Graceful Living at Modesto

Based on observation, the licensee did not comply with the section cited above in that the side gate was in need of repair/replacement to allow access from the inside and outside at all times. This lack of access from the exterior side gate posed an immediate health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above in that [1] out of [5] resident medications were not properly dispensed and documented as outlined by their assigned licensed medical professional which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation and interview, the licensee did not comply with the section cited above in by not ensuring that the front door did not have accessiblity to open the door for an emergency exit. LPAs observed a grey reinforcement lock on top of the original door lock that prohibited facility staff and residents from opening the door easily. This poses an immediate health, safety, and personal rights risks to persons in care.

Based on observation and record review, the licensee did not ensure that the Medication Administration Record was not completed at the time of administration. LPAs reviewed the Facility Administration Administration Record and observed that staff did not sign for medication that was administered from 04/03/2025-04/07/2025. This poses a potential health, safety, and personal rights risks to persons in care.

Administrative Qualifications: Administrator shall have... knowledge of and ability to conform to the applicable laws, rules and regulations...Based on observation, interview, and record review, the licensee did not comply with the section cited above as evidenced by the inability to produce required documents and the number of deficiencies cited during this annual inspection which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation and interview, the licensee did not comply with the section cited above when 5 items of expired and moldy food had to be discarded from the kitchen refrigerator. Over 20 packages of frozen meats wrapped in plastic wrap and without expiration date or labels of any kind were also found in the garage freezer which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review of 2/2 residents files and interview with the Administrator, the licensee did not comply with the section cited above and was unable to produce the hospice care plans, which poses an immediate health, safety or personal rights risk to persons in care.

Licensees who accept and retain residents with dementia ... annual medical assessment and appraisal...Based on record review the licensee did not comply with the section cited above in 1 of 3 residents did not have a medical assessment completed and 2 of 3 did not have a medical reappraisal which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review the documented fire drills are Jan 2022 and Feb 2023 13 months in-between, this poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review and interview with the Administrator the licensee was unable to provide the documented annual training (last documented training Feb 2022 and no medication training was available for review) for 4 of 4 staff. This poses a potential risk to the clients in care. .

Based on observation, interview and record review the licensee did not comply with the section cited above in one out of three persons are identified as being bedridden. The facility has fire clearance for 6 nonambulatory residents and no bedridden residents. This poses an immediate health, safety or personal rights risk to persons in care.

Based on review of three resident files and interview of staff and the Administrator, unusual incident and death reports are not being submitted to licensing per the requirement, the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation the licensee did not comply with the section cited above, during inspection the water temperature was measured at 148 degrees in the main shared bathroom, which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, the facility had accessible to residents cleaning solutions, gasoline, pesticides and pruning sheers in the back yard area, in the greenhouse and in the top drawer of one resident dresser, whom was not allowed access to personal care supplies per the 602, the licensee did not comply with the section cited above, which poses an immediate health, safety or personal rights risk to persons in care.

Based on LPAs testing of water temperature, the licensee did not comply with the section cited above as the temperature recorded during inspection was 137 degrees F which poses an immediate health, safety or personal rights risk to persons in care.