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Inspection visit

Incident investigation

KINGSTON BAY SENIOR LIVINGLicense 1072069391 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Katie Brown arrived at the facility unannounced to conduct a Case Management visit. LPA met with and explained the purpose of the visit with Interim Administrator (AD) Christopher Smith. The purpose of the visit is to address the incident that occurred on 9/14/22 resulting in Resident (R1) going absent without leave (AWOL). The facility submitted a Special Incident Report (SIR) to CCLD on 9/20/22. During the visit, LPA toured Memory Care inside and out including R1's apartment. LPA conducted interviews and reviewed R1's facility file. See attached LIC 9099D for citation issued in accordance with California Code of Regulations Title 22, Division 6, Chapter 8, Article 12. An exit interview was conducted and Plans of Corrections were reviewed and developed. A copy of this report and Appeal Rights were discussed and left with AD, whose signature on this form confirm receipt of these documents

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.

  • 87468.1(a)(1)Type B

    Dignity in personal relationships

    87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons.This requirement was not met as evidenced by: Licensee did not ensure that residents in care were acaorded dignity in their personal relationships with staff... On multiple documented and reported occasions, R1 has demonstrated innapropriate behavior and verbal outbursts which were disruptive and disrespectful to residents and staff. Outbursts often consist of yelling, cussing or throwing items at others.

  • 80075(b)(2)Type A

    87705 Care of Persons with Dementia (b) In addition to the requirements as specified in Section 87208, Plan of Operation, the plan of operation shall address the needs of residents with dementia, including: (2) Safety measures to address behaviors such as wandering…..This requirement was not met as evidenced by: Licensee did not ensure that the needs of R1s known wandering and exit seeking behaviors were met. R1 was able to jump over the facility wall and walk away without facility staff knowing R1's whereabouts.This poses an immediate health, safety or presonal rights risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the September 21, 2022 inspection of KINGSTON BAY SENIOR LIVING?

This was an other inspection of KINGSTON BAY SENIOR LIVING on September 21, 2022. 1 citation were issued: 1 Type A (serious).

Were any citations issued to KINGSTON BAY SENIOR LIVING on September 21, 2022?

Yes, 1 citation was issued (1 Type A, 0 Type B). The first citation was for: "87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly ..."

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.