Grace Senior Solutions #1

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Type of visit: Required - 1 Year

On October 9, 2025, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry into the facility by care giving staff after explaining the purpose for the visit. Administrator (AD) Glenn Navarro was notified via telephone and later arrived to assist with the inspection. LPA observed that Glenn Navarro has a valid Administrator certificate which expires on July 22, 2026. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents and has a hospice waiver for six. The facility is a single story home with six private resident bedrooms, two staff bedroom, four resident bathrooms, a living room, a dining room, a kitchen, and an attached two car garage. LPA, accompanied by the AD, conducted a tour of the interior portions of the facility. On today's visit, LPA observed five resident in care and two care giving staff present. LPA observed residents relaxing in their respective bedrooms. LPA observed the See Something, Say Something poster, (PUB 475) mounted on the wall by the entryway of the facility. LPA inspected all six resident bedrooms and observed them to be free of hazards. LPA observed resident bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed resident beds to have clean linens and blankets. LPA observed additional linens to be stored in a hallway closet. LPA inspected the four resident bathrooms and observed them to be clean. Bathrooms were equipped with grab bars and non-skid floor mats. Faucets and toilets were operational. Hot water temperature measured between 103.1 to 111 degrees Fahrenheit. LPA observed the two staff bedrooms are kept locked and inaccessible to residents in care. LPA observed the kitchen has a two day perishable and a seven day non-perishable food supply on hand. LPA observed kitchen appliances to be clean and operational. CONTINUED ON LIC809-C LPA observed the five burner gas stove lights unassisted. LPA observed kitchen knives and sharps to be stored in a locked kitchen cabinet. LPA observed chemicals and toxins to be stored in a separate locked kitchen cabinet under the sink. LPA observed a fire extinguishers to be mounted on the wall by the entryway of the facility and it was observed to be charged and serviced as of July 14, 2025. LPA tested the wired smoke detectors/carbon monoxide detectors which tested operational. LPA observed the facility conducted their last emergency disaster drill on July 18, 2025. LPA observed the centrally stored medication to be kept in a locked closet by the living room. LPA observed the facility has a First Aid Kit stored in the closet and it had all the required components. LPA observed the door leading to the attached two car garage to be kept locked and inaccessible to residents in care. LPA observed the two car garage to be used for storage and laundry. LPA observed the facility has a three day emergency food and water supply stored in the garage. LPA, accompanied by the AD, conducted a tour of the exterior portion of the facility. The exterior portion was observed to be free of hazards and obstructions. LPA observed a shaded outdoor seating area with furniture for resident use. LPA observed the perimeter gate of the facility to be self latching and can be opened in an evacuation. There are no bodies of water on the premises. LPA reviewed all five resident files. LPA observed that Resident #1 (R1) is diabetic and requires insulin injections. Staff interviews confirmed that facility staff are providing the injections to R1 and not a licensed medical professional. LPA reviewed the residents' medication and medication records. LPA observed the facility was providing one unprescribed supplement to Resident #3 (R3) and ten unprescribed supplements/medications to Resident #5 (R5) without valid prescriptions. LPA reviewed four staff files. All staff are background cleared and associated to the facility. Based on the observations made during today's visit, deficiencies are being cited on the attached LIC809-D. An exit interview was conducted with Administrator Glenn Navarro. A copy of the report and Appeal Rights were provided.the state’s words, verbatim · CDSS document, Oct 9, 2025

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Samer Haddadin is conducting this unannounced visit for the purpose of conducting a health and safety . LPA arrived at the facility was greeted and granted entry by staff member Jonathan Artjiu and explained the reason of the visit. During the visit LPA toured the interior and exterior of the facility. LPA observed that the facility was equipped with sufficient hand hygiene, cleaning, and disinfecting supplies and that toxic chemicals, cleaning solutions and disinfectants were locked and secured Based on the observation made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with the facility staff and a copy of this report was provided. .the state’s words, verbatim · CDSS document, Dec 23, 2024

