Senior Care Records.

Facility Evaluation Report

Amazing Grace Care Home, Fremont04/21/2022Licence 019200271

Capacity8
Census8
Date signed04/21/2022 12:33:29 PM
The inspector’s account

On 4/21/2022 at 7:54AM, Licensing Program Analysts (LPAs) C. Lin and L. Fici conducted case management while conducting an complaint investigation. LPAs met with Administrator, Emilissa Pangilinan and explained the purpose of the visit.

Based on interview and record reviews. Administrator also admitted that S1 has been providing activities to and supervising clients since March 2022.

The deficiency was observed (see LIC 809D) and cited from the California Code of Regulations. Failure to correct deficiency by POC date may result in additional Civil Penalties.

$500.00 Civil Penalty was assessed and issued today.

Exit interview conducted with Administrator. LIC809D, Appeal Rights and a copy of this report provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction