Grace Garden RCFE

Type of visit: Case Management - Other

Licensing Program Analyst Marcela Yanez conducted an unannounced case management visit to obtain documents for complaint number 26-AS-20260413164303. LPA announced to purpose of the visit and met with Patti Fesseha, Administrator. During visit LPA obtained copies of LIC 308 stating S1 as designated administrator dated 12/16/25, LIC 500 dated 12/16/25 and 04/27/26. ADM stated she will provide a Staff Roster via email to LPA. No deficiencies cited during today's visit. This report was reviewed with Patti Fesseha, Administrator and a copy of the signed report was provided.the state’s words, verbatim · CDSS document, Apr 27, 2026

Allegation investigated: Facility staff verbally abuses resident Staff do not assist residents with medical appointments Facility staff does not assist resident with changing of cloths daily

Licensing Program Analyst (LPA) Marcela Yanez conducted an unannounced compaint investigation visit. LPA announced the purpose of the visit and met with Patti Fesseha. LPA observed 3 residents in living room and 2 residents in their room. LPA observed 3 staff. On 04/13/2026 the department recieved a complaint with the above allegations. During visit LPA interviewed 5 residents and 3 staff including Adminsitrator. 5 out of 5 residents stated that the staff treat them with dignity and respect. 5 out of 5 residents stated the staff changes their clothing every day or as needed. 5 out of 5 residents stated they like living at the facility and they love the food. 2 out of 3 residents stated the facility staff will give them a ride to the doctors and the doctor will also come to see them at the facility. 2 out of 2 residents stated their family member will take them to the doctors. page 1 of 2 Unfounded Page 2 of 2 3 out of 3 staff stated that they have not seen staff verbally abuse residents. 3 out of 3 staff stated the residents get their clothing changed daily and sometimes more often if they become soiled. 2 out of 2 staff stated that that ADM will give resident a ride to doctor. 3 out of 3 staff stated everybody in the facility gets along and have not witnessed any staff treat residents rude or disrespectful. 1 out of 3 staff stated everyone is happy. This Department has investigated the above allegations to be unfounded meaning the allegations is false, could not have happened, and/or is without a reasonable basis. This report was reviewed with Patti Fesseha Administrator and a copy of the report was provided.the state’s words, verbatim · CDSS document, Apr 15, 2026 · control 26-AS-20260413164303

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Marcela Yanez conducted an unannounced case management visit. LPA announced the purpose of the visit and met with Patty Fesseha, Administrator. During visit LPA reviewed 2 residents care plan. Care plan does not state if resident needs 2 person assist. 2 out of 5 residents need assistance with transfer from bed to wheelchair and the facility will use a Hoyer lift when transferring. ADM stated S1 does not do any lifting. ADM stated his/her duties have been adjusted to a companion for residents and he/she makes breakfast for the residents. 1 out of 2 residents stated S1 does not do any lifting when he/she is being lifted from the bed to the wheelchair or vise versa. ADM stated the 2 residents need to be transferred using a hoyer lift so staff does not do any heavy lifting. No deficiencies cited during today's visit. This report was reviewed with Patti Fesseha, Administrator and a copy of the signed report was provided.the state’s words, verbatim · CDSS document, Apr 15, 2026

