A Grand Home Care

Type of visit: Required - 1 Year

On 05/01/2026 at 11:30 AM, Licensing Program Analyst (LPA) Jose Calderon conducted an unannounced annual inspection visit at the A Grand Home Care Facility. LPA Calderon was allowed entry into the facility by Administrator Ethel Monterroso. Facility is licensed to serve 6 non- ambulatory residents age 60 and over of which 1 may be bedridden. Bedridden may be in room 1 or room 3. The facility has an approved hospice waiver for 2 residents. One (1) of the residents is diagnosed with dementia. No residents are receiving home health. Two (2) residents are receiving hospice care services. Currently, the facility has six (6) residents living at the facility. LPA Calderon explained to Administrator Ethel Monterroso the purpose of the one-year Annual Inspection visit, and escorted LPA Calderon on a tour of the entire inside and outside facility grounds. As part of the inspection, LPA Calderon reviewed: Six (6) client service records, six (6) client medication records, three (3) staff records, and inspected the inside facility and outside grounds. The facility’s last fire drill was conducted on 03/17/2026. The one-story residential home consists of four (4) client bedrooms, two (2) client bathrooms, living room, dining room, kitchen, staff room, office area, attached garage with washer and dryer/ storage area, backyard with table and chairs. No weapons are stored on the premises. Kitchen was inspected and observed to be clean and operational. A two-day supply perishable and seven-day supply of non-perishable foods are present in the facility. Emergency Water Storage is in the garage and kitchen area. LPA Calderon observed that all facility rooms are clean and in good repair. A comfortable temperature was observed, and the facility has central air and heating. LPA Calderon observed the following during inspection of client’s rooms: mattresses are in good condition, adequate lighting present, plenty of dresser/closet space is present, and all bed linens present. All bedrooms contain furniture, lighting fixtures and personal storage space as required, all beds have the required amount of linen and mattress covers, LPA Calderon observed fully stocked closet with bedding, towels, and toiletries supplies. Bathroom fixtures are clean, in good repair, and working properly and contain the required nonskid mats and grab bars. LPA Calderon observed bathrooms were found to be within Title 22 regulation. Bathroom #1 hot water temperature properly measured at 108 degrees Fahrenheit, and bathroom #2 hot water temperature properly measured at 109 degrees Fahrenheit. Kitchen hot water temperature measured 116 degrees Fahrenheit. Facility one (1) Carbon Monoxide and eight (8) Smoke Detectors, hard-wired and connected, were tested and working properly. The facility two (2) Fire Extinguishers were checked and found to be fully charged and accessible. All exit doors in the facility have alarm systems. All toxins and knives are locked/secured and inaccessible to clients. Medications are centrally stored and in a locked storage cabinet. Facility first aid kit is fully stocked with manual was checked and in order. A working landline phone was operational. Outside grounds were toured and no bodies of water were observed. All Exits/ Walkways around the home were free of debris and hazards. Outside patio accessible to clients. Six (6) client files were reviewed and found to be complete. LPA Calderon reviewed six (6) resident medications, and they were all found to be administered according to doctor's orders. Three (3) staff files were checked, and they have the required documents. LPA Calderon noted the Administrator Ethel Monterroso Certification # 7023722740 expiration date of 10/28/2026 was valid at time of visit. The facility does NOT handle clients’ money/cash resources, and a Surety bond is NOT needed. Commercial General Liability Policy #001077305 policy period from 09/21/2025 to 09/21/2026 underwritten by James River Insurance Company, coverage 1,000,000/3,000,000 is valid at time of inspection. LPA Calderon reviewed the current Emergency and Disaster, Infection Control Plan. Administrator Ethel Monterroso to email LPA Calderon a full copy of the commercial insurance policy including all endorsements no later than 05/20/2026. All the required documents are posted in the facility in a clearly visible area. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA Calderon did not observe any deficiencies therefore no citations were issued at this time. Annual Licensing Fee is CURRENT. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Administrator Ethel Monterroso.the state’s words, verbatim · CDSS document, May 1, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sparkle Day conducted an unannounced visit to the above facility. The purpose of today’s visit was to conduct the one-year inspection. LPA met with Ethel Culala , Administrator and the purpose of the visit was discussed. Facility is licensed to serve 6 non- ambulatory residents age 60 and over of which 1 may be bedridden. Bedridden may be in room 1 or room 3. The facility has an approved hospice waiver for 2 residents. One (1) of the residents is diagnosed with dementia. No residents are receiving home health . Two (2) residents are receiving hospice care services. The facility does not handle any of the residents’ money. This home is a single story home consisting of: (4) resident bedrooms, (1) staff bedroom (2) Full bathroom, living room, dining area, kitchen, laundry room (located near kitchen), office area and an outdoor shaded patio area. LPA toured the Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place, water temperature measured at 112.1F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards; doorways were free of obstructions. Kitchen was checked and observed to be within Title 22 regulations. Perishable and non-perishable food supply was checked. All cleaning solutions, hazardous items, and medications were securely locked and inaccessible to residents. Smoke detectors were working properly and fire extinguisher was fully charged. Carbon monoxide detector was operational. First Aid kit was available. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises. During todays visit LPA did not observe any deficiencies. An Exit interview was conducted with Ethel Culala, Administrator and a copy of this report was provided.the state’s words, verbatim · CDSS document, Jan 29, 2025

Type of visit: Required - 1 Year

On 02/22/2024 8:54 AM, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced Required – Annual Inspection and met with Caregiver Renerose Seludo. Administrator Ethel Culala Monterroso joined us 30 minutes later. Six (6) residents and two (2) staff were present during this inspection. The facility is licensed to operate for six (6) non-ambulatory residents ages 60 and above. Facility is approved for one (1) bedridden (in room one or room three) and has a hospice wavier for four (4) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) resident's rooms, a staff room, two (2) bathrooms, living area, dining area, office area, kitchen, laundry area between the kitchen and hallway and (2) outside covered patio area with a table and chairs. There is an attached garage used for storage with access through the side of the house. Staff accompanied LPA inside and outside the facility during this inspection. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. There are no security bars or weapons on the premises. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards, doorways were free of obstructions. LPA toured the kitchen area and observed a two-day supply of perishable and a seven-day supply of non-perishable food. Knives and toxics were kept in locked storage cabinet. First Aid kit was available. One fire extinguisher, last serviced October 11, 2023 was observed in the dining room area. LPA tested all carbon monoxide detectors and smoke detectors located throughout the home. Both devices were functional and interconnected. Continue to LIC 809-C. 5 staff records were reviewed, 5 out of 5 staff records had current first aid certificates. Two staff interviews were conducted. 5 resident records were reviewed and, 5 out of 5 client records had Medical Assessments. Two residents’ medication was reviewed. One resident was interviewed. Deficiencies are being cited based on LPA observation, interviews conducted and record review in accordance with the California Code of Regulations, Title 22, see LIC809D. A violation regarding criminal record clearance warrants an immediate civil penalty of $500.00 and is hereby assessed, see LIC421BG. The Guardian roster searched on 02/21/24 did not show S3 associated to the facility and S3 was working on-site during LPA's 02/22/24 facility visit. Per Administrator, S3 started working on 02/09/24. On 02/22/24 2:25 PM, the Administrator emailed LPA Cloyd S3's criminal record transfer request, criminal record statement, and license. An exit interview was conducted, plans of corrections were developed and reviewed, and technical assistance was provided. A copy of this report and appeal rights were discussed and left with the Administrator Ethel Culala Monterroso.the state’s words, verbatim · CDSS document, Feb 22, 2024

The state marks this report as 6 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.