342700064-8-2-2024-27-AS-KVIA-D7RVQJ-20240802163825

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 342700064
Report Date: 08/02/2024
Date Signed: 08/02/2024 04:38:34 PM

Document Has Been Signed on 08/02/2024 04:38 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	GRAMERCY COURT		FACILITY NUMBER:	342700064
ADMINISTRATOR:	VERONICA MORALES		FACILITY TYPE:	740
ADDRESS:	2200 GRAMERCY DRIVE		TELEPHONE:	(916) 482-2200
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95825
CAPACITY:	85	CENSUS:	DATE:	08/02/2024
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Veronica Morales		TIME COMPLETED:	04:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 08/02/24 Licensing Program Analyst (LPA) Kimberly Viarella made an unannounced visit to this facility to conduct a quarterly case management visit. This visit was a follow up to a meeting conducted virtually with Community Care Licensing on 03/11/24. LPA identified herself upon arrival, stated the purpose of the visit, and asked to meet with the Designated Facility Administrator (DFA). LPA met with Veronica Morales and a brief interview followed. LPA reviewed the mandated reporting log from 2/23/24. The next training is tentatively scheduled for this August 2024. The DFA stated she was waiting to hear back from multiple agencies to confirm an exact date. Once the date is confirmed, Licensing will be notified. LPA and DFA discussed how the mandated reporting and reporting requirement training was implemented. The DFA stated she utilized videos, handouts and staff were also tested on the materials. LPA was provided a copy of the mandated reporting pre-test and handouts. Upon reviewing the materials, LPA noted that they needed to be updated to reflect the change in the law that occurred in January of 2024 which required incidents of abuse to be reported verbally within 2 hours to law enforcement, the local ombudsman, and licensing, and an SOC 341 should be submitted within 24 hours. The Licensee agreed to have additional oversight of the facility by having the Regional Director, Dan Bushnell, conduct on site reviews of operations monthly. When the LPA asked the DFA for the dates of these monthly inspections, she could not provide one. The DFA stated that the Regional Director makes unscheduled visits 2-3 times a month but she did not have those visits documented. The DFA added that the Regional Director schedules virtual meetings during the month to discuss concerns. The DFA also stated that she sends weekly reports on Fridays that include the current census, number of hospice, move outs/in, pending admissions, any incident reports, SOC 341s, or other concerns. LPA went on to review the 1-1 caregiver supervision policy created by the Skilled Nursing Administrator and the DFA. A copy of this document was emailed to Community Care Licensing.

SUPERVISOR'S NAME: Stephen Richardson	TELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Kimberly Viarella	TELEPHONE: (916) 809-5764
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: GRAMERCY COURT	FACILITY NUMBER: 342700064
	VISIT DATE: 08/02/2024

NARRATIVE

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LPA and DFA discussed eviction procedures. DFA had previously contacted this LPA seeking guidance regarding evictions. LPA has reviewed all eviction notices to ensure compliance.

As part of this visit, LPA and DFA conducted a walkthrough of the facility. LPA observed 10 residents in one of the two dining rooms of memory care along with 3 care staff and 1 med tech. The Olympics were on TV in the background. LPA walked through the assisted living building as well. LPA observed 5 residents in the dining area of assisted living.

LPA did not observe any activities during this visit but was told that all residents were offered the opportunity to participate in a daily exercise class and the Activity Director conducted Bingo in memory care. In assisted living there was a movie accompanied by popcorn following their exercise class.

According to the California Code of Regulations, Title 22, no deficiencies were observed or cited during today's visit. A copy of this report was provided. Exit interview.

SUPERVISOR'S NAME: Stephen Richardson	TELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Kimberly Viarella	TELEPHONE: (916) 809-5764
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2024

LIC809 (FAS) - (06/04)

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