management deficiency visit was conducted to assess compliance with staff fingerprint and criminal background clearance requirements.
Findings
The facility was found to have a staff member residing on-site without the required fingerprint and criminal background clearance, and this staff member had not received required training for care and supervision of residents. A civil penalty was assessed for this violation.
Deficiencies (1)
Staff member residing at the facility without fingerprint and criminal background clearance.
Report Facts
Civil penalty amount: 500
Staff count: 5
Facility capacity: 6
Resident census: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Ramiro Custodio | Administrator | Met with inspectors and discussed staffing and compliance issues. |
| Merclo Garcia | Licensee | Met with inspectors and participated in exit interview. |
| Maria Partoza | Licensing Program Analyst | Conducted the inspection and issued the report. |
| Marcella Tarin | Licensing Program Analyst | Conducted the inspection. |
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 0
Date: Oct 7, 2022
Visit Reason
The inspection was an unannounced required 1-year visit to evaluate the facility's compliance with regulations.
Findings
The Licensing Program Analyst toured the facility and observed compliance with hygiene, food supply, and PPE requirements. No deficiencies were cited during this inspection.
Report Facts
Food supply: 2
Food supply: 7
PPE supply: 30
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Ramiro Custodio | Administrator | Met during inspection and reviewed report |
| David Marrufo | Licensing Program Analyst | Conducted the inspection |
| Sarah Yip | Licensing Program Manager | Named in report header |
Inspection Report
Complaint Investigation
Census: 6
Capacity: 6
Deficiencies: 0
Date: Oct 22, 2021
Visit Reason
An unannounced complaint investigation visit was conducted in response to an allegation that the facility was overcharging a resident.
Complaint Details
The complaint alleged that the facility was overcharging a resident. Interviews with three residents and staff indicated that charges were consistent and damages were paid at a reduced rate. The allegation was determined to be unsubstantiated due to lack of preponderance of evidence.
Findings
Based on interviews with residents, staff, and review of facility records, the allegation was found to be unsubstantiated. No deficiencies were cited during the visit.
Report Facts
Damages cost estimate: 7065
Damages paid: 6200
Resident census: 6
Facility capacity: 6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Anna Bui | Licensing Program Analyst | Conducted the complaint investigation visit |
| Ramiro Custodio | Administrator | Facility administrator involved in the investigation and exit interview |
| Sarah Yip | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
Date: Oct 15, 2021
Visit Reason
An unannounced annual required 1-year visit was conducted to evaluate the facility's compliance with licensing requirements.
Findings
No deficiencies were cited during the visit; however, an advisory note was issued recommending documentation of staff temperature checks and screening questions.
Report Facts
Facility capacity: 6
Resident census: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Ramiro Custodio | Administrator | Met with Licensing Program Analyst during the inspection and reviewed the report and advisory note |
| Anna Bui | Licensing Program Analyst | Conducted the inspection visit |
| Sarah Yip | Licensing Program Manager | Named in the report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 6
Capacity: 6
Deficiencies: 0
Date: May 11, 2021
Visit Reason
The inspection visit was conducted as a complaint investigation regarding an allegation that the facility was not operating at a comfortable temperature.
Complaint Details
The complaint alleged that the facility was not operating at a comfortable temperature. The investigation included interviews with residents and staff, observation of the thermostat set at 75 degrees Fahrenheit, and confirmation that the heater was repaired. The allegation was found to be unfounded.
Findings
The investigation found that the facility's temperature was within the acceptable range, portable heaters were available, and the heater had been repaired. The allegation was determined to be unfounded.
Report Facts
Facility capacity: 6
Census: 6
Temperature: 75
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Anna Bui | Licensing Program Analyst | Conducted the complaint investigation visit |
| Sarah Yip | Licensing Program Manager | Reviewed the complaint investigation report |
| Ramiro Custodio | Administrator | Facility representative interviewed and acknowledged the report |
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