Cheri Grove

Type of visit: Required - 1 Year

This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of conducting a Required – 1 Year Inspection. LPA met with Administrator (AD) Gemma Sagucio and discussed the purpose of the inspection. LPA reviewed Infection Control requirements. At about 2:30PM, LPA and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, and garage and observed the following: Structure: facility is a 6-bedroom, 3-bathroom, two-story house with an attached garage that is used for storage. There is a back yard with a patio cover for the residents and a pool that is properly gated. LPA observed 2 staff and 3 residents present at the facility. Resident Bedrooms: the 3 resident bedrooms are spacious and will easily accommodate the residents’ furnishings. Furniture for each resident bedroom inspected. Staff Bedrooms: LPA observed three staff bedrooms on the second floor. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested 116 degrees F in the resident bathroom. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed and tested. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the kitchen. Toxins: observed locked in the kitchen and garage. Medication cabinet: observed to be locked. First-Aid Kit and Activity Supplies: observed and available. Facility’s licensing fees are paid. At about 1:00PM, LPA reviewed 3 resident files and 3 staff files, interviewed 2 residents and 2 staff, and inspected medications for 3 residents. Facility does not handle resident money. During the inspection, LPA and AD observed the following: based on observation, LPA observed the gate from the pool going east to the garden to be bolted shut and also a bolt placed, but not locked, on the sliding door from the covered patio; based on documents, S1's health screening does not have a TB result and the x-ray TB results in S1's file are inconclusive and recommend another scan to be done which is not documented; based on documents, S3 has not completed any hours of continuing annual training since January 2025; based on documents, S3 has not completed any hours of continuing medication training since January 2025; based on documents, the physician's reports for R1, R2, and R3 are on the old form and do not include required information, including behavioral expressions; based on documents, the physician's reports for R1 and R2 are more than a year old and there is no documentation of an annual routine visit within the past year in their files; based on documents, the facility did not conduct any emergency disaster drills between May 20, 2025 and January 16, 2026, meaning the drills were not conducted quarterly as required. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. Immediate civil penalties are being assessed. See LIC421IM. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.the state’s words, verbatim · CDSS document, Mar 17, 2026

The state marks this report as 9 pages; the online copy we transcribed has 8. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of conducting a Required – 1 Year Inspection. LPA met with staff Marissa Acerbo and discussed the purpose of the inspection. Administrator (AD) Darlyn Colesio arrived during the inspection. LPA reviewed Infection Control requirements. At about 12:30PM, LPA and staff Acerbo conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, and garage and observed the following: Structure: facility is a 6-bedroom, 3-bathroom, two-story house with an attached garage that is used for storage. There is a back yard with a patio cover for the residents and a pool that is properly gated. LPA observed 4 staff and 4 residents present at the facility. Resident Bedrooms: the 3 resident bedrooms are spacious and will easily accommodate the residents’ furnishings. Furniture for each resident bedroom inspected. Staff Bedrooms: LPA observed three staff bedrooms on the second floor. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested 117 degrees F in the resident bathroom. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed and tested. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the kitchen. Toxins: observed locked in the kitchen. Medication cabinet: observed to be locked. First-Aid Kit and Activity Supplies: observed and available. Facility’s licensing fees are paid. At about 1:30PM, LPA reviewed 4 resident files and 4 staff files, interviewed 4 residents and 3 staff, and inspected medications for 4 residents. Facility does not handle resident money. CONTINUED. During the inspection, LPA and AD observed the following: based on documents, the licensee did ensure Staff #1’s (S1) staff file contained documented evidence of the required 20-hour annual training; and based on documents and admission, Resident #1 (R1) is being given supplements including calcium with no doctor's orders on file and is not being given medications including Acetaminophen without discontinuation orders and Resident #2 (R2) was not given their iron and vitamin C supplements after December 2024 despite the doctor's order not being discontinued. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.the state’s words, verbatim · CDSS document, Jan 6, 2025

Type of visit: Required - 1 Year

This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of conducting a Required – 1 Year Inspection. LPA met with Administrator (AD) Gemma Sagucio and discussed the purpose of the inspection. LPA reviewed Infection Control requirements. At about 3:00PM, LPA and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, and garage and observed the following: Structure: facility is a 6-bedroom, 3-bathroom, two-story house with attached garage that is used for storage. There is a back yard with a patio cover for the residents. LPA observed 2 staff and 4 residents present at the facility. Resident Bedrooms: the 3 resident bedrooms are spacious and will easily accommodate the residents’ furnishings. Furniture for each resident bedroom inspected. Staff Bedrooms: LPA inspected the 3 staff bedrooms. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested at 117 degrees F in the common resident bathroom. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed and tested. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the kitchen, after corrections. Toxins: observed locked in the garage and kitchen, after corrections. Medication cabinet: observed to be locked. First-Aid Kit and Activity Supplies: observed and available. Facility’s licensing fees are paid. At about 3:30PM, LPA reviewed 4 resident files and 2 staff files, interviewed 4 residents and 2 staff, and inspected medications for 4 residents. Facility does not handle resident money. During the inspection, LPA and AD observed the following: based on observation and documents, the licensee did not ensure the two fire extinguishers were certified yearly when they were last serviced on 03/14/23; based on observation, the licensee did not ensure supplements and medications were secured in the non-lockable staff bedroom and sharps and toxins were secured in the kitchen where the key to the padlocks could not be located during the inspection; based on documents, no one present or associated with the facility has a valid administrator's certificate; based on observation, the facility has two stories but does not have an evacuation chair; and based on observation, the licensee has been using a full bedrail on the bed of R1 who is not on hospice and could not locate doctors' orders for half bedrails for all 4 residents who are using half bedrails. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.the state’s words, verbatim · CDSS document, May 29, 2024