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Inspection visit

Complaint

GREEN GABLES CARE HOME IIILicense 1072015562 citations on this visit
2 citations recorded

Inspector’s narrative

What the inspector wrote

Record review reveals that R1’s daughter had been the primary contact and completed/signed all admission documents. The facility Admission Agreement lists R1’s daughter as the Responsible Party. R1’s daughter was not notified of the incident by the facility. R1’s daughter was not aware that R1 was hospitalized until contacted by the hospital. Based on interviews and record reviews, The preponderance of evidence standard has been met, therefore both of the above allegations are found to be SUBSTANTIATED . Deficiencies are being cited in accordance with California Code of Regulations on the attached LIC 9099-D. Civil penalties are pending and currently under review. The details of the civil penalties will be outlined in a future report to the facility. An exit interview was conducted and Plan of Correction was developed. A copy of this report and Appeal Rights were discussed and left with Mario Ramos, whose signature on this form confirms receipt of these documents.

Citations

3 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.

  • 87464(f)(1)(c)Type A

    87464 Basic Services (f) Basic services shall at a minimum include: (1) Care and supervision as defined… in (c) "Care and supervision" means the facility assumes responsibility for, or provides or promises to provide in the future, ongoing assistance with activities of daily living without which the resident’s physical health, mental health, safety, or welfare would be endangered… Requirement not met as evidenced by: Licensee did not provide basic services such as care and supervision resulting in R1 exiting the facility without staff knowing. R1 passed away in the hospital. This poses an immediate health, safety or personal rights violation to persons in care.

  • 87466Type B

    Regular observation and documentation of resident changes

    87466 Observation of the Resident The licensee shall ensure that residents are regularly observed... Licensee shall ensure that such changes are documented and brought to the attention of the resident's physician and the resident's responsible person, if any. Requirement not met as evidenced by: Licensee did not ensure that R1's Responsible Party was notified that R1 was taken via ambulance to the hospital after being found by staff to have exited the home and experiencing a fall outside. This poses a potential health, safety or personal rights violation to persons in care.

  • 87355(e)(1)Type A

    Submit and maintain current mailing address

    87355(e) (1) Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (1)Obtain a California clearance or a criminal record exemption as required by the Department... This requirement was not met as evidenced by: Licensee did not ensure S1 had a Criminal Record Clearance. S1 was working on 1/16/24 at the facility. This poses an immediate health, safety or personal rights risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the March 19, 2024 inspection of GREEN GABLES CARE HOME III?

This was a complaint inspection of GREEN GABLES CARE HOME III on March 19, 2024. 2 citations were issued: 1 Type A (serious) and 1 Type B.

Were any citations issued to GREEN GABLES CARE HOME III on March 19, 2024?

Yes, 2 citations were issued (1 Type A, 1 Type B). The first citation was for: "87464 Basic Services (f) Basic services shall at a minimum include: (1) Care and supervision as defined… in (c) "Care ..."

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.