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Inspection visit

Routine inspection

SIMONE SUMMIT CARE HOMELicense 0792011391 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

On 04/29/2024 at 2:52PM, Licensing Program Analyst (LPA) T.Syess-Gibson conducted an unannounced 1-Year Required inspection. LPA met with Caregiver Christina Federico, spoke with Administrator, Maria Matel via telephone, and explained the of the visit. The Administrator arrived at 3:52PM. Administrator holds an Administrator Certificate (#6053192740) that expires on. The facility’s fire clearance was approved for five (5) non-ambulatory and one (1) bedridden residents. LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of six (6) bedrooms, five (5) occupied by residents, one (1) occupied by staff and three (3) bathrooms. All outdoor and indoor passageways are kept free of obstruction. LPA did not observe any bodies of water. A comfortable temperature is maintained at 74 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 122.6 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars .There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was purchased on 02/26/2024. Emergency Disaster Plan was last posted on 02/03/2024. First aid kit was observed to be complete. Continued on LIC809C. Continued from LIC809. LPAs requested the following documents to be submitted to CCLD by 05/06/2024. LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance LPAs observed the following deficiencies: At 3:11pm LPA observed medications in an unlocked cabinet in kitchen At 3:12pm LPA observed scissors and knives in an unlocked drawer in the kitchen Deficiency is cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. A copy of this report and appeal rights provided.

Citations

1 citation 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(f)(1)Type A

    Based on observation, the licensee did not comply with the section cited above in not having Knives and Scissors stored inaccessible to the residents with which poses an immediate health, safety risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the April 29, 2024 inspection of SIMONE SUMMIT CARE HOME?

This was a inspection inspection of SIMONE SUMMIT CARE HOME on April 29, 2024. 1 citation were issued: 1 Type A (serious).

Were any citations issued to SIMONE SUMMIT CARE HOME on April 29, 2024?

Yes, 1 citation was issued (1 Type A, 0 Type B). The first citation was for: "Based on observation, the licensee did not comply with the section cited above in not having Knives and Scissors stored ..."

What type of inspection was this?

This was a inspection inspection. inspection 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.