Inspection visit

Routine inspection (multi-day)July 18, 2023

MORI MANORLicense 01920105418 citations on this visit

18 citations recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Delmundo arrived unannounced to continue the annual required inspection that was started on July 6, 2023. LPA was granted entry by Maria Manjare, staff. Ferdinand Gutierrez, administrator, arrived after several minutes. LPA informed the reason for visit. LPA also met with other staff, JulyFrancia Yambao. On July 6, 2023, LPAs Delmundo and Fontanilla observed the following but LPAs were not able to issue citations due to technical difficulties/issues: -facility's Theft and Loss policy not posted and no Complaint poster. -broken window blinds and protruding cable wires in room # 2. -no paper towel in dispensers in 2 bathrooms. According to staff, supply of paper towel for the type of dispensers ran out - at 12:02 pm, CALRes incontinence since and Pine Sol cleaning agent in the bathrooms. -pieces of carpet, wood, metal, rolled carpet, piece of glass, fitted bedsheet in the side yard. -mattress, window screen, hoyer lift, pieces wood, bedsheet, grinder in the backyard. --residents' medications in the refrigerator. Medication Administration Record for May 2023 showed Insulin was administered by staff but not for June and July 2023; however, this medication was last filled 6/21/23. - resident (R4) does not have records in the facility -staff (S1) is not fingerprint cleared and associated to this facility. -staff (S2 and S3) First Aid certificates on file expired 2018 and 2021. -facility does not have file drill records. LPAs interviewed S3 who stated they don't do fire drill. ......continued on 809C (page 2) Page 2 -On 7/06/23, LPA Fontanilla observed staff (S1) does not have First Aid/CPR training on file. S4 and administrator's First Aid/CPR certificates expired. -LPAs Delmundo and Fontanilla observed cameras in the living room. kitchen and family room. LPAs checked with staff who has access to the camera and observed the cameras also capture audio. The following additional deficiencies were also observed: -S1, S2, S3 and S4 do not have the 20 hours required annual training. -S3 administers medications but does not have required 8 hours annual training. Last training on file was dated 2016. -Staff (S6) who came to work at 5:00 pm 7/06/23 and on this day (7/18/23) not associated to this facility. -Resident's (R2) bed has half bed rails but no doctor's order on file. -Resident (R6) also does not have records. -Resident (R5) has no TB test record on file. -Residents do not have call buttons. -Three residents need 2 person assist in transferring which LPA confirmed with 2 staff and administrator; however, there are only 2 staff scheduled at the time leaving other residents with no staff available to assist. -Resident's (R7) LIC602A PhysIcian's Report indicated ambulatory; however, R7 needs assistance in transferring which LPA confirmed with the staff, administrator and family member. -No LIC9020 Register of Facility Clients/Residents Deficiencies are cited from Title 22 California Code of Regulations, and listed on 809Ds. A $500 civil penalty is assessed for section 87355(e)(1), .and $250.00 for repeat violation of section 87303(a) within 12 month period. Deficiencies, plan and proof of corrections and civil penalties were discussed with the administrator. Administrator has to leave and authorized JulyFrancia Yambao to sign and receive this report. Copy of this report, Appeal Rights, LIC9098 Proof of Correction form, LIC421IM and IC421FC Civil Penalty Assessments provided.

Citations

18 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.

1569.153(a)Type B
Based on observation, the licensee did not comply with the section cited above for not posting facility's Theft and Loss Policy which poses a potential personal rights risk to persons in care.
1569.269(a)(2)Type B
Based on observation and interview, the licensee did not comply with the section cited above for having cameras installed that capture audio which poses a potential personal rights risk to persons in care.
1569.625(b)(2)Type B
Based on interview and record review, the licensee did not comply with the section cited above for 4 staff not having the required annual training which poses a potential health, safety and/or personal rights risk to persons in care.
1569.695(c)Type B
Based on interview and reord review, the licensee did not comply with the section cited above for not conducting disaster driill which poses a potential safety risk to persons in care.
87303(a)Type B
Based on observation, the licensee did not comply with the section cited above for the following: (a) pieces of carpet, wood, metal, rolled carpet, piece of glass, fitted bedsheet in the side yard; (b) mattress, window screen, hoyer lift, pieces wood, bedsheet, grinder in the backyard; (c) broken window blinds and protruding cable wires in room # 2. These pose a potential safety and/or personal rights risk to persons in care.
87303(i)Type B
Based on observation, the licensee did not comply with the section cited above for resident not having signal system or call button which pose a potential health, safety and/orr personal rights risk to persons in care.
87307(a)(3)Type B
Based on observation, the licensee did not comply with the section cited above for not having paper towels for residents use for drying hands in 2 bathrooms which pose a potential health and/or personal rights risk to persons in care.
87355(e)(2)Type B
Based on record review, the licensee did not comply with the section cited above for staff (S6) not associated to this facility which poses a potential personal rights risk to persons in care.
87411(a)Type B
Based on observation and interview and review of staff schedule, the licensee did not comply with the section cited above for not having sufficient staff which poses a potential health, safety and/or rsonal rights risk to persons in care.
87411(c)(1)Type B
Based on record review, licensee did not comply with the section cited above for 1 staff with no CPR/First and 4 staff with expired CPR/First Aid certiicates on file which posed a potential safety and/or personal rights risks to persons in care.
87458(b)(1)Type B
Based on record review, the licensee did not comply with the section cited above for R5 not having TB test on file which poses a potential health risk to persons in care.
87458(b)(5)Type B
Based on observation, interviews and record review, the licensee did not comply with the section for R7 who is non-ambulatory but LIC602A Physician's Report indicated ambulatory which poses a potential health and safety riisks to person in care.
87465(f)(1)Type B
Based on observation, the licensee did not comply with the section cited above for not having LIC9020 Register of Facility Clients/Residents which poses/posed a potential health,or personal rights risk to persons in care.
87465(h)(2)Type A
Based on observation, the licensee did not comply with the section cited above for the insulin in the refrigerator which poses an immediate health and safety risks to persons in care.
87468(c)(2)(A)Type B
Based on observation, licensee did not comply with the section cited above for not posting Complaint poster which poses a potential personal rights risk to persons in care.
87506(a)Type B
Based on interview and rord review, the licensee did not comply with the section cited above for R4 and R6 not having records which pose a potential health, safety and/or personal rights risks to persons in care.
87608(a)Type B
Based on interview and record review, the licensee did not comply with the section cited above for not having doctor's order for R2's half bed rails which poses a potential safety and/or personal rights risk to persons in care.
87355(e)(1)Type A
Based on interview and record review, the licensee did not comply with the section cited above for S1 not fingerprint cleared which poses an immediate safety and/or personal rights risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the July 18, 2023 inspection of MORI MANOR?

This was a other inspection of MORI MANOR on July 18, 2023. 18 citations were issued: 2 Type A (serious) and 16 Type B.

Were any citations issued to MORI MANOR on July 18, 2023?

Yes, 18 citations were issued (2 Type A, 16 Type B). The first citation was for: "Based on observation, the licensee did not comply with the section cited above for not posting facility's Theft and Loss..."

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 CCLD View original report

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Data from CCLD public records. Last updated May 25, 2026. If you believe any information is inaccurate, report it here.

Routine inspection (multi-day)·July 18, 2023