342700064-12-17-2024-27-AS-KVIA-DC33M4-20241217172142

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 342700064
Report Date: 12/17/2024
Date Signed: 12/17/2024 05:21:47 PM

Document Has Been Signed on 12/17/2024 05:21 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/ DIRECTOR:	VERONICA MORALES		FACILITY TYPE:	740
ADDRESS:	2200 GRAMERCY DRIVE		TELEPHONE:	(916) 482-2200
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95825
CAPACITY: 85	TOTAL ENROLLED CHILDREN: 0	CENSUS: 80	DATE:	12/17/2024
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Toni Jones		TIME VISIT/ INSPECTION COMPLETED:	12:15 PM

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On 12/17/24, Licensing Program Analyst (LPA) Kimberly Viarella made an unannounced case management visit to this facility. The purpose of this visit was to follow up with this quarterly visit and inquire about the requirements that were laid out in an office meeting which took place on 3/19/24 . The LPA identified herself upon arrival, stated the purpose of the visit, and asked to meet with the Designated Facility Administrator. LPA met with Toni Jones and a brief interview followed.

In summary the facility agreed to the following and will provide the department documentation of policy and procedure changes.

Updated one on one supervision policy

Documentation of most recent reporting requirements training and mandated reporter training to be completed every six months.
Increased oversight of the facility by licensee as regional director will be on site once per month to ensure compliance.
Facility completed TSP.

LPA requested copies of the following:

Updated one-on-one supervision policy
Documentation of the most recent reporting requirement training and mandated reporter training
Log of site visits by the regional director

Stephen Richardson	TELEPHONE: (916) 263-4746
Kimberly Viarella	TELEPHONE: (916) 809-5764
	DATE: 12/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

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: 12/17/2024

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LPA received the documents requested.

LPA and Designated Facility Administrator conducted a tour of the facility. In memory care, LPA observed 6 staff in memory care: 4 caregivers and 2 medtechs. LPA observed a medication cart during the tour and checked to ensure that all medications were locked and inaccessible to residents in care. Memory care was free of odor and LPA observed 16 residents in the dining room preparing for lunch.

In assisted living, LPA observed 10 residents listening to an entertainer singing. 3 other residents were sitting by the fireplace and all were being supervised by 2 carestaff.

According the California Code of Regulations, Title 22, there were no deficiencies observed or cited during this 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: 12/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

LIC809 (FAS) - (06/04)

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