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13 | Licensing Program Analyst (LPA) A. Canela conducted an unannounced complaint follow up inspection to deliver findings, and met with Administrator, Mikayla Muehleisen. LPA toured memory care unit, made observations and took statements.
It is alleged staff did not meet residents needs, resident sustained multiple falls with injury and staff did not safeguard residents personal belongings. LPA previously conducted interviews and reviewed records. Investigation revealed, resident (R1) fell on several occasions, 11/29/2020, 12/27/2020, 12/31/2020, 1/22/2021 and 3/14/2021. Rockville Terrace Resident assessment form of 2/15/21 indicated, R1 needed to be escorted to meals and frail or slow. Review of resident notes indicated R1 was noted by staff, to be unbalanced the morning of, 3/13/2021 and on 3/14/2021 R1 was not escorted by staff, fell on her way to breakfast, R1 hit the back of head on wall. |
| Substantiated | Estimated Days of Completion: |
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Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Type A
11/18/2021
Section Cited
HSC
1569.269 | 1
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7 | 1569.269 Enumerated rights; severability (a) Residents of residential care facilities for the elderly shall have all of the following rights: (6) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs.
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7 | Facility to send in written plan on how they will ensure residents needs are being met per H&S 1569.269 |
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14 | This requirement was not met as evidenced by: Resident R1 sustained several falls, R1 was observed to require additional needs and services for their safety along with staff escort to meals. This is an immediate risk to the health and safety of residents in care | 8
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14 | POC due date 11/19/2021
To LPA A. Canela |
Type B
11/29/2021
Section Cited
CCR
87218(a) | 1
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7 | 87218(a) Theft and Loss
(a) The licensee shall ensure an adequate theft and loss program as specified in Health and Safety Code Section 1569.153. | 1
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7 | Facility to send in written plan on how residents belongings/clothing items are not lost or misplaced during laundry time and that facility has an inventory of all durable equipment, identified per resident |
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14 | This requirement was not met as evidenced by: Resident R1 had several clothing items missing and after moving out, family found several items of clothing that did not belong to R1 along with a wheelchair that belong to another resident. This is a potential risk to the personal rights of residents in care
Residents property, | 8
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14 | and how they will ensure residents have their own items.
POC due date 11/29/2021
To LPA A. Canela |
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13 | Licensing Program Analyst (LPA) A. Canela conducted an unannounced complaint follow up inspection to deliver findings, and met with Administrator, Mikayla Muehleisen. LPA toured memory care unit, made observations and took statements.
It is alleged Residents room is not safe, sanitary or in good repair and
resident sustained weight loss. LPA took statements, reviewed records; facility and medical information reviewed did not show or document a weight loss for R1. It was also reported R1s room was observed to have feces in the bathroom & smelled of urine. Staff interviewed disclosed R1s room was cleaned, LPA toured the facility and during todays inspection the hallways or resident rooms inspected were observed clean with no odors. LPA did not receive corroborating evidence,
Although the allegations may be true, or are valid, there is not a preponderance of evidence to prove the alleged violations did, or did not, occur. Therefore, the above allegations are both UNSUBSTANTIATED. No citations issued regarding the above. |
| Unsubstantiated | Estimated Days of Completion: |
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