01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-08-21 | 16 | 2025-08-21 | 5 |
| Cycle 2 | 2024-06-27 | 3 | 2024-06-27 | 4 |
| Cycle 3 | 2021-07-12 | 16 | 2021-07-12 | 4 |
CMS CCN 5554872026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Mission De La Casa
2501 Alvin Avenue · San Jose, CA 95121 · Santa Clara County
Certified beds163CMS provider file
Recent citation rows48current CMS citation release
Penalty rows1current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
48 rows in the current release
2 rows carry G–L scope/severity codes; 1 carry J–L. 8 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-08-21 · HEALTHF0645Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
Correction field: Deficient, Provider has date of correction · 2025-09-162025-08-21 · HEALTHF0656Severity E · pattern; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2025-09-162025-08-21 · HEALTHF0657Severity E · pattern; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2025-09-162025-08-21 · HEALTHF0684Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2025-09-162025-08-21 · HEALTHF0700Severity E · pattern; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2025-09-162025-08-21 · HEALTHF0740Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
Correction field: Deficient, Provider has date of correction · 2025-09-162025-08-21 · HEALTHF0800Severity D · isolated; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2025-09-162025-08-21 · HEALTHF0801Severity F · widespread; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2025-09-162025-08-21 · HEALTHF0802Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
Correction field: Deficient, Provider has date of correction · 2025-09-162025-08-21 · HEALTHF0803Severity D · isolated; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2025-09-162025-08-21 · HEALTHF0812Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2025-09-162025-08-21 · HEALTHF0813Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
Correction field: Deficient, Provider has date of correction · 2025-09-162025-08-21 · HEALTHF0814Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Dispose of garbage and refuse properly.
Correction field: Deficient, Provider has date of correction · 2025-09-162025-08-21 · HEALTHF0880Severity K · pattern of immediate jeopardy
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2025-09-162025-08-21 · HEALTHF0908Severity D · isolated; potential for more than minimal harm
Environmental Deficiencies
Keep all essential equipment working safely.
Correction field: Deficient, Provider has date of correction · 2025-09-162025-08-21 · HEALTHF0925Severity D · isolated; potential for more than minimal harm
Environmental Deficiencies
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Correction field: Deficient, Provider has date of correction · 2025-09-162025-08-21 · FIREK0321Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Correction field: Deficient, Provider has date of correction · 2025-09-112025-08-21 · FIREK0324Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2025-09-112025-08-21 · FIREK0345Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2025-09-112025-08-21 · FIREK0355Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Properly select, install, inspect, or maintain portable fire extinguishes.
Correction field: Deficient, Provider has date of correction · 2025-09-112025-08-21 · FIREK0753Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
Have restrictions on the use of highly flammable decorations.
Correction field: Deficient, Provider has date of correction · 2025-09-112024-06-27 · HEALTHF0645Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
Correction field: Deficient, Provider has date of correction · 2024-07-262024-06-27 · HEALTHF0759Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure medication error rates are not 5 percent or greater.
Correction field: Deficient, Provider has date of correction · 2024-07-262024-06-27 · HEALTHF0812Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2024-07-2603 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| 2025-08-21 | Fine | $51,753 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- NGUYEN, NGAIIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 10/27/1999
- NGUYEN, NGAIIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/27/1999
- NGUYEN, NGAIIndividual · CORPORATE OFFICERNOT APPLICABLE · since 10/27/1999
- AOAY, NORIEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/03/2024
- EIETA, JULIEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/01/2017
- EVANS, JOYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/14/2025
- GUPTA, ATINIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 09/30/2024
- HEDGER, JOSHIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/17/2017
- LUC, HAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/16/2020
- LUCAS, ALETHEAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/08/2023
- NGUYEN, ANHIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2007
- NGUYEN, KYMIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/01/2018
- NGUYEN, NGAIIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/27/1999
- PEREZ, ANGELICAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/16/2025
- RABARA, ROSANAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/01/2018
- TSE, DANIELIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/01/2002
- VETSA, SUREKHAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/01/2020
- AOAY, NORIEIndividual · ADP OF THE SNFNOT APPLICABLE · since 06/03/2024
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours3.95per resident day
RN hours0.68per resident day
Weekend nurse hours3.65per resident day
Staff turnover16.7%CMS reported field
06 / LOCAL RECORDS
Open the San Jose ledger →Other published facilities nearby
A Grace Sub Acute & Skilled Care166 beds · CMS overall 4/580 citation rowsAlmaden Health And Rehabilitation Center77 beds · CMS overall 4/577 citation rowsCanyon Springs Post-Acute199 beds · CMS overall 4/5109 citation rowsCourtyard Care Center76 beds · CMS overall 3/574 citation rowsCreekside Post-Acute130 beds · CMS overall 5/572 citation rowsEmpress Care Center, Llc67 beds · CMS overall 4/568 citation rowsHerman Health Care Center99 beds · CMS overall 1/5107 citation rowsInspire Behavioral Health116 beds · CMS overall 2/567 citation rows