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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 075601395
Report Date: 02/05/2025
Date Signed: 02/05/2025 12:37:18 PM

Document Has Been Signed on 02/05/2025 12:37 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
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:GRACE HOMES 2, LLCFACILITY NUMBER:
075601395
ADMINISTRATOR/
DIRECTOR:		HERBERT, HELEN GRACE S.FACILITY TYPE:
740
ADDRESS:423 MCLAUGHLIN STREETTELEPHONE:
(510) 233-5377
CITY:RICHMONDSTATE: CAZIP CODE:
94805
CAPACITY: 6CENSUS: 6DATE:
02/05/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Mariam Salazar, CaregiverTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 02/05/2024 around 09:15 AM, Licensing Program Analyst (LPA) L. Holmes arrived unannounced to conduct a required annual inspection. Helen Herbert, Administrator (ADM) was notified. LPA met with Araceli Emerick, Staff (S1) and explained the purpose of the visit. ADM who currently holds a Standard Certificate #(7000752740) that expires on 06/12/25. The facility’s fire clearance was approved for six (6) ambulatory clients; three (3) may be non-ambulatory and three (3) may be bedridden.

Upon arrival, LPA observed two (2) staff attending to four (4) residents dining and watching television. LPA toured the facility with S1 including, but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of five (5) total bedrooms which four (4) are occupied by the residents and one (1) by staff. All outdoor and indoor passageways were free of obstruction. There are not any bodies of water. A comfortable temperature was maintained at 71 degrees Fahrenheit (F). LPA observed lighting in all rooms to be adequate for the comfort and safety of the residents. Hot water temperature in the shared residents bathroom was measured at 116.2 degrees (F). Toilet, hand washing, and bathing areas were safe, sanitary and in operating condition. Hand washing poster, paper towels, and soap observed at all hand washing stations. Linen and hygiene products were available for residents. PPE, sanitizer, and paper goods are sufficient. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher last inspected 06/13/24. Emergency Disaster Plan is updated. First aid kit observed complete. Fire drill was last conducted on 12/2024.

Six (6) resident and four(4) staff records were reviewed, all staff have criminal record clearance.

No deficiencies cited during visit.

Exit interview conducted and a copy of this report provided to Mariam Salazar, Caregiver.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Lisha Holmes
LICENSING EVALUATOR SIGNATURE: DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/05/2025
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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