Amazing Grace Home Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Hannah Rodgers conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by and discussed the purpose of the visit to Administrator Mary Trias. The facility's license shows a maximum capacity of six (6) non-ambulatory residents, of whom one (1) may be bedridden. Hospice waiver for six. During today’s inspection there were five (5) residents in care. LPA with Administrator Trias toured the interior and exterior of the facility and inspected each room. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to residents. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per Administrator Trias, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguishers were serviced within the last 12 months. First aid kits were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. No deficiencies were cited during the inspection. An exit interview was conducted with Administrator Trias to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Apr 1, 2026

Type of visit: Required - 1 Year

On 04/01/2025 at 11:38 AM, Licensing Program Analyst (LPA) Melody Brown made an unannounced visit to the facility. The purpose of the visit was to conduct the required comprehensive annual inspection. LPA Brown met with a staff and was granted entry to the facility. Licensee/Administrator Mary Grace Trias was informed of the visit. LPA Brown informed Licensee/Administrator Trias of the purpose of the visit. At the time of the visit there were two (2) staff present, and three (3) residents present. The facility is a four (4) bedroom, three (3) bathroom home with a kitchen/dining area, living room/activity room, laundry room and an attached garage. The facility is Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of six (6) non-ambulatory residents of which one (1) may be bedridden. The facility’s approved for six (6) hospice waiver. The current census is four (4) residents. LPA Brown was accompanied by Licensee/Administrator Trias to conduct a general overall inspection, which included, but was not limited to the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 70 degrees Fahrenheit (F). LPA Brown inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA Brown observed sufficient furniture and lighting throughout the facility. LPA Brown measured and observed the water temperature in the residents bathroom to be at 112.8 degrees F. The facility is equipped with operating combined smoke detectors and carbon monoxide alarms. Charged fire extinguisher was also observed at the facility. Posters such as personal rights, the CCLD complaint poster, Ombudsman poster, and the disaster plan, House Ruled and Visitation Policy were posted in a common area. ***Continuation in LIC809C *** However, LPA Brown noted that the facility did not review the Emergency Disaster Plan (LIC610D) annually and no Licensee or Administrator signature and signature date. Deficiency will be issued. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There's a designated storage space for resident/staff files. There is a medicine cabinet with the resident’s medications locked. LPA Brown observed the complete first aid kit however, no first aid book observed at the facility. Deficiency will be issued. Moreover, LPA Brown noted that the facility has the required emergency supplies, emergency food and emergency water maintained. Food Service: More than seven (7) days’ supply of non-perishable foods and more than two (2) days’ supply of perishable food supply were observed and sufficient for the number of residents in care. Care & Supervision: The facility has an Administrator present at the facility with appropriate and enough hours to appropriately manage the facility. However, LPA Brown observed that the facility does not have a staff scheduled to work the night shift, awake and on duty as required for facility with dementia residents that are reported by their physician in Physician Report (LIC602) with sun downing or wandering behavior. Deficiency will be issued. Record Review: LPA Brown noted that the facility has an updated Infection Control Plan and updated Liability Insurance. LPA Brown reviewed four (4) resident files for admission agreements, updated physician reports, pre-placement appraisals, centrally stored medication list/physician orders and needs and services plans. LPA Brown observed resident files reviewed were complete. In addition, LPA Brown noted that Resident #2 (R2) half bed rail has written orders from R2's physician indicating the need for half bed rail for mobility. LPA Brown reviewed two (2) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings with tuberculosis (TB) test result. LPA Brown observed that Staff #1 (S1) First Aid/CPR Certification expired on 03/2025. Deficiency will be issued. However, Licensee/Administrator Trias informed LPA Brown that no trainings were provided by the two (2) Hospice Agencies to facility staffs for implementation of the hospice care plan. Deficiency will be issued. During medication audit, LPA Brown observed that staffs at the facility are assisting their residents with their self-administered medication per their doctor's order. No issues observed. Based on the observations made during today’s visit, deficiencies and technical assistance were cited per Title 22, Division 6, Chapter 8 of the California Code of Regulations (CCR). An exit interview was conducted, and this report (LIC809), LIC809D, LIC9102 and Appeal Rights were discussed and provided to Licensee/Administrator Mary Grace Trias.the state’s words, verbatim · CDSS document, Apr 1, 2025

The state marks this report as 10 pages; the online copy we transcribed has 7. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ryan Gardner made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Administrator Mary Grace Trias and was granted entry to the facility. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for a capacity of six (6) non-ambulatory residents, one (1) resident may be bedridden. The current census is five (5) residents. LPA was accompanied by Administrator to conduct a general overall inspection, which included, but was not limited to, the following: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to interior and exterior passageways. The facility is maintained at a comfortable temperature. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperature in the bathrooms to be at 112.8 degrees F. The facility is equipped with operating smoke detectors and carbon monoxide alarms. The postings such as the facility license, personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. The cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to the residents in care. There was a designated storage space for resident files and staff files. The medications are stored in a filing cabinet in the kitchen inaccessible to the residents. The non-perishable and perishable food supply is sufficient for the residents in care. LPA reviewed five (5) residents files for admission agreements, updated physician reports, and needs and services plans. LPA reviewed three (3) staff files for First Aid/CPR certifications, criminal record clearances, trainings, and health screenings. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Administrator Mary Grace Trias.the state’s words, verbatim · CDSS document, Mar 12, 2024