Inspection visit

Routine inspectionOctober 12, 2023

GRACIOUS CARE HOMELicense 33188074025 citations on this visit

25 citations recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Amy Goldenberg arrived at 0845 unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry. LPA began inspection with introduction, visit purpose and provided the facility caregiver with LPA identification and business card. LPA began review of resident records. Two (2) records were reviewed. LPA reviewed for admission agreement, medical assessment and TB test results, consent forms, identification and emergency information, appraisal needs and service plans, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. R2 is missing a physician's order for 1/2 bedrails. LPA observed two 1/2 rails on the bed of R2. Resident Rights are posted in the facility and a copy is signed on file. Dementia and hospice regulation requirements are being met. LPA began review of employee records. Three (3) records were reviewed. LPA reviewed employee record for first aid certification, finger print clearance, personnel/job application, health screening and TB test results, criminal record statement, employee rights, training verification, and current administrator certification. Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. LPAs observe the facility to be clean and in good repair. The home is maintained at a comfortable temperature for the residents. Lighting is sufficient for safety and comfort. Water temperature measured 107 degrees F. Grab bars, non slip mats are present in the restrooms. Laundry facilities tour revealed bleach and laundry soap unlocked and accessible to residents. Fire extinguishers are charged, mounted and current. All outdoor and indoor passageways are free of obstruction. Night lights and emergency lighting is present. A locked area is provided for medications, however, LPA observed that the medication cabinet lock does not prevent access to others. LPA was able to open the medication cabinet. It is only secured with a baby type device and is easily opened by non employees and residents. There is a telephone working at this location. The LIC 610E, emergency disaster plan is maintained. The facility has a current written definitive plan of operation. Review of resident records revealed that the facility is not in compliance with their approved fire clearance. R2 is identified on their physicians report ad bedridden. This facility does not have a bed ridden fire clearance. Personnel Records/Training/and Staffing- LPA reviewed two employee records for CPR and annual training requirements. To assess if the facility employs enough staff to maintain cleanliness and meet the needs of the residents in care. Administrator certification is present. There are no training records available to review. The facility retains residents with dementia and require awake staff at night. There are no scheduled awake staff present to meet the requirement. Food Service- LPA were present during the breakfast and lunch time meal. The meal is adequate to meet the nutritional needs of the residents. Food prep areas are clean and organized. Food supply meets the requirement of one week supply of nonperishable and 2 day supply of perishables food on hand. Two client interviews were attempted. One Staff interview was conducted. Based on the information received during this visit today, the following deficiencies are being cited per Title 22, Division 6 of The California Code of Regulations. This report was reviewed with and a copy provided to the facility representative. Appeal Rights were also provided at the time of the exit interview. See also LIC 809D.

Citations

25 citations recorded^*CCLD

What does Type A vs Type B mean?

Type A. Serious citation. Imminent or substantial risk to children. The regulator requires corrective action immediately and may impose a civil penalty.

Type B. Lower-severity citation. Corrective action required, no imminent risk. The regulator monitors compliance on the next visit.

