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Inspection visit

Routine inspection

COBBLE STONE RESIDENTIAL HOME CARE LLCLicense 1572088325 citations on this visit
5 citations recorded

Inspector’s narrative

What the inspector wrote

On 04/03/25, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an annual visit. LPA introduce self, stated the purpose of the visit, and was greeted by staff Eleanor White. Administrator(A1) Catherine Clark was called and arrived shortly. All five residents were present during the inspection. LPA toured facility with A1. Administrator left the facility later during inspection. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside or outside. An adequate supply of perishable and non-perishable food was observed. Expired food was observed in refrigerator. At approximately 11:03AM, knives were observed stored in kitchen drawer unlock. Medications were observed locked under kitchen cabinet. MARs were reviewed and medications were checked. Chemicals were observed locked under kitchen sink. Bathrooms were toured. Cleaning supplies were observed unlocked in under hall bathroom sink and under master bathroom sink. Hot water tested at 107.8 degrees F in hall bathroom, 111.7 and 112.4 degrees F in master bathroom. Non-skid mat was observed in hall bathroom. Master bathroom was observed with no non-skid mat. Grabbed bars were observed in all bathrooms. All bedrooms were observed to have the required furnishings and with adequate lightening. Extra linens were observed. Fire extinguisher was observed with a purchased date of: 07/22/24. Chemical cabinet was observed unlock in laundry room and in the garage. Outside of facility toured and observed to be free of debris. Adequate outdoor seatings available for residents. Sample of staff and all of the residents’ files were reviewed. Carbon monoxide and smoke detector operational during visit. A deficiency is being cited on the attached Lic 809D in accordance to California Code of Regulations, Title 22, Division 6. Exit Interview conducted. The requested documents are to be submitted to the department by 04/09/25: Lic 308, Lic 500, Lic 610E, current liability insurance, and current Administrator Certificate. A copy of this report and appeal rights was provided to Administrator via email.

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.

  • 87309(a)Type A

    Ensure hazardous items are locked and not unattended

    Based on observation, the licensee did not comply with the section cited above when knives, chemicals, cleaning solutions were unlock accessible to residents in care this poses an immediate health, safety or personal rights risk to persons in care.

  • Give PRN medication by physician order

    Based on records review and observation, staff did not administer R1’s medication Memantine Hcl 10mg, Quetiapine 25 mg, Donepezil Hcl 10mg, and Midodrine 5mg as directed by physician, which poses an immediate health and safety risk for the person in care.

  • Record dose details and resident medication response

    Based on observations, records reviewed, and interviews conducted, S1 administered all the residents’ medication in the morning of 04/03/25 and did not sign in the residents’ MARs, which poses/ posed a potential health and safety risk for the person in care.

  • Food quality controls and rejected damaged goods

    Based on observation, expired food was observed in the refrigerator which poses/posed an immediate health, safety or personal rights risk to persons in care.

  • Use slip-resistant surfaces in bathing areas

    Based on observation, the licensee did not comply with the section cited above no non-skid mat was observed in master bathroom, which poses/posed a potential health, safety or personal rights risk to person in care.

FAQ · About this visit

Common questions about this visit

What happened during the April 3, 2025 inspection of COBBLE STONE RESIDENTIAL HOME CARE LLC?

This was an inspection of COBBLE STONE RESIDENTIAL HOME CARE LLC on April 3, 2025. 5 citations were issued: 3 Type A (serious) and 2 Type B.

Were any citations issued to COBBLE STONE RESIDENTIAL HOME CARE LLC on April 3, 2025?

Yes, 5 citations were issued (3 Type A, 2 Type B). The first citation was for: "Based on observation, the licensee did not comply with the section cited above when knives, chemicals, cleaning solution..."

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.