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Inspection visit

Incident investigation

SIERRA PALACE FOR THE ELDERLYLicense 1072065602 citations on this visit
2 citations recorded

Inspector’s narrative

What the inspector wrote

On 6/30/25 Licensing Program Analyst (LPA) M. Garza arrived at the facility to complete an unannounced case management visit. LPA met with House Manager, Virginia Jimenez explained reason for visit and was permitted entry into the facility. Administrator, Elizabeth Perera-Moreland was contacted, stated they were unavailable and the visit could be conducted with House Manager, Virginia. LPA completed a tour of the facility inside and out. Residents not present at time of visit. Currently there are no residents receiving hospice or home health. This case management is being conducted for an incident report received by the department involving R1. LPA reviewed daily notes, prescription, incident report and centrally stored medication log. Incident occurred on 2/26/25 and 2/27/25. CCL received incident report on 3/14/25. Incident report stated R1 was observed with a swollen mouth on 2/26/25. R1 was asked if they were in pain and stated "no". R1 attended day program this date. On 2/27/25 R1's face remained swollen. Non-emergency EMS was contacted. No pain reported by R1 to EMS. R1 refused going to hospital. A dental appointment for R1 was scheduled 2/27/25,lk with no new findings. Antibiotics prescribed as a precautionary measure. Review of medication log shows that prescription was not given as prescribed. Deficiencies cited for reporting requirements and medications per California Code of Regulations, Title 22. Deficiencies are being cited on the attached 809D. If not corrected, the violations with have a direct and potential risk to the health, safety and/or personal rights of residents in care. Exit interview was conducted with House Manager, Virginia. A copy of this report, deficiencies, and appeal rights were discussed and provided. A plan of correction was developed by House Manager and reviewed by LPA.

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.

  • 80061(b)Type B

    80061 Reporting Requirements(b) Upon the occurrence, during the operation of the facility, of any of the events specified in (1) below, a report shall be made to the licensing agency within the agency's next working day during its normal business hours. In addition, a written report containing the information specified in (2) below shall be submitted to the licensing agency within seven days following the occurrence of such event. This requirement was not met by: LPA records review, the licensee did not comply with the section cited above in that incident involving R1 occurred on 2/26/25 & 2/27/25 and was not reported until 3/14/25. This posed a potential health, safety and or personal rights risk to persons in care.

  • 80075(5)(B)Type B

    80075 Health Related Services(5) If the client's physician has stated in writing that the client is unable to determine his/her own need for nonprescription PRN medication, but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the client with self-administration, providing all of the following requirements are met: (B) Once ordered by the physician the medication is given according to the physician's directions. This requirement was not met by: LPA records review, the licensee did not comply with the section cited above in that R1 was not provided medication as per physicians orders. This posed a potential health, safety and or personal rights risk to persons in care.

  • 1569.695(a)(2)Type B

    Based on record review, the licensee did not comply with the section cited above in that the facility has a plan but does not have the required information listed. This poses a potential health, safety or personal rights risk to persons in care.

  • 80087(a)Type B

    Based on LPA observation, the licensee did not comply with the section cited above in that Holes observed in bedroom #5 door in need of repair or replacements. Plug cover in bedroom #6 missing and in need of replacement. Holes in stucco on back left side of house in need of repair. Fence on left side yard leaning in need of repair. Carpet in living room observed dirty and in need of cleaning. Bedroom #4 observed with bed railing without prescription for repositioning. Vents throughout the house observed rusted in need of paint or replacement. Carpet outside bedrooms 2 & 3 observed torn in need of repair/replacement. Bedroom #1 in need of touch up paint in bedroom/bathroom. This poses a potential health, safety or personal rights risk to persons in care.

  • 87457(c)(1)(A)Type B

    Based on LPA file reviews, the licensee did not comply with the section cited above in that 2 of 2 files reviewed did not have a pre-appraisal/functional capabilities. This poses a potential health, safety or personal rights risk to persons in care.

  • 87608(a)(5)(A)Type B

    Based on LPA observation, the licensee did not comply with the section cited above in that 1 of 4 resident rooms was observed with a 1/2 bed rail. File review showed a prescription was not found for repositioning. This poses a potential health, safety or personal rights risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the June 30, 2025 inspection of SIERRA PALACE FOR THE ELDERLY?

This was an other inspection of SIERRA PALACE FOR THE ELDERLY on June 30, 2025. 2 citations were issued: 2 Type B.

Were any citations issued to SIERRA PALACE FOR THE ELDERLY on June 30, 2025?

Yes, 2 citations were issued (0 Type A, 2 Type B). The first citation was for: "80061 Reporting Requirements(b) Upon the occurrence, during the operation of the facility, of any of the events specifie..."

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 CCLDView original report

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Data from CCLD public records. Last updated . If you believe any information is inaccurate, report it here.