Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Type A
07/31/2024
Section Cited
CCR
87411(a) | 1
2
3
4
5
6
7 | 87411(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. In facilities licensed for sixteen or more, sufficient support staff shall be employed to ensure provision of personal assistance and care as required... This requiement was not met as evidenced by: | 1
2
3
4
5
6
7 | Facility to send in written plan on how they will ensure that residents do not leave the facility unassisted. Facility to train all staff regarding Care and Supervision, AWOL procedures. Staff training to include date, time of day, duration, subject, names and signatures of staff who attended. |
 | 8
9
10
11
12
13
14 | Based on staff interviews and records reviewed: Facility did not ensure supervision of R2 and R3, who AWOL'd from the facility without their knowledge. R2's & R3's Physician's Report(LIC 602) states diagnoses of Dementia & they may not leave the facility unassisted. This is an immediate risk to the health and afety of residents care. | 8
9
10
11
12
13
14 | Written Plan and staff training to be submitted to Community Care Licensing (CCL) by POC due date 07/30/2024
Civil Penalty for $500.00 was issued during today's visit for Zero Tolerance, Absence of Supervision.
|
Type B
07/31/2024
Section Cited
CCR
87303(a) | 1
2
3
4
5
6
7 | 87303(a) Maintenance and Operation- (a)The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not met. As evidenced by: | 1
2
3
4
5
6
7 | Facility called pest control and took care of the pest issue. Facility provided copies of pest contract invoice, to clear deficiency. |
| 8
9
10
11
12
13
14 | Residents room had an issue with mice in their closet/room. no mice dropping were observed in the kitchen. This is a potential risk to the health & Safety of residents in care. | 8
9
10
11
12
13
14 | |
1
2
3
4
5
6
7
8
9
10
11
12
13 | Licensing Program Analyst (LPA) Canela arrived unannounced for the purpose of delivering findings to the above allegations and met with Jasmine Seiffert, Executive Director.
In the course of the investigation LPA took statements, reviewed records and consulted regarding resident R1's falls and injuries. The department was not able to determine if the resident’s falls at the facility resulted to the subdural hematomas noted on their CT of 11/11/2023, as R1, prior to transferring to the Lodge at Glen Cove facility on 11/1/2023, had multiple falls at home resulting to head trauma per R1's family member. Also, resident was not assessed by a clinician to assess possible head injury after each fall in the facility and was not sent to the ER for evaluation.
Although the allegation may be true, based on the above information, and records reviewed, there is not a preponderance of evidence to prove or, disprove, the allegation did occur. Therefore, it is UNSUBSTANTIATED at this time. No citation issued. |
| Unsubstantiated | Estimated Days of Completion: |
|