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Inspection visit

Follow-up on corrections

PASADENA MANSIONLicense 1976052161 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Luis Mora conducted an unannounced case management visit regarding an incident reports that were not reported to the Community Care Licensing Department. LPA met with Ewa Nyczak (Administrator) and explained the reason for the visit. On 01/11/2024, during a complaint investigation (complaint control number: 28-AS-20240105092231) LPA Mora found out that the facility failed to report Resident 1 (R1) fall, hospitalization and death back in September 2023. During the visit, the Administrator could not remember the date of the fall and hospitalization. The death date is 09/18/2023. The deficiency cited is documented on the LIC809-D. Exit interview held and a copy of the report and appeal was provided.

Citations

1 citation 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.

  • 87211(a)(1)(A)(D)Type B

    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.

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FAQ · About this visit

Common questions about this visit

What happened during the January 11, 2024 inspection of PASADENA MANSION?

This was a other inspection of PASADENA MANSION on January 11, 2024. 1 citation were issued: 1 Type B.

Were any citations issued to PASADENA MANSION on January 11, 2024?

Yes, 1 citation was issued (0 Type A, 1 Type B). The first citation was for: "Reporting Requirements(a) Each licensee shall furnish to the licensing agency such reports as the Department may require..."

What type of inspection was this?

This was a 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.