Grace Home Tavel

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Andrew Martinez made an unannounced visit to the facility to conduct a required comprehensive annual inspection. LPA met with Administrator Jennifer Hahn, and discussed the purpose of the visit. LPA conducted a general inspection walk through of facility with Administrator Hahn, which included, but was not limited to, the following: Physical Plant: The facility is a single-story (5) bedroom, (3) bathroom Residential Care Facility for Elderly (RCFE) home operating in approved licensed capacity by the Community Care Licensing Division (CCLD), with a current census of (6). The facility has no swimming pools or similar bodies of water. The facility is equipped with sufficient indoor and outdoor space and seating for resident activities; all indoor and outdoor passageways were kept free of obstruction. The facility indoor temperature was maintained at 75 degrees Fahrenheit. Cleaning supplies, toxins, and sharps were kept locked and inaccessible to residents in care. Bedrooms: Resident bedrooms were furnished with mattresses, night stands, chairs, storage space, and sufficient lighting. No resident bedrooms is a passageway to another bedroom. Bathrooms: Resident bathrooms were maintained clean and fixtures were operating properly. Hot water temperatures in the bathrooms was measured at 115 degrees Fahrenheit. Restrooms were equipped with grab rails and slip mats. Food Service: Kitchen and dining areas were maintained cleaned. Non-perishable and perishable food supply is sufficient for number of residents in care. Facility refrigerators and freezers were maintained in healthful manner. Care & Supervision: The facility has care staff coverage, 24 hours a day, 7 days a week. All staff working in the facility have criminal record clearance through the Department. Medical Services: Medications were labeled and centrally stored in a locked cabinet adjacent to the kitchen, inaccessible to residents in care. LPA reviewed resident medications and compared it to the facility's Medication Administration Report (MARs) and Centrally Stored Medication Log. No medication errors observed. Record Review: LPA reviewed (6) resident files for admission agreements, updated physician reports, and needs and services plans. Reappraisals/Needs and Services Plans for (5) of (6) residents have not been updated within the prior twelve (12) months, and (6) of (6) Reappraisals/Needs and Services Plans are required to be reviewed, agreed upon with, and signed by all appropriate parties to comply with Title 22 regulation. A Technical Violation advisory is being cited; Licensee agrees to have all (6) of (6) resident Reappraisals/Needs and Services Plans updated and provide proof of completion to Licensing by close of business on June 12, 2026. LPA also reviewed (3) staff files for First Aid/CPR certifications, training, employee personnel documentation and health screenings. Miscellaneous: The facility maintains a sufficient supply of bed linen, towels, emergency supplies and personal hygiene products for residents in care. The facility is equipped with laundry equipment, telephone service, and a centralized fire/carbon monoxide system. Posters such as personal rights, the Community Care Licensing complaint poster, Ombudsman poster, and the disaster plan, facility license, and resident personal rights were posted in a common area. Based on observations and records reviewed, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted where reports (LIC 809 & LIC 9102) were discussed and a copy provided to Administrator Hahn at the conclusion of the visit.the state’s words, verbatim · CDSS document, Jun 1, 2026

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required comprehensive annual inspection. LPA met with Jennifer Hahn, Administrator, and discussed the purpose of the visit. The facility is a (5) bedroom, (3) bathroom, Residential Care Facility for Elderly (RCFE) with a license capacity of (6), and a current census of (6). LPA conducted a general inspection of facility, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by the Community Care Licensing Division (CCLD). Indoor and outdoor passageways were kept free of obstruction. The facility has no swimming pools or similar bodies of water. The facility has sufficient indoor and outdoor space for resident activities. The facility is maintained at a comfortable temperature. Resident bedrooms were furnished with mattresses, night stands, chairs, storage space, and sufficient lighting. Resident bathrooms were maintained clean and fixtures were operating properly. The hot water temperatures in the bathrooms measured 106 degrees F and were equipped with grab rails and slip mats. The facility maintains a sufficient supply of bed linen, towels, emergency supplies and personal hygiene products for residents in care. The facility is equipped with laundry equipment, telephone service, and a centralized fire/carbon monoxide system. Posters such as personal rights, the Community Care Licensing complaint poster, Ombudsman poster, and the disaster plan, facility license, and resident personal rights were posted in a common area. Cleaning supplies, toxins, and sharps were kept locked and inaccessible to residents in care. Food Service: Kitchen and dining areas were maintained cleaned. Non-perishable and perishable food supply is sufficient for number of residents in care. Facility refrigerators and freezers were maintained in healthful manner. Care & Supervision: The facility has care staff coverage, 24 hours a day, 7 days a week. All staff working in the facility have criminal record clearance through the Department. Medical Services: Medications were labeled and centrally stored in a locked cabinet inaccessible to residents in care. Record Review: LPA reviewed (6) resident files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed (3) staff files for First Aid/CPR certifications, training, employee personnel documentation and health screenings. Based on observations and records reviewed, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted where reports (LIC809 & LIC9102) were discussed and a copy provided to the Administrator at the conclusion of the visit.the state’s words, verbatim · CDSS document, Jun 7, 2024

The state marks this report as 4 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.