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Jerome Haley made an announced visit to conduct the second pre-licensing inspection. LPA Haley was greeted and granted entry by House Manager Glenn Navarro. LPA Haley explained the reason for the visit upon entry. During a tour of the facility, LPA Haley observed that the following items have been corrected. 1. The stove has been replaced. The applicant bought a brand new stove. All burners on the new gas stove are operational. 2. All the bulk items that were on the side of the facility have been removed. The side of the facility is clan and organized. All items have been corrected. No new deficiencies were observed, and no additional corrections are needed. The facility is ready for licensure. Component III was waived, as the applicant operates other licensed facilities. An exit interview was conducted, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Oct 9, 2024

Type of visit: Prelicensing

Licensing Program Analysts (LPA) Jerome Haley made an announced visit for the purpose of conducting a pre-licensing evaluation. LPA Haley was greeted and granted entry by applicant Jennifer Ghahyasi. Initial application: To operate a Residential Care Facility for the Elderly, with a capacity of 6 non-ambulatory residents was submitted to the department for licensure. Fire clearance: Orange County Fire Authority granted the Fire Clearance May 16, 2024 Structure: The facility is a single level structure, with an attached garage. There’s a total of 8 bedrooms, 6 of which are used for residents and 2 bedrooms are designated for staff. There’s one living room space, two dining areas, and four bathrooms. Bedrooms (Residents): All bedrooms have the required furnishings: bed, lamp, chair, and storage space. Bathroom(s): Bathrooms are equipped with a working toilet, wash basin, and shower. Grab bars are tightly secured. Hot Water temperature measured in the range of 105.6 and 115.8 degrees Fahrenheit. Kitchen: 3 of 4 burners were operational on the gas stove. Sharps are locked in a drawer. Food Service: A food supply that meets regulation requirements was observed in the refrigerator. A non-perishable food supply that meets regulation requirements was observed, A sample menu was observed on the refrigerator. Office Area: There's no designated office area. Staff members use the smaller dining room space to work and there’s a fax machine/copy machine in the garage. Laundry: There's a laundry area in the garage with a washer and dryer. Toxins: All toxic chemicals and cleaning solutions are inaccessible to residents and are stored in a locked cabinet in the garage. Resident & Staff Files: Resident and staff files are stored in a locked cabinet under the fax machine/copier in the locked garage. Medications/First-Aid Kit: Medications are kept in a locked medication cart that’s stored in the smaller dining room space where the staff members get their work done. A first aid kit with all the required elements is mounted on the wall at the entrance of the facility. Continued on LIC809C Linens & Hygiene Supplies: Adequate supply of linen was stored in cabinets in the hallway. An additional supply of hygiene items are stored in the garage. Backyard/Exterior: There’s a large backyard with self-latching exit gate. A shaded patio area with a table and chairs was observed. All walkways were clear and free of obstruction. Bodies of Water: No bodies of water were observed. Smoke/Carbon Monoxide Detectors: Smoke and carbon monoxide detectors tested operational. A carbon monoxide detector was observed mounted on the wall in between the kitchen and large dining room. Emergency Phone Numbers, House Rules, Exit Plan & Menu: Posted & readily available for review an emergency disaster plan, a list of emergency phone numbers, house rules on the facility postings board in the living room area, and a sample menu posted in the kitchen. Fire Extinguisher: Observed full charged mounted on the wall as soon as you enter the facility next to the front door. Component III: Is not ready to be presented at this time. Component III will be presented after corrections are made and the follow up visit is completed. Corrections: The applicant has two corrections to make before the facility is ready to be licensed. 1) Repair or replace the stove. The front right burner on the stove is not working. The stove should light unassisted. 2) Discard the bulk items on the side of the facility. A follow up visit is tentatively scheduled for Thursday, October 3, 2024 around 1:00pm. An exit interview was conducted, and a copy of this report was provided to applicant Jennifer Ghayasi.the state’s words, verbatim · CDSS document, Oct 1, 2024

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): 0 COMP II Participants: GHAHYASI, JENIFER - Applicant/Administrator; Ahmad Reshad, CAB analyst. Interview Method: Telephone interview On 08/21/2024, applicant(s)/administrator participated in COMP II for the below pending facilities: Grace Senior Solutions #2, 306006551 and Grace Senior Solutions #1, 306006542. Identification of the applicant(s) and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant(s) and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Aug 21, 2024