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Inspection visit

Follow-up

MORI MANORLicense 0192010546 citations on this visit
6 citations recorded

Inspector’s narrative

What the inspector wrote

On this day, September 29, 2023 at 12:05 pm, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct case management inspection as part of monitoring plan from Non-compliance Conference held on August 31, 2023. LPA met with staff Maria Manjarez, and informed the reason for visit. LPA also met with other staff, Blesilda Yamat, and Pedro Rabulan. LPA spoke over the phone with Ferdinand Ferdie' Gutierrez, administrator, who gave permission to have Maria Manjarez be with LPA during inspection. Administrator arrived after above 3 hours. LPA toured the facility inside out. LPA inspected the living room, dining area, kitchen, bathrooms, residents rooms. front, side and backyard. LPA inspected the food supples and observed good for 2 days of perishables and 7 days of non-perishables. LPA reviewed 2 residents' file. LPA observed the following: -at 12:30 pm, 12:34 pm and 12:40 pm., weed and grass killer in the front yard, shave cream unlocked in the common bathroom, and shovel in the side yard respectively. -resident (R1) has 8 medications but no doctor's order on file. -resident (R2) has 8 medications listed on After Visit Summary dated July 24, 2023 provided by the administrator via email to LPA on July 27, 2023. This document has 8 medications listed; however, facility has only 5 medications on hand of which 2 have labels with strength and dosage different from the list, 1 (a PRN) no longer on the list. Vitamin B-12, melatonin and multi Vitamin were on the list but facility does have these. Vaccine is also listed but it's not clear if resident received the vaccine. .....continued on 809C -R2's LIC602A signed by a Physician Assistant (PA-C) indicated mild cognitive impairment not consistent with document signed by Hospitalist (MD). R2's After Visit Summary indicated R2 to have a follow-up visit August 21, 2023. LPA verified with administrator, and administrator indicated he has not communicated with R2's case manager to schedule the appointment. -R2's LIC625 Appraisal/Needs and Services Plan is over a year old. Deficiencies are cited from Title 22 California Code of Regulations, and listed on 809Ds. A civil penalty of of $250.00 for repeat violation of section: 87465(e), and will continue for $100.00/day if not corrected within due date. Deficiencies, plan and proof of corrections and civil penalty were discussed with the administrator. Copy of this report, Appeal Rights, LIC9098 Proof of Correction form, LIC421FC Civil Penalty Assessment, and copy of this report provided.

Citations

6 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(a)Type B

    87458 Medical Assessment(a)Prior to a person's acceptance as a resident, the licensee shall obtain and keep on file, documentation of a medical assessment, signed by a physician, made within the last year.-This requiement is not met as evidenced by: -Based on records, the licensee did not comply with the section above for R2's LIC602A signed by PA-C not consistent with MD's assessment. R2 was not followed-up with his MD. These pose potential health, safety, and/or personal rights risks to person in care.

  • 87463(e)Type B

    87463 Reappraisals (c) The licensee shall arrange a meeting with the resident, the resident’s representative,,,, when there is significant change in the resident’s condition, or once every 12 months, whichever occurs first, as specified in Section 87467......-This requirement is not met as evidenced by: -Based on record review, the licensee did not comply with the section above for R2's LIC625 Appraisal/Needs and Services Plan more than a year old which poses potential health and/or personal rights risks to person in care.

  • 87465(a)(4)Type A

    87465 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 records review, the licensee did not comply with the section above for not having 3 of R2's medications and 2 medications dosage and stregth different from the order which poses immediate risks to person in care.

  • 87465(e)Type A

    87465 Incidental Medical and Dental Care: (e) For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician, on a prescription blank, maintained in the residents file..... -This requirement is not met as evidenced by:-Based on records review, the licensee did not comply with the section above for not having doctor's order for R1's 8 medications which poses immediate health risk To person in care.

  • 87705(f)(2)Type A

    87705 Care of Persons with Dementia(f) The following shall be stored inaccessible to.....(2) Over-the-counter medication, nutritional supplements or vitamins, alcohol, cigarettes, and toxic substances such as certain plants, gardening supplies, cleaning supplies and disinfectants. -This requirement is not met as evidenced by:-Based on observation, the licensee did not comply with the section above for weed and grass killer unlocked which poses an immediate risk to persons in care,

  • 87705(1)Type A

    87705 Care of Persons with Dementia (f) The following shall be stored inaccessible to residents with dementia:(1) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s).-This requirement is not met as evidenced by: -Based on observation, the licensee did not comply with the section above for having shovel and shave cream unlocked which poses an immediate safety risks to persons in care,

FAQ · About this visit

Common questions about this visit

What happened during the September 29, 2023 inspection of MORI MANOR?

This was a other inspection of MORI MANOR on September 29, 2023. 6 citations were issued: 4 Type A (serious) and 2 Type B.

Were any citations issued to MORI MANOR on September 29, 2023?

Yes, 6 citations were issued (4 Type A, 2 Type B). The first citation was for: "87458 Medical Assessment(a)Prior to a person's acceptance as a resident, the licensee shall obtain and keep on file, doc..."

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.