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Inspection visit

Follow-up on corrections

MONTGOMERY SPRINGS MANORLicense 0156015063 citations on this visit
3 citations recorded

Inspector’s narrative

What the inspector wrote

While at the facility investigating a complaint (Control # 15-AS-20250808113155) and upon review of residents' files and interviews, Licensing Program Analyst (LPA) Delmundo learned that resident (R1 and R2) LIC602A Physician's Reports are outdated. R1's LIC602A was dated 1/09/17 and showed R1 able to bathe, dress/groom and feed self and care for own toileting needs; however, R1's condition has changed and is now dependent on the staff on all activities of daily living. R2's LIC602 dated 4/14/24 indicated ambulatory but R2 uses walker to ambulate. Deficiencies are cited from Title 22 California Code of Regulation, and listed on 809Ds. Failure to submit proof of corrections by plan of correction due dates and any repeat violations within 12 month period may result in civil penalties. Deficiencies and plan and proof of corrections were discussed with the ADM. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.

Citations

3 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.

  • 87458(c)(5)Type B

    87458 Medical Assessment: (c) The medical assessment shall include, but not be limited to: (5) The determination whether the person is ambulatory or nonambulatory as defined in Section 87101, ..The assessment shall indicate whether nonambulatory status is based upon the resident's physical condition, mental condition, or both....-This requirement is not met as evidenced by:-Based on record review and observation, the licensee did not comply with the section above in R2's LIC602A not consistent with R2's ambulatory status

  • 87463(e)Type B

    87463 Reappraisals(e) The licensee shall immediately, or as soon as reasonably possible, bring any significant change in condition....to the attention of the appropriate licensed medical professional ....-This requirement is not met as evidenced by: -Based on record review, interviews and observation, the licensee did not compy with the section above for not having R1'sLIC602A updated when R1's conditions changed which poses a potential health and/or personal rights risks to person in care.

  • 87615(a)(5)Type B

    87615 Prohibited Health Conditions (a) Persons who require health services for or have a health condition.....shall not be admitted or retained in a residential care facility for the elderly: (5) Residents who depend on others to perform all activities of daily living for them......-This requirement is not met as evidenced by --Based on record review, interviews and observation, the licensee did not compy with the section above in retaining R1 who is dependent on all ADLs which poses a potential health and/or personal rights risks to person in care,

FAQ · About this visit

Common questions about this visit

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

This was a other inspection of MONTGOMERY SPRINGS MANOR on August 14, 2025. 3 citations were issued: 3 Type B.

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

Yes, 3 citations were issued (0 Type A, 3 Type B). The first citation was for: "87458 Medical Assessment: (c) The medical assessment shall include, but not be limited to: (5) The determination whether..."

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.