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Inspection visit

Follow-up on corrections

MONTGOMERY SPRINGS MANORLicense 0156015061 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

While at the facility investigating a complaint (Control # 15-AS-20250206094236) and upon review of resident's (R1) file, Licensing Program Analyst (LPA) Delmundo observed R1 has prescribed antibiotics medication to be administered 3 times a day for 3 days. The medication was received by the facility on 2/06/25 and administration was started same day; however, the medication was not recorded on LIC622 Centrally Stored Medication and Destruction Record nor administration of this medication recorded on Medication Administration Record (MAR). Staff (S1) stated the medication was received and administered but she didn't record. These were discussed with Mirriam Paras, administrator (ADM). Deficiency is cited from Title 22 California Code of Regulations, and listed on 809D. Failure to submit proof of correction by plan of correction due date may result in additional civil penalty. Deficiency, plan and proof of correction were discussed with ADM. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.

Citations

2 citations recorded*CCLD

What does Type A vs Type B mean?

Type A. Serious citation. Imminent or substantial risk to children. The regulator requires corrective action immediately and may impose a civil penalty.

Type B. Lower-severity citation. Corrective action required, no imminent risk. The regulator monitors compliance on the next visit.

  • 87506(a)Type B

    87506 Resident Records(a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. -This requirement is not met as evidenced by:-Based on record review and interview, the licensee did not comply with the section above in not completing the record when R1's medication was received and administered which posed a potential personal rights risk to person in care.

  • 87303(a)Type B

    87303 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 is not met as evidenced by:-Based on observation, the licensee did not comply with the section above for the following which pose a potential health and/or personal rights risks to persons in care: strong smell of urine in the bathroom; mouse droppings; dusty air vents; stain and dusty floor

FAQ · About this visit

Common questions about this visit

What happened during the February 14, 2025 inspection of MONTGOMERY SPRINGS MANOR?

This was a other inspection of MONTGOMERY SPRINGS MANOR on February 14, 2025. 1 citation were issued: 1 Type B.

Were any citations issued to MONTGOMERY SPRINGS MANOR on February 14, 2025?

Yes, 1 citation was issued (0 Type A, 1 Type B). The first citation was for: "87506 Resident Records(a) The licensee shall ensure that a separate, complete, and current record is maintained for each..."

What type of inspection was this?

This was a other inspection. other inspections are conducted by CCLD as part of their licensing oversight.

SourceView on CCLDView original report

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Data from CCLD public records. Last updated . If you believe any information is inaccurate, report it here.