Senior Care Records.

Facility Evaluation Report

Amazing Grace Care Home, Fremont08/21/2025Licence 019200271

Capacity8
Census7
Date signed08/21/2025 03:25:34 PM
Name of licensing program analystPatricia Manalo
Name of licensing program managerYvonne Flores-Larios
The inspector’s account

On 8/21/2025 at 2:05 PM, Licensing Program Analyst (LPA) P.Manalo arrived unannounced to conduct a case management visit. LPA met with Direct Care Staff, Irma Avila, and explained the purpose of the visit. Administrator, Emilissa Pangilina came shortly after.

While LPA was at the facility for a complaint investigation (#15-AS-20250815090718) the following deficiencies were observed:

At 9:40 AM, LPA observed Clorox Wipes and Lysol Spray in the dining room area. A repeat civil penalty of $250.

At 10:32 AM, LPA observed all 7 clients at the facility and one staff member.

The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct deficiencies may result in civil penalties.

Exit interview conducted. A copy of this report and appeal rights provided.

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