Abundant Grace Senior Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ivashia Wright conducted an unannounced annual required visit. Upon entry, LPA was greeted by Holly Martin, house manager, and informed them of the purpose of the visit. Administrator Kanisha Arzu arrived shortly after. At the time of the visit, there were three (3) staff members and five (5) residents present. Facility Overview: The facility is a single story home with four (4) resident bedrooms and two (2) bathrooms, office, dinning room, living area, kitchen, an outdoor area, and a garage. There is no gated pool and there are no firearms on the premises. Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility’s infection control plan was reviewed and found to meet department requirements. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. The outdoor area was free of hazards. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked and inaccessible to residents in a kitchen cabinet. Both the smoke detector and carbon monoxide detector were operational. LPA observed fire extinguishers to be in compliance with the department's requirements and last serviced 4/1/2026. Food Service: The facility’s kitchen was clean and equipped to prepare food. The facility maintained the required two-day supply of perishable foods and a seven-day supply of non-perishable foods. Continued on LIC809-C.... Care & Supervision/Administration: Adequate staff were present to supervise residents during the visit. The administrator holds a current administrator’s certificate which expires 2/22/2027. Record Review and Resident/Staff Files: LPA reviewed files for three (3) staff members, confirming criminal clearances, updated training, and CPR/First Aid certification. Three (3) resident files were reviewed and contained all required documentation. LPA observed first aid kit to be stored in a hallway closet inaccessible to residents. Health-Related Services/Incidental Medical Services: All resident medications were securely locked. LPA reviewed medications for three (3) residents, confirming that all medications were listed on the Medication Administration Record (MAR) and accounted for. Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan, including documentation of the last fire/earthquake drill conducted on 4/26/2026, which met department requirements. All facility exits were clear of obstructions. No deficiencies were cited during the visit. An exit interview was conducted, during which this report was reviewed and provided to the Administrator.the state’s words, verbatim · CDSS document, Jul 21, 2026

Allegation investigated: Facility staff restraining resident to furniture by material Facility staff recording resident visit with visitors Resident got food poising from food prepared by Facility staff

Licensing Program Analyst (LPA) Gabriela Castro conducted an unannounced complaint visit on 05/23/2026 to deliver findings related to the above allegations. LPA was greeted by facility staff Holy Martin and Elizabeth Goette. Administrator Kanisha Arzu was contacted via phone and explained the purpose of the visit. Administrator was available to LPA via phone. The investigation included a review of the client roster, staff roster, R1 face sheets, R1 physician’s reports,admissions reports, Updated Resident Communication & Incident Report Summaries (March 2023 – July 2023), Admissions Agreement, communication logs between the facility and R1’s responsible party, staff task lists, and a facility walkthrough. In addition, LPA conducted interviews with three (3) staff members (S1–S3) and three (3) residents (R1–R3). (continued on 9099C) Unsubstantiated Allegation: Facility staff restraining residents to furniture by material It is alleged that facility staff restrained residents to furniture, including recliners, using fabric or other materials. During resident interviews, residents denied ever being restrained to a bed or recliner. R1 also denied ever witnessing staff restraining other residents to recliners. During staff interviews, staff denied the use of restraints at the facility and stated residents are not secured to furniture or chairs. Staff stated restraints are prohibited unless ordered by a physician and approved exception by licensing. Staff further stated the facility utilizes door alarms and monitoring devices to assist with residents identified as fall risks or wanderers. During the facility walk through, LPA observed recliner chairs throughout the facility and did not observe any type of restraint, fabric, ties, or materials attached to or being used on the recliners. During record review, LPA reviewed R1’s records, Updated Resident Communication & Incident Report Summaries, Admissions Agreement, and communication logs between the facility and R1’s responsible party. No documentation was found indicating the use of restraints, physician orders for restraints, or approval for restraint use at the facility. Allegation: Facility staff recording resident visit with visitors It is alleged that facility staff recorded resident visits with visitors. During staff interviews, staff stated the facility has cameras located in common areas of the facility for safety purposes, including the living room, kitchen, dining area, hallways, and outdoor front and back areas. Staff denied that visits are specifically recorded and stated residents, responsible parties, and visitors are informed about the cameras upon admission. During resident interviews, residents did not express concerns regarding cameras or being recorded during visits. During the facility walk through, LPA observed cameras located in common areas of the facility. During record review, LPA reviewed the Admissions Agreement, which documented the presence of cameras in the common areas of the facility. Documentation reviewed indicated R1’s responsible party signed the Admissions Agreement acknowledging awareness of the cameras. Allegation: Resident got food poising from food prepared by Facility staff It is alleged that a resident became ill due to food prepared by facility staff. During resident interviews, residents stated they liked the food served at the facility and denied becoming sick from the food. It was reported by S1 that R1 experienced dizziness, vomiting, and diarrhea and had difficulty keeping food down. S1 stated there was no direct diagnosis from a physician and that the information regarding symptoms was reported to the facility by R1’s responsible party. S1 stated the facility treated the symptoms as reported and made reports to hospice regarding R1’s history of dizziness and vomiting as communicated by the responsible party. Per S1, pre-placement documentation included notes reported by the reporting party. During staff interviews, staff denied concerns regarding food quality or residents becoming ill due to food prepared at the facility. Staff stated food is routinely monitored, expiration dates are checked daily, and food supplies are regularly inspected and replaced as needed. (continued on 9099C) During the facility walk through, LPA observed an adequate supply of fresh food. Food observed did not appear rotten or spoiled. Canned goods and bread observed during the visit were within expiration dates. During record review, LPA reviewed staff task lists which included instructions for staff to create grocery lists on Mondays and Thursdays and confirm there was no expired food present at the facility Based on the investigation conducted, which included interviews with staff and residents, as well as a review of relevant records, there was insufficient evidence to support the reported allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview was held, and a copy of this report was provided.the state’s words, verbatim · CDSS document, May 23, 2026 · control 18-AS-20240122113736