1569.153(b)Type B
Based on record review there are no training records available to verify that the requirement is met. This poses a health, safety or personal rights risk to persons in care.
1569.618(c)(3)Type A
Based on review of records there are no training records available to verify that this requirement has been met.
1569.625(b)(1)Type B
Based on record review there are no training records available to verify that the requirement is met. This poses a health, safety or personal rights risk to persons in care.
1569.625(b)(2)Type B
Based on record review there are no training records available to verify that the requirement is met. This poses a health, safety or personal rights risk to persons in care.
1569.625(c)(1)Type B
Based on record review there are no training records available to verify that the requirement is met. This poses a health, safety or personal rights risk to persons in care.
1569.625(c)(2)Type B
Based on record review there are no training records available to verify that the requirement is met. This poses a health, safety or personal rights risk to persons in care.
1569.625(c)(3)Type B
Based on record review there are no training records available to verify that the requirement is met. This poses a health, safety or personal rights risk to persons in care.
1569.625(c)(4)Type B
Based on record review there are no training records available to verify that the requirement is met. This poses a health, safety or personal rights risk to persons in care.
1569.625(c)(5)Type B
Based on record review there are no training records available to verify that the requirement is met. This poses a health, safety or personal rights risk to persons in care.
1569.625(c)(6)Type B
Based on record review there are no training records available to verify that the requirement is met. This poses a health, safety or personal rights risk to persons in care.
1569.625(c)(7)Type B
Based on record review there are no training records available to verify that the requirement is met. This poses a health, safety or personal rights risk to persons in care.
1569.625(c)(8)Type B
Based on record review there are no training records available to verify that the requirement is met. This poses a health, safety or personal rights risk to persons in care.
1569.625(c)(9)Type B
Based on record review there are no training records available to verify that the requirement is met. This poses a health, safety or personal rights risk to persons in care.
1569.69(a)(3)Type A
Based on review of records there is no documentation on file to support that this requirement is met. This poses an immediate health, safety or personal rights risk to persons in care.
1569.696(a)(1)Type B
Based on record review there are no training records available to verify that the requirement is met. This poses a health, safety or personal rights risk to persons in care.
1569.696(a)(2)Type B
Based on record review there are no training records available to verify that the requirement is met. This poses a health, safety or personal rights risk to persons in care.
87202(a)(2)Type A
Based on review of resident records, the licensee did not comply with the section cited above. Resident #2 physician report dated 06/21/2023 indicates bedridden status. This facility does not have a room cleared for a bedridden individual included in the fire clearance, which poses an immediate health, safety or personal rights risk to persons in care.
87309(a)Type A
Based on LPA observation, the licensee did not comply with the section cited above as evidenced by LPA observation of bleach and laundry soap unlocked and accessible to residents in the laundry room. This poses an immediate health, safety or personal rights risk to persons in care.
87411(a)Type A
Based on Caregiver Interview the licensee did not comply with the section cited above.Caregiver #1 is on duty 24 hours for 5 days straight without assistnce. This facility retains residents with a diagnosis of dementia. Resident #2 has two 1/2 bedrails on their bed and Caregiver #1 tells LPA that the resident moves around a lot at night and she fears that Resident #2 will fall. This poses an immediate health, safety or personal rights risk to persons in care.
87411(c)(1)Type B
Based on record review there are no training records available to verify that the requirement is met. This poses a health, safety or personal rights risk to persons in care.
87411(c)(6)Type B
Based on record review there are no training records available to verify that the requirement is met. This poses a health, safety or personal rights risk to persons in care.
87411(d)Type B
Based on record review there are no training records available to verify that the requirement is met. This poses a health, safety or personal rights risk to persons in care.
87412(e)Type A
Based on Interview the licensee did not comply with the section cited above. Staff member #1 indicated that resident #2 is awake all night and may require supervision to not fall out of bed. There is no awake supervision provided on night shift. This poses an immediate health, safety or personal rights risk to persons in care.
87465(h)(2)Type A
Based on LPA observation. LPA observed that the medication cabinet lock does not prevent access to others. LPA was able to open the medication cabinet. It is only secured with a baby type device and is easily opened by non employees and residents. This poses a risk to the health and safety of the persons in care.
87613(a)(2)(B)Type B
Based on record review there are no training records available to verify that the requirement is met. This poses a health, safety or personal rights risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the October 12, 2023 inspection of GRACIOUS CARE HOME?

This was a inspection inspection of GRACIOUS CARE HOME on October 12, 2023. 25 citations were issued: 7 Type A (serious) and 18 Type B.

Were any citations issued to GRACIOUS CARE HOME on October 12, 2023?

Yes, 25 citations were issued (7 Type A, 18 Type B). The first citation was for: "Based on record review there are no training records available to verify that the requirement is met. This poses a healt..."

What type of inspection was this?

This was a inspection inspection. inspection inspections are conducted by CCLD as part of their licensing oversight.

SourceView on CCLD View original report

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Data from CCLD public records. Last updated May 25, 2026. If you believe any information is inaccurate, report it here.

Routine inspection·October 12, 2023