Inspection visit

Follow-up on correctionsOctober 17, 2022

FAIRWINDS - WOODWARD PARKLicense 1072011562 citations on this visit

2 citations recorded

Inspector’s narrative

What the inspector wrote

On 10/17/22 at 3:00 PM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct a case management - deficiencies inspection. LPA explained the reason for inspection and met with Administrator Desiree Valero. LPA found that on 6/5/22, R1's medication Ciprofloxacin 500 mg Tabs (Take 1 tablet orally two times daily) were given three times at the times of 8:10 AM, 5:37 PM, and 7:22 PM. On 6/7/22, the facility received new Amlodipine 5mg (Take 1 tablet orally daily) from the pharmacy some time in the evening of the day and S1 administered a dose the same evening after finding that the new medication was received and in the med room. The facility had already given the medication Amlodipine 10mg (Take 1 tablet orally daily) earlier that day at 6:30 AM. LPA found that the facility did not receive the doctor's order for the change in dosage for the medication until 6/8/22. LPA found that R1's medication bubble pack Amlodipine 10mg that was filled on 4/21/22 to be started 5/1/22 and the bubble pack Amlodipine 10 mg that was filled on 5/20/22 to be started 5/29/22 was recorded on the Centrally Stored Medication sheet and in the facility's internal digital medication administration log as given, but both bubble packs were still intact and full without any doses administered. CCL received a faxed incident report on 6/20/22 for an incident that occurred on 6/10/22. The facility sent an incident report to CCL on 6/23/22 for an incident that occurred on 6/7/22. Deficiencies are being cited based on LPA's observations, interviews, and record review in accordance with the California Code of Regulations, Title 22, see LIC809D. A civil penalty of $250 is being assessed for a repeat violation of CCR 87211(a)(1)(D) which was first issued on 6/2/22. See LIC421FC for more details. Exit interview conducted and Plan of Corrections were developed and reviewed with Administrator Desiree Valero. A copy of this report and appeal rights were given to Administrator, whose signature confirms receipt of this report.

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.

87211(a)(1)(D)Type B
87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports...(1) A written report shall be submitted to the licensing agency...within seven days of the occurrence of any of the events specified in (A) through (D)...(D) Any incident which threatens the welfare, safety or health of any resident...This requirement is not met as evidenced by: CCL received a faxed incident report on 6/20/22 for an incident that occurred on 6/10/22 and the facility sent an incident report to CCL on 6/23/22 for an incident that occurred on 6/7/22, which poses a potential health, safety, or personal rights risk to residents in care.
87465(a)(4)Type B
Assist residents with self-administered medication
87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility...(4) The licensee shall assist residents with self-administered medications as needed.This requirement is not met as evidenced by: LPA found that on 6/5/22, R1's medication Ciprofloxacin 500 mg Tabs (Take 1 tablet orally two times daily) were given three times at the times of 8:10 AM, 5:37 PM, and 7:22 PM. On 6/7/22, the facility received new Amlodipine 5mg (Take 1 tablet orally daily) from the pharmacy some time in the evening of the day and S1 administered a dose the same evening after finding that the new medication was received and in the med room. The facility had already given the medication Amlodipine 10mg (Take 1 tablet orally daily) earlier that day at 6:30 AM. LPA found that the facility did not receive the doctor's order for the change in dosage for the medication until 6/8/22. LPA found that R1's medication bubble pack Amlodipine 10mg that was filled on 4/21/22 to be started 5/1/22 and the bubble pack Amlodipine 10 mg that was filled on 5/20/22 to be started 5/29/22 was recorded on the Centrally Stored Medication sheet and in the facility's internal digital medication administration log as given, but both bubble packs were still intact and full without any doses administered. Which poses a potential health and personal rights risk to resident in care.
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FAQ · About this visit

Common questions about this visit

What happened during the October 17, 2022 inspection of FAIRWINDS - WOODWARD PARK?

This was an other inspection of FAIRWINDS - WOODWARD PARK on October 17, 2022. 2 citations were issued: 2 Type B.

Were any citations issued to FAIRWINDS - WOODWARD PARK on October 17, 2022?

Yes, 2 citations were issued (0 Type A, 2 Type B). The first citation was for: "87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports...(1) A written report..."

What type of inspection was this?

This was an 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 June 22, 2026. If you believe any information is inaccurate, report it here.

Follow-up on corrections·October 17, 2022