Pasadena Mansion

Reporting Requirements(a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events...(A) Death of any resident from any cause regardless of where the death occurred, including but not limited to a day program, a hospital, en route to or from a hospital, or visiting away from the facility. (D) Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident. This regulation has not been met as evidenced by:Based on interviews and records review, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care. The facility failed to report an incident reports regarding R1 fall, hospitalization and death to CCLD.

Based on record review, the licensee did not comply with the section cited above in no record of emergency drills conducts was available for review which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above in Emergency Disaster plan has not been updated to the most current or does not meet the most current version of Emergency Disaster plan version (12/21) which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above in facility does not have an evacuation chair by the stairwell which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above in bug killer spray and laundry detergent are accessible to the residents which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above in staff's medication was observed on top of kitchen's dining table, an apothecary accessible to the residents was observed with varios medication which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation and interviews, the licensee did not comply with the section cited above in R3's medication (pill) is put in the residents ensure for R3 to take without a physician's order which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above in cleaning,disinfecting supplies,and sharps were unlocked during the visit which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above in R4 status is nonambulatory and resides in second floor which poses an immediate health, safety or personal rights risk to persons in care.

Based on file review, the licensee did not comply with the section cited above in S2 does not have a TB test clearance on file which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation and medication review, the licensee did not comply with the section cited above in R2 had PRN medication without prescription order, R3 did not have labels in PRN medication which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above in medication cabinet, and resident's medication observed in refrigerator were not lock during the visit which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation during medication review, the licensee did not comply with the section cited above in 1 out of 3 residents, R1 medication was transfer from original bottle to another bottle which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on file review, the licensee did not comply with the section cited above in R3 and R4 do not have a current annual physician's report which poses/posed a potential health, safety or personal rights risk to persons in care.