331880511-4-15-2024-18-AS-JGEE-D4CS33-20240415133028

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 331880511
Report Date: 04/15/2024
Date Signed: 04/15/2024 01:30:32 PM

Document Has Been Signed on 04/15/2024 01:30 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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME:	PALMS AT LA QUINTA, THE		FACILITY NUMBER:	331880511
ADMINISTRATOR:	ROLAND GANDY		FACILITY TYPE:	740
ADDRESS:	45160 SEELY DRIVE		TELEPHONE:	(760) 345-5353
CITY:	LA QUINTA	STATE: CA	ZIP CODE:	92253
CAPACITY:	120	CENSUS: 105	DATE:	04/15/2024
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	Roland Gandy, Executive Director		TIME COMPLETED:	01:40 PM

NARRATIVE

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On April 15, 2024, Licensing Program Analyst (LPA) Javina George arrived at the facility to conduct an unannounced annual inspection. LPA met with Administrator, Roland Gandy and explained the purpose of the inspection. The facility serves residents that reside in assisted living, memory care and independent living. The residents range from being aged 60 and over, and are non-ambulatory. The facility has an approved hospice waiver for 18 residents.

Physical plant: during today's visit LPA conducted a tour of the interior and exterior of the facility. The facility was observed to be clean, clutter and odor free. LPA observed a 7-day supply of non-perishable and 2-day supply of perishable foods were present. Six (6) resident apartments were inspected and observed to be clean and furnished with a bed, chest of drawers, chairs and adequate lighting. The bathrooms were observed to be clean and equipped with grab bars in the shower. The medications and hazardous items were stored in a locked area, and are inaccessible to residents in care. The hot water tested in multiple apartments and were found to be within regulatory limits ranging from 105.9-113.5 degrees Fahrenheit.

Carbon monoxide & smoke detectors were tested and observed to be operable. Delayed egress devices were operable on all exit doors. Resident call buttons and pendants were tested and observed to be operable. There are no known guns or ammunition on the premises. There are were no bodies of water were observed.

Records review: Five (5) resident files were reviewed, and all 5 resident files were observed to have the required documentation such as medical assessments, admission agreements, pre appraisal assessments. Five (5) staff records were reviewed and all #5 contained the required training, however there were only two (2) staff observed to have current first-aid/CPR certification for the entire facility. A citation will be issued in accordance with the California Code of Regulations (Title 22, Division 6, Chapter 8).

An exit interview was conducted where this report, 809D, LIC9098 proof of corrections form, LIC 811 and appeal rights were discussed with and provided to the Roland Gandy, Executive Director.

SUPERVISOR'S NAME: Tricia Danielson	TELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Javina George	TELEPHONE: (951) 217-3970
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2024

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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Document Has Been Signed on 04/15/2024 01:30 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: PALMS AT LA QUINTA, THE	FACILITY NUMBER: 331880511
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/15/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

HSC

1569.618(c)(3)

Other Provisions

(c)The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staff to provide CPR. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review , the licensee did not comply with the section cited above in 5 out of 5 times as there are only two staff that obtained current CPR certification, and they do not work at the facility 24 hours 7 days a week, which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 04/16/2024
	Plan of Correction
1 2 3 4	The licensee agrees to enroll staff in a recognized CPR certification class, in order to be in complaince with the regulation cited above. Proof of correction is to be submitted to the department by 5pm on the due date (4/16/24) indicated.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Tricia Danielson	TELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Javina George	TELEPHONE: (951) 217-3970
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2024

LIC809 (FAS) - (06/04)

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