Gift of Grace Care Home

Type of visit: Required - 1 Year

On 08/13/26 Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was greeted by Staff (S1) Maliny Keo. LPA was granted entry. 6 clients were present during inspection. Administrator (A1) Phoeun Marez arrived shortly after LPA’s arrival. LPA toured facility with A1. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. Freezer temperature was maintained at 1 degrees F and refrigerator temperature was maintained at 38 degrees F. Cleaning chemicals was observed stored and locked in garage area. Fire extinguisher was observed with a service date of: 7/6/26. Fire drill last completed on 6/19/26. Clients' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are toured and observed to be operational. Hot water temperature was tested at a range of 109.2 to 114 degrees F. in 4 bathrooms. Outside of facility toured. Side gates were self-closing and self-latching. Outside was observed with adequate outdoor seatings available for clients. Medications were checked and observed kept locked in medication cart. Clients’ MARS was reviewed. Samples of medications, and medication logs were reviewed with no errors. Carbon monoxide and smoke detectors were tested and observed to be operational. All clients’ file reviewed to have all the required documents. Samples of staff files were reviewed and observed to have all the required documents. No deficiencies issued during this inspection. Exit Interview conducted. LPA is requesting the following documents be submitted to the Fresno CCL office by 8/27/26: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization LIC 309, Affidavit regarding Client/Resident Cash Resources LIC 400, Liability Insurance-RCFE, Emergency and Disaster Plan LIC 610E, Personnel Report LIC500, Register of Facility Clients/Residents for LIC9020A A copy of this report with 9102 was distributed to Administrator whose signature confirms receipt of this report.the state’s words, verbatim · CDSS document, Aug 13, 2026

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 09/12/2025 Licensing Program Analyst arrived at the facility to complete an unannounced annual visit. LPA met with Care Giver, Josephine Jo and Care Giver, Ryan Figueroe. LPA introduced self, explained reason for visit and was permitted entry into the facility. Administrator, Phoeun Marez was contacted and arrived some time later. LPA completed a tour of the facility inside and out. A health and safety check was completed on residents in care. 6 residents present during visit. 2 residents receiving hospice services at time of visit. Pathways and doors were clear and free from obstruction. Facility was without odor. Common areas were adequately furnished, and adequately lit. Smoke detectors and carbon monoxide detectors were present and operational at time of visit. Resident rooms observed to have the required furnishings and with adequate lighting. Sharps, chemicals and medications were located in locked cabinets/closets and cupboards. LPA observed sufficient seating under covered patio areas. The following issues were observed during today’s visit: Interviews with 3 of 3 residents disclosed they are not able to request, or refuse services. Facility does not have a device for the residents to use or access. Facility does not have activities for the residents to participate. R3's file missing home health care plan reflecting services, frequency and duration of care. Training is not being completed and documented with staff by hospice. 2 of 2 staff files reviewed do not have the required training. Deficiencies cited per California Code of Regulations, Title 22, deficiencies are being cited on the attached 809D. If not corrected, the violation with have a potential risk to the health, safety and/or personal rights of residents in care. CONT... CONT... LPA requested the following documents to be submitted to CCL by 09/19/25: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-D), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) and a copy of liability insurance in order to update the facility file. Exit interview was conducted with Administrator, Phoeun. A plan of correction was developed by Administrator and reviewed by LPA. A copy of this report, deficiencies, TV's and appeal rights were discussed and provided to Administrator. TSP was discussed. An office meeting will be scheduled and TSP will be offered at that time.the state’s words, verbatim · CDSS document, Sep 12, 2025

Type of visit: Required - 1 Year

On 9/4/24 Licensing Program Analyst (LPA) M. Garza arrived unannounced for an annual inspection visit. LPA was met by Care Giver, Josephine Jo and Care Giver, Ryan Figueroe. LPA introduced self, explained reason for visit and was permitted entry into the facility. Administrator, Phoeun Marez was contacted and arrived some time later. LPA completed a health and safety check on residents in care. LPA toured the facility inside and out. Residents observed in common areas and in rooms. There was 1 resident on hospice at the time of the inspection. Pathways and doors were clear and free from obstruction. Facility was clean and without odor. Common areas were clean, adequately furnished, and adequately lit. Smoke detectors and carbon monoxide detectors were present and operational at time of visit. Fire extinguisher last serviced 2/5/24. Last fire drill on 7/1/24. Water temperature measured at 109 degrees F in restroom #1 and 110 degrees F in restroom #2 and kitchen. Resident rooms observed to have the required furnishings and with adequate lighting. Linen supplies are kept in linen closets. Sharps, chemicals located in locked closets/rooms. LPA observed sufficient seating under covered patio areas. The following issues were observed during time of visit. Chemicals observed unlocked in restroom #1 drawer. Medications observed in lock box unlocked and accessible to residents in care. LPA requested the following documents to be submitted to CCL by 9/13/24: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-E), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) in order to update the facility file. Deficiencies cited on 809D. Exit interview completed with Administrator, Phoeun Marez. A copy of this report, deficiencies and appeal rights were provided.the state’s words, verbatim · CDSS document, Sep 4, 2024

Type of visit: POC

On 9/4/24 Licensing Program Analyst (LPA) M. Garza completed an unannounced case management visit. LPA met by Care Giver, Josephine Jo and Care Giver, Ryan Figueroe. LPA introduced self, explained reason for visit and was permitted entry into the facility. Administrator, Phoeun Marez was contacted and arrived some time later. A health and safety check was completed for residents in care. Residents observed in common area. Case management visit was conducted to follow up on proof of corrections on deficiencies previously cited. Water temperature was measured at 109 degrees F within regulation. POC cleared. During tour of facility LPA observed chemicals in restroom #1 and medications in refrigerator lock box unlocked and accessible to residents in care. POC not cleared. Exit interview completed with Administrator, Phoeun Marez. A copy of this report and POC clearance letter provided.the state’s words, verbatim · CDSS document, Sep 4, 2024