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA), Stephanie Martinez, made an unannounced visit to the facility for the purpose of conducting a required annual inspection. The LPA was greeted and allowed to enter the facility to conduct the inspection. On today’s visit the LPA met with Administrator, Kanisha Arzu. She was notified of the purpose for the visit. PHYSICAL PLANT: Residents appear to be protected against immediate hazards. Outdoor and indoor passageways are kept free of obstruction. No pool or body of water was observed on the property. According to the Administrator, there are no weapons kept on the property. Disinfectants, cleaning solutions, and poisons were inaccessible to residents in care. A comfortable temperature was being maintained in the home. There was sufficient lighting in resident bedrooms to ensure the comfort and safety of residents. Hot water signs were observed to be posted in resident bathroom. Toilets, hand washing and bathing facilities were kept safe, sanitary, and in operating condition. Additional equipment for physically handicapped residents is available. The smoke and carbon monoxide alarms were tested and found to be in operating condition. The interior and exterior areas of the home were observed to be exceptionally clean, safe and organized. FOOD SERVICE: There was a variety of food which appeared to be selected and stored in a safe and healthful manner. Food supply of nonperishable and perishable foods was sufficient. Sufficient supplies for resident's dinning use was observed to be available. RECORD REVIEW: Staff files had required training; including, but not limited to, First Aid/CPR, Reporting Requirements, and Emergency and Disaster Training. Hospice training has been completed for care staff. Hospice Care Plans are on file fore residents in care. Staff present had the required criminal record clearances. Admission Agreement, Medical Assessment (Physician's Report), Assessments, and Service Plans were observed on file for residents in care. Administrator Arzu has an active Administrator's certificate, which expires on 02/22/2025. The facility currently has 4 residents in care receiving hospice services; which is within their Hospice Waiver limit. According to Arzu, the Licensee (GRACE AND LOVE RESIDENTIAL CARE HOME LLC) is active with the California Secretary of State and Limited Liability Insurance is in place. MEDICATION: Medication storage areas were inspected. Medications were labeled and maintained in compliance with label instructions and State and Federal law. Medications were observed to be safe, locked, and inaccessible to residents in care. No deficiencies have been cited at this time. This report was reviewed with Administrator Arzu and a copy was provided.the state’s words, verbatim · CDSS document, Jul 24, 2024

Allegation investigated: Staff did not administer resident's medication as prescribed

Licensing Program Analyst (LPA), Stephanie Martinez, conducted an unannounced visit to the facility to start the investigation into the above allegation. The LPA met with Administrator, Kanisha Arzu, and informed her of the purpose for her visit. A report was received by the Department alleging a resident in care, Resident One (R1), did not receive one of their medications which caused the resident to be hospitalized on 10/11/2023. Administrator, Kanisha, was interviewed; she reported R1 was admitted to the facility on 10/05/2023 from a skilled nursing facility (SNF). She reported R1's medications were received at admission, however, necessary equipment to administer one of the medications was not available. Text messages between the Administrator and the SNF Discharge Coordinator were received from the facility. The text messages revealed a request was made by the Administrator on 10/06/2023 to obtain the necessary equipment so R1's medication could be administered. Text messages from 10/10/2023 show the SNF Discharge Coordinator reported there was still no response provided from their intake team regarding the medication equipment. The SNF Discharge Coordinator was Unsubstantiated interviewed and reported they believed the equipment for R1's medication was not provided; however, instruction was given on how to administer the medication with alternate equipment. Per Administrator and staff, alternate equipment was not available. An inspection of R1's medication and medication equipment could not be conducted due to the resident's medication no longer being available at the facility. Therefore, due to insufficient information, this allegation is deemed UNSUBSTANTIATED at this time. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted; this report was reviewed with Administrator Arzu and a copy was provided.the state’s words, verbatim · CDSS document, Oct 19, 2023 · control 18-AS-20231012101521