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Inspection visit

Follow-up on corrections

PACIFICA SENIOR LIVING UNION CITYLicense 0192005091 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Luisa Fontanilla conducted a case management visit in connection with complaint 15-AS-20220526161218. During the course of investigation, it was observed that the elopement incident that happened on May 23, 2022 when a resident in the Memory Care Unit wandered out of the facility was not reported to CCL. Deficiency is cited per Title 22 California Code of Regulations Sec 87211(refer to Lic 809D). Exit interview was conducted with Director and Appeal Rights was 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.

  • 1569.269(a)(10)Type A

    (a) Residents of residential care facilities for the elderly shall have all of the following rights:(10) To be free from neglect, financial exploitation, involuntary seclusion, punishment, humiliation, intimidation, and verbal, mental, physical, or sexual abuse.This requirement is not met as evidenced by:This requirement is not met as evidenced by: On May 23, 2022, R1 wandered out of the building. R1 has dementia and medical records indicate R1 is not allowed to leave the facility unassisted.

  • 87465(a)(4)Type B

    87465(a)(4) Incidental Medical and Dental Care(a) A plan for incidental medical and dental care shall be developed....(4) The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by:Based on review of MAR for May 2022, R1 was given Donepezil for only 9 days.

  • 87211(a)(1)(D)Type B

    87211 Reporting Requirements(a) Each licensee shall furnish to the licensing agency such report...(D) Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident. This requirement is not met as evidenced by:R1 who has dementia and is not allowed to leave facility unassisted wandered out of the facility on 5/23/2022 but facility failed to report incident to CCL which poses a potential threat to safety of clients in care.

FAQ · About this visit

Common questions about this visit

What happened during the July 19, 2023 inspection of PACIFICA SENIOR LIVING UNION CITY?

This was a other inspection of PACIFICA SENIOR LIVING UNION CITY on July 19, 2023. 1 citation were issued: 1 Type B.

Were any citations issued to PACIFICA SENIOR LIVING UNION CITY on July 19, 2023?

Yes, 1 citation was issued (0 Type A, 1 Type B). The first citation was for: "(a) Residents of residential care facilities for the elderly shall have all of the following rights:(10) To be free from..."

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.