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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700064
Report Date: 08/29/2024
Date Signed: 08/29/2024 03:07:03 PM


Document Has Been Signed on 08/29/2024 03:07 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 COURTFACILITY NUMBER:
342700064
ADMINISTRATOR:VERONICA MORALESFACILITY TYPE:
740
ADDRESS:2200 GRAMERCY DRIVETELEPHONE:
(916) 482-2200
CITY:SACRAMENTOSTATE: CAZIP CODE:
95825
CAPACITY:85CENSUS: 80DATE:
08/29/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Veronica MoralesTIME COMPLETED:
03:30 PM
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On 8/29/24 at 2:00pm Licensing Program Analyst (LPA) Kevin Gould conducted an unannounced Case Management inspection at Gramercy Court to address and incident report from 4/1/23 where it was disclosed a resident had sexually harassed another resident in the facility. LPA met with administrator Veronica Morales and together discussed the reported incident and obtained additional information.

LPA Gould conducted an interview with one resident.

Based on the interviews and information gathered during today's inspection, the department will conduct additional interviews and file review before making a determination regarding the reported incident.

Exit interview was conducted and a copy of this report was left a the facility.
SUPERVISOR'S NAME: Czarrina A Camilon-LeeTELEPHONE: (916) 214-5136
LICENSING EVALUATOR NAME: Kevin GouldTELEPHONE: (619) 672-5924
LICENSING EVALUATOR SIGNATURE:
DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/29/2024
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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