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Marcela Yanez conducted an unannounced case management visit regarding regarding an SOC341. LPA announced the purpose of the visit and met with Administrator, Patti Fesseha. LPA observed 1 resident eating a snack and 1 resident watching television. LPA observed 3 staff including Administrator. During visit LPA toured the facility and observed the facility in good repair and residents rooms with bedding and functioning lights and closet for residents belongings. LPA interviewed Staff S1 and ADM. LPA reviewed staff files for S1 and S2. LPA observed staff training dated 01/2026. No deficiencies cited during today's visit. This report was reviewed with Patti Fesseha, Administrator and a copy of the signed report was provided.the state’s words, verbatim · CDSS document, Apr 7, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Marcela Yanez conducted an unannounced Required 1 Year visit and met with Patti Fesseha, Administrator (ADM). LPA announced the purpose of the visit. LPA observed 2 staff and 5 residents. During visit, LPA toured the facility inside and out. LPA toured the garage which is converted to a kitchen with stove and cooking area and pantry. LPA observed the separate kitchen area and observed locked cabinets for medications, sharp objects, and cleaning supplies. LPA observed perishable food supply of at least two days and a non-perishable food supply of at least seven days. Refrigerator temperature displayed on refrigerator 37 degrees f and freezer at 0 degrees f. LPA toured 5 resident bedrooms. Each bedroom had available bedding and clothing storage areas as well as functioning lights. LPA toured two out of two resident bathrooms. Each bathroom had available soap and paper towels and functioning lights. The water temperatures in the bathroom sinks measured with thermometer at 115.1-115.5 degrees F. LPA observed 1 staff bedroom. During visit LPA observed Staff S1 was not associated or fingerprint cleared and living at the facility. ADM stated S1 started on 12/18/25. ADM stated fingerprint live scan was just done on 12/18/25. ADM verified new staff has been providing care to residents since 12/18/25. Page 1 of 2 Page 2 of 2 During tour ADM tested the smoke detector and found smoke detector to function properly. LPA toured the outside area and found the exits to be clear of obstructions. LPA observed fire extinguisher was last serviced on 02/19/25. LPA reviewed Fire and Earthquake log. The last disaster drill was conducted on 10/01/25. LPA reviewed resident records for 3 out of 5 residents and centrally stored medication. LPA reviewed 2 staff records. A deficiency is being cited per California Code of Regulations, Title 22. See LIC809-D. A civil penalty is being assessed for the amount of $500 ($100 x 5 days) = $500 for S1 working in the facility without a fingerprint clearance. See LIC421BG. This report was reviewed with ADM and a copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Dec 22, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced annual inspection visit, and met with Administrator Patti Fesseha. During the visit, LPA observed 5 residents and 2 staff. LPA explained the purpose of the visit. LPA toured the facility inside out with ADM which included the Living room, kitchen, dining room, 2 restrooms and 5 residents bedrooms. The staff area of the facility was also inspected. The front yard and backyard were inspected. There was no obstruction to block the walkways. Two-day perishable food supplies and seven day nonperishable food supplies were observed. LPA observed the medication storage area, knives storage area, and cleaning product storage area as locked and inaccessible to residents in care. Room temperature was at 70 degrees F, and hot water temperature was measured at 115 degrees F in both resident bathrooms. While touring the home, LPA observed the family room, adjacent to bedroom #4. LPA observed the family room was being used as a bedroom. ADM stated she is having a resident stay there and did not notify the Department of the change of use of this room. (Photographs were taken). While touring the backyard, LPA observed a sliding screen door installed in bedroom #4 and the family room adjacent to bedroom #4. ADM stated stated these changes were done sometime in February 2024. LPA requested to review the facility fire/earthquake drill log. The facility's last drill was on September 31, 2024. LPA observed the fire drill for the fourth quarter had already been signed, for December 31, 2024. ADM stated it was a typo and the drill was conducted in December 1, 2024. LPA requested ADM conduct another drill for the month of December and send LPA documentation that the drill had taken place. Page 1 Out of 2. Fire extinguisher was serviced in February 1, 2024. The facility was equipped with smoke and carbon monoxide detectors. Smoke detectors was tested by ADM, and were functional. LPA observed facility first aid kit LPA reviewed facility records for 3 residents. Resident R1's physicians report dated June 14, 2022 and May 29, 2024 states R1 has a neurocognitive disorder. A review of R1's needs and services plan, dated February 8, 2023, states R1 has mild dementia. ADM stated she did review R1's May 29, 2024 physicians report. LPA asked to review resident R3's care plan. ADM stated she has not created one. ADM stated she only has the pre-admission appraisal. LPA asked again if she has any documentation of the care plan for R3. ADM stated she has not done it. LPA reviewed 3 staff records. LPA requested to review staff S1 and S2 health screening. ADM stated she has not done the health screenings for these two staff. LPA requested to review S1 and S2 and S3's education background and past experience. ADM stated she knows but has not documented it in the staff's files. LPA requested to review S1, S2 and S3's first aid training. (S2's first aid training is expired.) ADM stated the staff has not completed their first aid, but they are planning on completing the first aid training later this month. LPA reviewed 3 resident medications and centrally stored medication records. LPA conducted interviews with 2 residents. LPA provided ADM with a flyer "Important updates to Dementia Care & Miscellaneous Changes, Effective January 1, 2025." LPA requested a copy of the following documents: 1.LIC 500, Personnel Summary 2.LIC 308, Designation of Administrative Responsibility 3.LIC400, Affidavit Regarding Client/Resident Cash Resources 4. Liability Insurance 5. Qualifications of Administrator (Certificate) 6. Copy of surety bond 7. Please review your facility program for updates (incorporating new laws and/or regulations) Deficiencies cited during today's visit, see LIC809-D. Technical violations were cited. This report was reviewed with Administrator Patti Fesseha and a copy of the signed report was provided. Appeal rights were provided. Page 2 Out of 2. END OF REPORT.the state’s words, verbatim · CDSS document, Dec 11, 2024