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Inspection visit

complaint

ROSELEAF SENIOR CARELicense 0450027783 citations on this visit
3 citations recorded

Inspector’s narrative

What the inspector wrote

The complainant did not provide a specific incident nor a specific resident. This department pulled a sample of residents based on interviews with staff, to review. During staff interviews, this department found staff are not ensuring residents are receiving medical care timely, this was confirmed by record review. Staff provided a name of resident (R1) who they observed had a change in condition. Staff stated the resident started throwing up and was not at resident’s baseline. Staff admitted to not summoning EMS at time of observation which was documented on 12/17/2021 at 3:02PM. Upon further review of staff observations, provided to the department by Roseleaf Executive Director, in excel sheet format, this department noted that staff believed R1 had a UTI (urinary track infection) on 12/10/2021 at 8:14 PM. The next entry is listed as a “critical” observation on 12/11/21 at 7:30 PM stating R1 was in bed all day and refused all meals. On 12/11/21 at 10:28PM, staff notes R1 had no urine output. There are no observation notes until 12/12/21 at 8:57 PM which is listed as critical stating, R1 has large skin discoloration on the right side of R1’s head and R1 has no recollection of what happened. On 12/13/21 at 2:02 PM, Staff note R1 woke up at 8AM and had stayed in bed at an awkward angel since awakening. Staff attempted several times throughout breakfast to get R1 to join the others at breakfast but R1 declined. On 12/13/21/ at 10:25 PM, staff noted resident has a red and purple skin discoloration on her left knee. Its not documented until 12/18/21, R1 had been to the emergency room under staff observations. From 12/10/2021-12/18/2021, although staff notated “critical” observations to include change in condition and injuries to R1’s head and knee, R1 did not receive medical care. This department confirmed R1 was sent out on 12/17/2021 at the request of the responsible party after being contacted by the facility's med tech as directed by Executive Director Eric Perry, at which time R1 was hospitalized however this was not reported to CCLD. Staff interviews confirmed these observations and staff who observed changes in condition and bruising did not summon medical. Substantiated Based on the departments observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division & Chapter number), are being cited on the attached LIC 9099D. Appeal Rights were explained and provided to the facility representative listed above and an Exit Interview was conducted. If any of the cited deficiencies are not corrected by the noted due dates; civil penalties may be assessed.

Citations

7 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.

  • 87219(a)Type A

    87219(a)-Planned Activities-Residents shall be encouraged to maintain and develop their fullest potential for independent living through participation in planned activities.This requirement is not met as evidenced by: Based upon observation and interview the Licensee failed to provide all residents in care with the opportunity to participate in planned activities.This poses an immediate Health, Safety and/or Personal Rights risk to residents in care.

  • 87405(h)(8)Type B

    87405(h)(8) Administrator - Qualifications and Duties-The administrator shall have the responsibility to: Have the personal characteristics, physical energy and competence to provide care and supervision and, where applicable, to work effectively with social agencies. This requirement is not met as evidenced by: Based upon observation and interview the Licensee failed to have an administrator with the personal characteristics, competence and ability to work effectively with social agencies.This poses a potential Health, Safety and/or Personal Rights risk to residents in care

  • 87411(a)Type A

    87411(a) Personnel Requirements – General-Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs.This requirement is not met as evidenced by: Based upon observation and interview the Licensee failed to ensure staff are sufficient in numbers and competent to provide services necessary to meet resident needs.This poses an immediate Health, Safety and/or Personal Rights risk to residents in care.

  • 87211(a)(1)(D)Type B

    87211(a)(1)(D)-Reporting requirements- A written report shall be submitted to the licensing … within 7 days of the occurrence …Report shall include resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. Any incident which threatens the welfare, safety or health of any resident.This requirement was not met as evidenced by interview and record review: Licensee failed to report injuries and hospitalization of 1 of 1 residents in care. This poses a potential risk to the health and safety of residents in care

  • 87466Type A

    87466 Observation of the Resident- The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs.This requirement was not met as evidenced by: Based on record review and interviews, Licensee did not observe for changes and provide appropriate assistance to those changes for 1 of 1 resident which poses an immediate health and safety risk for resident in care.

  • 87468.2(a)(4)Type A

    87468.2(a)(4)-Additional Personal Rights of Residents in Privately Operated Facilities-residents...shall have all of the following personal rights: To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs This requirement was not met as evidenced by: Based on record review and interviews, Licensee did not provide resident's right to care, supervision and services for 1 of 1 residents in care. This poses an immediate health and safety risk for resident in care.

  • 87625(b)(3)Type A

    87625(b)(3) Managed Incontinence- In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for the following: Ensuring that incontinent residents are kept clean and dryThis requirement is not met as evidenced by: Based upon record review and interview the Licensee failed to ensure 2 of 2 residents were kept clean and dry.This poses a potential Health, Safety and/or Personal Rights risk to clients in care

FAQ · About this visit

Common questions about this visit

What happened during the April 8, 2022 inspection of ROSELEAF SENIOR CARE?

This was a complaint inspection of ROSELEAF SENIOR CARE on April 8, 2022. 3 citations were issued: 2 Type A (serious) and 1 Type B.

Were any citations issued to ROSELEAF SENIOR CARE on April 8, 2022?

Yes, 3 citations were issued (2 Type A, 1 Type B). The first citation was for: "87219(a)-Planned Activities-Residents shall be encouraged to maintain and develop their fullest potential for independen..."

What type of inspection was this?

This was a complaint inspection. Complaint inspections are triggered when someone reports a concern about the facility to CCLD.

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.