Graceful Living at Modesto

Type of visit: Required - 1 Year

Unannounced Annual visit made out to this facility on 04/21/2026 by Licensing Program Analyst (LPA) Charlie Yang. This LPA was met by the facility caregivers, Remedios VeBelen and Linda Aguilar, who were briefly interviewed at this time. This LPA requested that they go ahead and contact the facility designated Administrator to inform them that CCL was present at this time. The facility designated representative, Voica Matis, was present at this time and was briefly interviewed at this time. Current census was 5 residents. It was learned that there were (3) residents under the care of hospice at this time. This facility does have an approved waiver to be able to accept and retain up to (3) residents under the care of hospice at any given time. It was learned that this facility has a program to be able to accept and retain dementia residents at any given time. It was learned that there were (3) residents diagnosed with dementia at this time. It was learned that there weren't any residents receiving services through home health at this time. It was learned that this facility does not have an approved bedridden fire clearance to be able to accept or retain any residents deemed to be bedridden at any given time. Tour of this facility was conducted. Dining area, living area, and all other areas intended for resident use were toured. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. Linen closet, located in facility hallway closet, was reviewed and observed to contain a sufficient supply of towels, sheets, and bedding able to meet the needs of the residents at this time. Kitchen area was toured. Kitchen drawers and cabinets were opened and reviewed. Food supply for 2-day perishable and 7-day nonperishable quantities was reviewed to make sure that they were in compliance at all times. Pantry area was toured. Laundry area was toured and observed to be locked at this time. A review of the bleach, detergent, and all other cleaning supplies was conducted to make sure that they were locked and made inaccessible to the residents at this time. Administrator certificate # 7006881740 for Mircea Bogdan Condor was observed to have an expiration date of 08/22/2026 and observed to be in compliance at this time. Medication cabinet, located in the facility kitchen cabinet, was observed to be locked and made inaccessible to the residents at this time. First aid kit, located in the medication cabinet, was reviewed. This LPA observed that it did contain all of the required components at this time. Fire extinguisher located hanging on the hallway wall adjacent to the kitchen was observed to have been annually inspected by the local fire extinguisher company, Touch Down Fire Inc, with the inspection date of 02/05/2026 and in compliance at this time. Facility resident bedrooms were toured. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. Facility resident restrooms were toured. Grab bars and non skid mats were observed to be present and in good repair at this time. Hot water temperatures were taken to make sure that they were within the allowed range of 105-120 degrees at all times. A tour of the facility exterior grounds was conducted. A review of the facility perimeter fence, side gates, and all other exits was conducted. A review of (4) facility personnel records was conducted and noted on the following LIC 859. A review of (5) facility resident records was conducted and noted on the following LIC 858. The following forms and documents were requested to be updated and submitted into CCL for review by this LPA: LIC 308 LIC 400 LIC 500 LIC 610 The following deficiencies were observed and cited on the following LIC 809-D pursuant to Title 22 Rules and Regulations, Health and Safety Code. Appeal Rights were printed and a copy was given to the facility representative at this time. Exit Interviewthe state’s words, verbatim · CDSS document, Apr 21, 2026

