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ICF/DD-N (Nursing)License activeMedi-Cal certified

TUPAZ HOME #9

ICF/DD-N (Nursing) · 6 licensed beds · San Jose, CA

Homes of 4–15 beds for medically fragile people with developmental disabilities who need intermittent skilled nursing.

Address

TUPAZ HOME #91602 ORCHARD VIEW DRSan Jose, CA 95124 · Santa Clara County

Phone: (408) 448-5411

Facility details

CDPH listing, data as of Oct 16, 2026
Facility type
ICF/DD-N (Nursing)
Licensed beds
6
Licensee
TUPAZ HOMES LLC · Limited Liability Company
Administrator
SISANTE, BEVERLY G
CDPH facility ID
070000726
License number
070000302
First licensed
January 13, 1992
Current license
Jan 1, 2026 to Dec 31, 2026
CDPH district office
San Jose

Federal certification (CMS)

CMS Provider of Services file
CMS Certification Number (CCN)
55G754
Status in CDPH's listing
Licensed And Certified
Program
Medi-Cal (Medicaid, Title XIX)
Participating since
June 19, 2017
Last certification survey
December 11, 2025
CMS certification status
Certified
In compliance (CMS)
No
Last certification action
Recertification
Ownership type (CMS)
Private (proprietary)
Certified beds (CMS)
6
Staffing reported to CMS
RN 0.25 · LVN/LPN 1.5 · direct care 8.25 · all employees 10.75

State citations and penalties (CDPH)

6 penalties, newest first

CDPH issues citations under Health and Safety Code §1424: Class AA (a violation that was a substantial factor in a resident's death), Class A (imminent danger or a substantial probability of death or serious harm) and Class B (a direct relationship to residents' health, safety or security). State citations explained

  • Class BPatient Care

    Citation - B · Violations: W&I 4502(b)(4), W&I 4502(b)(6), W&I 4502(b)(8), 483.410(a)(1), 483.460(c) · Violation Sep 10, 2025 · Penalty #070023014 · Survey 0VYF11

    Status: Closed

  • Class BPatient Care

    Citation B (HSC 1424) · Violation Jun 16, 2010 · Penalty #070007356 · Survey BLZP11

    Status: Closed · Appealed (received Jul 13, 2010)

    $950

    initially $800

  • Class BPatient Rights

    Citation B (HSC 1424) · Violation Feb 14, 2007 · Penalty #070003832 · Survey J2GG11

    Status: Closed · Not appealed

    $1,000

  • Class BAbuse/Facility Not Self Reported

    Citation B (HSC 1424) · Violation Feb 14, 2007 · Penalty #070003837 · Survey J2GG11

    Status: Closed · Not appealed

    $1,000

  • Class BPatient Rights

    Citation B (HSC 1424) · Violation Jan 19, 2000 · Penalty #070002314

    Status: Closed · Not appealed

    $500

  • Class BPatient Care

    Citation B (HSC 1424) · Violation Jan 19, 2000 · Penalty #070002315

    Status: Closed · Not appealed

    $600

Federal inspections (CMS-2567)

15 surveys since 2018 · CMS data through Oct 12, 2026

CDPH surveys certified ICFs for CMS. Each deficiency is a W-tag (a federal ICF/IID requirement), an E-tag (emergency preparedness) or a K-tag (Life Safety Code), cited at the standard level or, more seriously, the condition level. How to read an ICF inspection

Content note: these federal findings describe residents' care and can include abuse, neglect, injuries and medical details. They're shown as CMS published them; residents are identified only by number (such as "Client 1").

  1. · Complaint

    Event 36A275-H1 · 1 deficiency

    Official 2567 ↗
  2. · Complaint

    Event 231A39-H1 · no deficiencies cited

    Official 2567 ↗
  3. · Recertification

    Event 0VYF21 · 1 deficiency

    Official 2567 ↗
  4. · Complaint, Recertification

    Event 0VYF11 · 23 deficiencies (2 condition-level)

    Official 2567 ↗
  5. · Recertification

    Event 7K3Z21 · 1 deficiency

    Official 2567 ↗
  6. · Recertification

    Event 7K3Z11 · 9 deficiencies

    Official 2567 ↗
  7. · Recertification

    Event AJWX21 · 6 deficiencies

    Official 2567 ↗
  8. · Recertification

    Event AJWX11 · 12 deficiencies

    Official 2567 ↗
  9. · Complaint

    Event 242W11 · no deficiencies cited

    Official 2567 ↗
  10. · Focused Infection Control, Other-Fed

    Event ZVT711 · no deficiencies cited

    Official 2567 ↗
  11. · Recertification

    Event 9V7R21 · 3 deficiencies

    Official 2567 ↗
  12. · Recertification

    Event 9V7R11 · 8 deficiencies

    Official 2567 ↗

From CMS's QCOR ICF/IID statement-of-deficiency download, saved Oct 26, 2026. CMS notes that ICF/IID data after March 19, 2026 may be incomplete while its systems migrate. Plans of correction and state-only (licensing) deficiencies aren't in that file; the official 2567 documents on CalHealthFind have them.

Complaints and reported incidents

CDPH doesn't publish complaints or facility-reported incidents as a bulk file, so they aren't on ICFLookup. Its CalHealthFind page for this facility lists them (intake date, allegation category and whether each was substantiated), along with state licensing deficiencies and ownership details.

Federal surveys that came from a complaint or an incident report do appear above, marked "Complaint" as the survey type.

Open this facility on CalHealthFind ↗How to file a complaint with CDPH

Change history

22 events, newest first

Dates marked "state record" are the agencies' own: the license date, federal survey dates and penalty issue dates. "Detected" changes are ones we noticed by comparing CDPH's monthly facility listing with the one before it, tracked since Oct 26, 2026.

  1. ReportFederal survey (complaint): 1 deficiency(state record)

    See this survey →
  2. ReportFederal survey (complaint): no deficiencies(state record)

    See this survey →
  3. ReportState Class B citation ($1,000)(state record)

    See this citation →
  4. ReportFederal survey (recertification): 1 deficiency(state record)

    See this survey →
  5. ReportFederal survey (complaint, recertification): 23 deficiencies, 2 condition-level(state record)

    See this survey →
  6. ReportFederal survey (recertification): 1 deficiency(state record)

    See this survey →
  7. ReportFederal survey (recertification): 9 deficiencies(state record)

    See this survey →
  8. ReportFederal survey (recertification): 6 deficiencies(state record)

    See this survey →
  9. ReportFederal survey (recertification): 12 deficiencies(state record)

    See this survey →
  10. ReportFederal survey (complaint): no deficiencies(state record)

    See this survey →

Sources: CDPH Licensed and Certified Healthcare Facility Listing (data as of Oct 16, 2026), CDPH State Enforcement Actions, and CMS's ICF/IID statement-of-deficiency (CMS-2567) and Provider of Services files. ICFLookup is not affiliated with CDPH or CMS; always confirm with CDPH's CalHealthFind ↗ before making a decision. See How our data works.