Graceful Hearts Assisted Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ramon Serrano conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was allowed entry and discussed the purpose of the visit with Administrator Jullia Arida. According to the facility’s license, the facility has a maximum capacity of six (6)residents. Two (2) of whom may be non-ambulatory. Hospice waiver approved for two (2) residents. LPA, accompanied by Administrator toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Both the ambient and water temperatures were at compliant readings. Doors, windows, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to clients. Medications were labeled, as required, and stored in locked areas. There is a pool on the premises that is secured with a gate and lock. Per Administrator, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. [CONTINUED ON LIC 809-C] LPA reviewed multiple staff and resident records/files. LPA records review did not raise any licensing concerns. The files which LPA reviewed contained required documents. Confidential records were stored in locked areas. No deficiencies were observed or cited during today's annual inspection. An exit interview was conducted with Jullia Arida whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, May 4, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ramon Serrano conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was allowed entry and discussed the purpose of the visit with Administrator Jullia Arida. According to the facility’s license, the facility has a maximum capacity of six (6)residents. Two (2) of whom may be non-ambulatory. Hospice waiver approved for two (2) residents. LPA, accompanied by Administrator toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Both the ambient and water temperatures were at compliant readings. Doors, windows, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to clients. Medications were labeled, as required, and stored in locked areas. Their is a pool on the premises that is secured with a gate and lock. Per Administrator, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. [CONTINUED ON LIC 809-C] LPA reviewed multiple staff, resident and facility records/files. Records review revealed facility staff health screening records were missing from file. The resident files which LPA reviewed contained required documents. Confidential records were observed to be stored in locked areas. Based on interviews, observations, and record review, deficiencies were observed and cited on the attached LIC 809D. An exit interview was conducted with Jullia Arida whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Jun 2, 2025

Allegation investigated: Untrained individual dispensed medication to resident.

Licensing Program Analyst (LPA) Ramon Serrano conducted an unannounced visit to deliver investigative findings. LPA was granted entry into the facility and met with Administrator Jullia Arida to whom LPA explained the purpose of the visit. Community Care Licensing (CCL) has investigated the above listed complaint allegation. The investigation consisted of records review and interviews with staff and outside sources. It was alleged that an untrained individual dispensed medication to Resident 1 (R1) (an LIC 811 Confidential Names List was provided to the facility representative to identify the resident) It was reported that R1's responsible party dispensed medication to R1. Interview with R1's responsible party (RP) revealed that R1 was on end stage hospice care. On June 4, 2024 R1 was having difficulty breathing and per the hospice nurse's instruction RP administered morphine to R1. RP further stated that prior to administering the medication he received training and education regarding R1's hospice "comfort kit." Unsubstantiated LPA interviewed outside agency (OA) who stated that the facility Administrator does not allow their staff to administer morphine to residents. OA stated that together R1's responsible party, the hospice agency and facility administrator devised a plan for R1's responsible party to administer the morphine to R1. OA stated that teaching was provided and that everyone was in agreement with the plan. OA further stated that they have a "good working relationship" with the facility since they are "not new" and they have worked with them in the past. OA further stated that they have provided various training's to the facility. LPA interviewed Administrator who stated that facility staff does not administer any form of morphine to the hospice residents. Administrator stated that the normal procedure for end stage hospice is they report symptoms to hospice; then they are instructed which medications to give. If hospice instructs to give morphine to a resident, the facility staff would give the morphine to the trained family member to administer, unless the hospice nurse is present at the facility. Administrator stated that the family had the option to wait for the hospice nurse to arrive or to administer the medication themselves. Administrator stated that on June 4, 2024 she along with R1's responsible party contacted the hospice agency to advise them of R1's symptoms. Hospice nurse authorized R1's responsible party to administer the morphine so that R1 would not have to wait in distress until she arrived at the facility. LPA reviewed outside agency clinical notes dated June 4, 2024. Clinical notes indicated Hospice nurse met with R1's responsible party and administrator for update. Clinical notes indicated that R1's responsible party administered morphine to R1 one hour prior to RN's arrival. Clinical notes further stated that R1 appeared to be transitioning to end of life care. Upon thorough investigation, it was determined that R1's responsible party, under the guidance of the hospice agency, administered the medication (morphine) to R1 as per established protocols and instructions provided by the hospice agency. Based upon the foregoing, the above listed allegation is unsubstantiated. This finding means that the preponderance of the evidence standard has not been met and the allegation is not valid. An exit interview was conducted with Jullia Arida. A copy of this report along with licensee rights (LIC 9058, 3/22) was provided to Jullia Arida whose signature below verifies receipt of these rights.the state’s words, verbatim · CDSS document, Jun 18, 2024 · control 08-AS-20240611121226

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ramon Serrano conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was allowed entry and discussed the purpose of the visit with Administrator Jullia Arida. According to the facility’s license, the facility has a maximum capacity of six (6)residents. Two (2) of whom may be non-ambulatory. Hospice waiver approved for two (2) residents. During today’s inspection there were 4 residents present in the facility. LPA, accompanied by Administrator toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to clients. Medications were labeled, as required, and stored in locked areas. Their is a pool on the premises that is secured with a gate and lock. Per Administrator, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. [CONTINUED ON LIC 809-C] LPA interviewed staff and residents and reviewed multiple staff and resident records/files. LPA interviews did not raise any licensing concerns. The files which LPA reviewed contained required documents. Confidential records were stored in locked areas. No deficiencies were observed or cited during today's annual inspection. An exit interview was conducted with Jullia Arida whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, May 2, 2024