Type of visit: Required - 1 Year

On 04/07/2025, Licensing Program Analysts (LPAs) Arielle Pascua and Triel Lindstrom arrived unannounced to this facility to conduct an annual visit. LPAs met with staff member (SM), Remedios De Belen and explained the purpose of the visit. LPA Pascua asked SM De Belen to contact the Facility Designated Administrator (FDA), Bogdan Condor and inform them that CCL was present at this time. Shortly after, LPAs met with FDA Condor and explained the purpose of the visit. The purpose of the visit was to conduct an annual. Current census was 5. A brief interview with FDA Condor was conducted. This facility is licensed to serve and retain 6 elderly residents who all may be deemed non-ambulatory. This facility also has a hospice waiver for 3 and a dementia plan on file. Upon arrival at the facility LPA Pascua rang the ring doorbell located on the right side of the double front doors. After several attempts LPA Pascua knocked on the door and heard an individual on the inside of the facility state that they heard the knock but was unable to open the door. LPA continued to knock on the door 3 more times until the door was opened by facility staff. Upon entrance to the facility both LPAs walked through the double front doors and observed a grey reinforcement locking mechanism above the top lock of the door. LPAs observed that this lock would prohibit the door from being open. Shortly after, LPAs met with FDA Condor and informed him of the lock on the door. LPA Pascua informed FDA Condor that the lock was a safety hazard which prohibited both staff and residents to exit the facility in case of emergency. LPA Pascua asked FDA Condor to take the lock out before the tour of the facility was conducted. During this time, Licensee Voica Matis, arrived at the facility. A tour of the facility was conducted. Fire extinguisher was identified and was last serviced on 02/18/2025 by the local fire extinguisher company. Living room areas, dining areas, and other residents intended for resident use were toured. Furniture and furnishings were observed to be in good repair and able to meet resident needs. Kitchen area was toured. A review of the food supply was conducted to ensure that the facility has a 2 day perishable and 7 day non-perishable food supply to meet the residents needs. Knives were observed to be locked and made inaccessible. LPA Pascua identified one medication cabinet located in the kitchen. Along with Licensee Matis, LPAs reviewed and compared medication with medication dispensing logs. It was learned through review of the facility records that the facility staff had not initialed medication dispensing logs throughout the weekend of 4/4/2025 through today's date of 04/07/2025. In addition, the dates that were initialed were initialed for medication that was supposed to be provided during 8:00pm. LPA Pascua provided assistance to the facility staff and reminded them of the importance of ensuring that medication administration records must be initiated at the time of administration. A review of medication also showed that the facility was pre-pouring medication for the next administration. LPA Pascua stated that the department no longer allowed pre-pouring. Licensee and staff member understood and stated that this would be attended to. First aid kit was also present and contained all the required components. A tour of back yard was conducted. LPAs observed a separate casita in the backyard, which staff use for breaks or live in staff. LPA asked the Licensee send an updated facility sketch to reflect changes. Perimeter fence was observed to be in good repair. The emergency gate was observed, however, upon opening the gate, it was observed that the gate was not easy to open and did not self latch or self close. LPA Pascua advised that the exit gate shall be fixed to ensure that the facility staff and residents were able to open the gate easily and that it would self latch and self close. A tour of the resident bedrooms were conducted. Bedroom #1 has an adjacent bathroom. Bedrooms #2-4 were single occupancy bedrooms. Furniture and furinishings were observed to be in good repair. A tour of the facility bathroom was conducted. Hot water was taken to ensure that it was within 105-120 degrees. LPAs observed rusting on the bottom of the facility shower that may have been from the shower chairs. In addition, black residue was observed in the corners and grout areas of the bathroom shower. A linen closet was identified and contained a sufficient supply of linens to meet the residents needs. A tour of the laundry area was conducted. Cleaning supplies, laundry detergent, and other items were locked and made inaccessible. A tour of the garage was conducted. Additional food supply was identified. LPAs reviewed 6 resident files and 7 staff files was conducted. The administrator has a expired administrator certificate. The following documents were requested to be submitted to the department: -LIC 308 -LIC 400 -LIC 500 -LIC 610E -Updated Facility Sketch -Updated Program Design to reflect staffing such as live in staff -Updated Administrator documentation A immediate civil penalty is being issued today in violation of Section 87202(a). This is due to the reinforcement lock observed at the time of the visit. A technical assistance is being provided for Section 87303(a) and 87465(h)(5). The following deficiencies were observed and cited per California Code of Regulations, Title 22 see LIC 809-D. Exit interview conducted with Licensee and copy of report and appeal rights were left at facility.the state’s words, verbatim · CDSS document, Apr 7, 2025

