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Inspection visit

Routine inspection

CROMWELL HAVENLicense 1072091815 citations on this visit
5 citations recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Katie Brown arrived unannounced to conduct the Annual Inspection. LPA met with and explained the reason for the visit with Licensee (LIC) Percival Tobias. During this visit, LPA toured the facility inside & out. Resident rooms and common areas were clean, in good repair and contained required equipment, furnishings and lighting. LPA observed required items in bathrooms which were clean. LPA observed hygiene items, towels, extra bedding, and linens which were stored and available for use. The kitchen was observed to be clean, in good repair with necessary items and appliances. LPA observed required food supply and paper products. Knives, cleaning/disinfecting supplies and chemicals were locked are stored separate from food. Medications are centrally stored in a locked cabinet in a hallway closet. Doors and passageways are unobstructed throughout the facility including outdoors. First aid kits contained required items. LPA walked the outdoors to find the grounds well-kept with clear walkways, sitting area and a gate with working latch. Fire extinguishers were found to be charged and were serviced 9/5/2024. Smoke and carbon monoxide detectors were observed and tested. LPA conducted resident and staff file reviews and a medication audit. Emergency Disaster and Infection Control requirements were reviewed during the inspection. Deficiencies are being cited in accordance with California Code of Regulations on the attached LIC 809-D in the areas of: Hospice Care, Postural Supports, Allowable Health Conditions and the Use of Home Health Agencies, Personnel Records and Medical Assessment. An exit interview was conducted and Plan of Correction (POC) developed. A signed copy of this report and Appeal Rights were provided. LPA requested the following updated forms faxed to CCLD by 1/20/2025: Designation of Facility Responsibility (Lic308), Administrative Organization (Lic309), Emergency Disaster Plan LIC610E (12/22), Personnel Report (LIC 500), Client Roster (LIC 9020), Proof of current Liability Coverage.

Citations

5 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.

  • 87412(a)Type B

    Maintain required personnel records for staff

    Based on record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. Documentation is not retained that records complete Initial or Annual staff training. S1 and S2 were reviewed during the visit

  • 87458(b)(5)Type B

    Based on record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. R1's current Physician's Report states R1 is Ambulatory. Per Licensee description of R1's change of condition, R1 is non-ambulatory.

  • 87608(a)(1)Type B

    Limit postural support devices to mobility needs

    Based on observation and record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. R5 has a hospital with both half side rails. The Physician Order states the rails are for safety, not positioning.

  • 87609(b)(4)Type B

    Agree in writing on agency and facility responsibilities

    Based on interview, the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care. R1 is currently receiving Home Health Nursing services. The facility does not have a written agreement on the responsibilities of the home health agency, and those of the licensee in caring for the resident's medical condition(s).

  • 87633(b)Type B

    Facility must keep complete hospice care plan on file

    Based on record review, the licensee did not comply with the section cited above in 2 out of 3 residents receiving Hospice care which poses/posed a potential health, safety or personal rights risk to persons in care. R2 and R3 files were reviewed. The files did not contain the Hospice plans of care (poc). Licensee confirmed they did not have them.

FAQ · About this visit

Common questions about this visit

What happened during the December 18, 2024 inspection of CROMWELL HAVEN?

This was an inspection of CROMWELL HAVEN on December 18, 2024. 5 citations were issued: 5 Type B.

Were any citations issued to CROMWELL HAVEN on December 18, 2024?

Yes, 5 citations were issued (0 Type A, 5 Type B). The first citation was for: "Based on record review, the licensee did not comply with the section cited above which poses/posed a potential health, s..."

What type of inspection was this?

This was an 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.