Facility Evaluation Report

On 0/3/27/23, at 10:00 AM, an unannounced annual inspection was conducted by Licensing Program Analysts, (LPAs), Kimberly Viarella and Charlie Yang at Graceful Living at Village One in Modesto. LPAs identified themselves and the purpose of their visit to staff, Rainilda Clavano, and instructed that the facility administrator be notified of their arrival.

Voica Matis, Licensee, arrived and stated that Letecia Suasin, the listed designated facility administrator, was on vacation and that she was the designated facility administrator. A brief interview with the designated facility administrator followed. Facility reported census was 5 with 2 bedridden and 2 hospice, no home health at this time. Upon inspection the LPA noted a census of 5 of which 3 were bedridden based on the LIC 602 and 3 were receiving hospice services. The facility is licensed for 6 nonambulatory and 1 bedridden and has been approved for a hospice waiver for 2 residents. Residents with dementia were observed to be in care at this facility.

The tour began in the kitchen/areas. LPAs checked the food supply and found that there were enough groceries for 2 days of perishable and 7 days of non-perishable items at this time. Knives were secured in a locked drawer and chemicals were stored in a locked cabinet under the sink and separate from the food supply. The fire extinguisher was last inspected on 03/06/2023, by Stanislaus Fire.

The tour progressed to the backyard. An alert sounded upon exiting the building. There were no bodies of water present. LPAs observed a wooden fence enclosing the backyard.