Type of visit: Required - 1 Year

On 4/4/24 at approximately 11:45am Licensing Program Analyst (LPA) Maja Jensen arrived at facility unannounced to conduct a required 1 year annual inspection. LPA Jensen met with Neal Clavano and explained the purpose of today's visit. LPA Jensen also spoke to the LIcensee Voica Matis by telephone and explained the purpose of today's visit. The Administrator holds current Administrator's certificate number 6022459740 good through 8/22/24. There are currently 5 residents, 1 of which is on hospice and 1 of which uses oxygen. The facility is licensed for 6 clients, all of which may be non-ambulatory and 3 of which may be receiving hospice services. The facility also provides dementia care. LPA Jensen toured the facility grounds and observed the grounds to be maintained. There is outdoor furniture available for client activities. LPA Jensen observed a gate in the backyard and tested the gate to ensure the self latching mechanism was functional. The backyard gate did close without assistance and should be monitored for continued functionality. There are no bodies of water on the property. LPA Jensen toured the interior and observed the facility to be sanitary and free of odor. There was adequate furnishings and lighting throughout. The facility has prominently information related to the Ombudsman, resident rights, resident council and fair labor practices. There was no Residential Care Facility for the Elderly Compliant poster displayed or available. Technical assistance was provided. The thermostat was set at 72 degrees Fahrenheit which falls within the required range of 68-85 degrees Fahrenheit. The water temperature in the main hall bathroom was measured at 111.9 degrees Fahrenheit which falls within the the required regulatory temperature. There is an adequate supply of linens at the facility. The bathrooms are equipped with grab bars and non-slip flooring in the bathroom and shower areas. The bedrooms are furnished with beds, dressers, night stands, lamps and chairs. LPA Jensen observed a 2 days supply of perishable food and a 7 day supply of non-perishable food. LPA Jensen tested the carbon monoxide detector and smoke detector ad determined them to be in good working order. The fire extinguisher was recently purchased and is compliant. The facility maintains an emergency supply of water and emergency lighting. The Emergency disaster plan was reviewed and is comprehensive, current and compliant. The facility conducts quarterly drills with the last drill having been conducted on 2/5/24. All knives, toxins and medications were observed to be locked and inaccessible to residents in care. The fire department has been notified that there is oxygen in use. There is no-smoking signs posted on the room utilized by the resident with a need for oxygen. LPA Jensen reviewed the liability insurance and determined it to be current. LPA Jensen conducted interviews with 2 of 2 care providers present at the time of facility. LPA Jensen also interviewed 3 of 5 residents who stated they are satisfied with all aspects of their care. LPA Jensen reviewed 5 staff files and determined 5 of 5 had current first aid certificates and health screens. LPA reviewed 5 of 5 resident files and determined them to be complete. LPA Jensen provided technical assistance on navigating the CDSS website and locating provider resources. The facility was determined to be in substantial compliance. No deficiencies were cited. The inspection tool was used during the course of this visit. An exit interview was conducted and a copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Apr 4, 2024

The state marks this report as 5 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Case Management - Other

On 11/15/23 Licensing Program Analyst (LPA) Maja Jensen arrived at facility unannounced to conduct a quarterly visit to monitor for compliance with previously identified deficiencies. LPA Jensen met with Licensee Voica Matis and explained the purpose of today's visit. The facility is being monitored for compliance in the following areas: Presence of the Administrator Fire Clearance with respect to retention and acceptance of bedridden clients Pre-placement appraisals Needs and Service Plans Physician Reports Reporting Requirements Record Keeping LPA Jensen interviewed 2 of 2 staff members who advised the Administrator is typically present at the facility from 9am-5pm Monday to Friday. The facility currently has 3 clients, 2 of which are ambulatory and 1 of which is non-ambulatory. There are no bedridden clients currently residing at the facility. LPA reviewed both staff files for the care providers present at the time of the visit and found them to be complete and in compliance. LPA Jensen reviewed 3 of 3 client files and determined them to be complete and in compliance. LPA Jensen reviewed documentation detailing a communication exchange between the Licensee and a hospice provider wherein the hospice provider has agreed to conduct staff training on postural support, patient transitioning and infection control to be scheduled after 11/20/23. LPA Jensen reviewed training records and found the training to be in compliance. The facility was observed to be sanitary and in good repair. No deficiencies are being cited. An exit interview was conducted and a copy of this report was given.the state’s words, verbatim · CDSS document, Nov 15, 2023