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Inspection visit

Incident investigation

IVY PARK AT HAYWARDLicense 0192009222 citations on this visit
2 citations recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct case management as a follow-up on the Unusual Incident Report (UIR) received by the Department. UIR indicated that on October 19, 2022, staff checked on resident (R1) in room and common areas around 9:10 am, and unable to locate R1. Staff immediately activated code silver. Executive Director checked the camera monitor and saw R1 leaving around 9:00 am. Staff followed the route R1 headed, and found R1. R1 was not on apparent distress. LPA requested for copies of LIC602A Physician's Report which revealed R1 has dementia and wandering and sundowning behaviors, and can not leave the facility unassisted. On this day, LPA observed the front door entrance's auditory device not working. Deficiendies cited from Title 22 California Code of Regulations (see 809D). Failure to submit proof of corrections (POCs) by plan of correction due dates, and any repeat violations within 12 month period may result in civil penalties. Deficiency and plan and proof of correction were discussed with Rosana Frias. 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.

  • 87705(b)(2)Type A

    87705 Care of Persons with Dementia(b) In addition to the requirements as specified in Section 87208, Plan of Operation, the plan of operation shall address the needs of residents with dementia, including: (2) Safety measures to address behaviors such as wandering...... -This requirement is not met as evidenced by:-Based on records review, the licensee did not comply with the section above for R1 who has dementia was able to leave the facility unnoticed which posed immediate safety risk to person in care.

  • 87705(j)Type A

    87705 Care of Persons with Dementia(j) The licensee shall have an auditory device or other staff alert feature to monitor exits, if exiting presents a hazard to any resident.-This requirement is not met as evidenced by -Based on observation, the llicensee did not comply with the section above.for the auditory device on the front door not working which poses immediate safety risks to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the January 19, 2023 inspection of IVY PARK AT HAYWARD?

This was a other inspection of IVY PARK AT HAYWARD on January 19, 2023. 2 citations were issued: 2 Type A (serious).

Were any citations issued to IVY PARK AT HAYWARD on January 19, 2023?

Yes, 2 citations were issued (2 Type A, 0 Type B). The first citation was for: "87705 Care of Persons with Dementia(b) In addition to the requirements as specified in Section 87208, Plan of Operation,..."

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.