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Inspection visit

Routine inspection

CARRILLO MANORLicense 1976073055 citations on this visit
5 citations recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Tyler Reyes conducted an unannounced required 1 year visit and met with Administrator, Rowena Marantal Carrillo to discuss the purpose for todays visit. Administrator Carrillo's has an Administrator Certificate for Residential Care Facility for Elderly that expires Jun 4, 2025. The facility is a single-story building in a residential area, with a living room, kitchen, dining area, office area, entertainment room, 4 bedrooms, 1 staff bedroom, 2 restrooms, front and backyard. Fire extinguisher observed kitchen fully charged. There are smoke detectors/ Carbon monoxide located throughout the facility, tested and operational. During a tour of the kitchen LPA observed with Administrator Carrillo in the unlocked cabinets above the fridge (3) sprag cans Thompson's WaterSeal (water proof exterior surfaces), Zep Heavy Duty Foaming (Degreaser), Resolve (Carpet Cleaner). Backyard LPA observed with Administrator Carrillo (2) bottles Ortho and Spectracide (Insect Killer). In the backyard LPA observed with Administrator Carrillo a mattress with a metal frame in the back yard near the laundry area. LPA observed with staff #1 (S1) in the office area (3) individual pills in an unlocked drawer located in the office area. In the unlocked metal file cabinet in the hallway LPA observed with S1 an Advion Cockroach Insecticide 1.06 oz (30g). LPA observed with Administrator Carrillo in a plastic container medication in the unlocked end table in Room 4, which was unlocked and as accessible to residents. The medication observed in a plastic container was Haloperidol Injection, BD Intega Syringe 25G/3ml, Ipratropium Bromide and Albuterol Sulfate Solution, Hyosyne 0.125, and Eliquis. (Continued LIC 809-C) During medication review of resident #1 (R1) and R2 it was observed medication was not given as prescribed by the physician for the month of November 2024. R1's AM Medication - Midodrine Hcl 5mg (Take 1 tablet by mouth daily for Hypertension) were still in the bubble 11/1/24 and 11/2/24 despite been marked on the Nov 2024 medication sheet as given. R1's Medication - Tramadol 50mg ( Take 1 tablet by mouth prior to movement or may give every 6hrs for pain) on the Nov 2024 medication sheet it was initialed by staff as being given 11/1/2024 -11/18/24 despite only (15) pills being removed from the bubble pack. R1's Medication - Haloperidol 5mg (Take 1 tablet by mouth every 6hrs as needed) on the Nov 2024 medication sheet it was initialed by staff as being given 11/1/2024 -11/18/24 despite only (11) pills being removed from the bubble pack. R1's Bedtime Medication- Senna 8.6 mg (Take 1 tablet by mouth at bedtime) on the Nov 2024 medication sheet for 11/18 was already intialed by staff as being given despite still being in the bubble pack. R1's Bedtime Medication - Mirtazapine 7.5 mg( Take 1 tablet by mouth at bedtime) on the Nov 2024 medication sheet for 11/18 was already initialed by staff as being given despite still being in the bubble pack R2's AM Medication (Take 1 tablet for Hypertension) on the Nov 2024 medication sheet for 11/18 was initialed by staff as being given despite still being in the bubble pack Last Disaster Drill was 10/19/24 Fire and Earthquake. Administrator Carrillo was unable to provide a document from the physician for bed rails approval for C2-C3 Pursuant to Title 22 code of regulations, the following deficiencies were cited (refer to LIC 809-D): Exit Interview Conducted with Administrator / Appeal Rights Provided / A Copy of the Report given to Administrator Carrillo

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 in LPA observed with Administrator Carrillo in the kitchen in the unlocked cabinets above the fridge a (3) sprag cans Thompson's WaterSeal (water proof exterior surfaces), Zep Heavy Duty Foaming (Degreaser), Resolve (Carpet Cleaner). Backyard LPA observed with Administrator Carrillo (2) bottles Ortho and Spectracide (Insect Killer) which poses an immediate health, safety or personal rights risk to persons in care.

  • Store centrally held medications in locked secure place

    Based on observation, the licensee did not comply with the section cited above in LPA observed with staff #1 (S1) in the office area (3) individual pills in an unlocked drawer located in the office area. In the unlocked metal file cabinet in the hallway LPA observed with S1 an Advion Cockroach Insecticide 1.06 oz (30g). LPA observed with Administrator Carrillo in a plastic container medication in the unlocked end table in Room 4, which was unlocked and as accessible to residents. The medication observed in a plastic container was Haloperidol Injection, BD Intega Syringe 25G/3ml, Ipratropium Bromide and Albuterol Sulfate Solution, Hyosyne 0.125, and Eliquis which poses an immediate health, safety or personal rights risk to persons in care.

  • Give PRN medication by physician order

    Based on observation , the licensee did not comply with the section cited above During medication review of resident #1 (R1) and R2 it was observed medication was not given as prescribed by the physician for the month of November 2024. R1's AM Medication - Midodrine Hcl 5mg (Take 1 tablet by mouth daily for Hypertension) were still in the bubble 11/1/24 and 11/2/24 despite been marked on the Nov 2024 medication sheet as given. R1's Medication - Tramadol 50mg ( Take 1 tablet by mouth prior to movement or may give every 6hrs for pain) on the Nov 2024 medication sheet it was initialed by staff as being given 11/1/2024 -11/18/24 despite only (15) pills being removed from the bubble pack.R1's Medication - Haloperidol 5mg (Take 1 tablet by mouth every 6hrs as needed) on the Nov 2024 medication sheet it was initialed by staff as being given 11/1/2024 -11/18/24 despite only (11) pills being removed from the bubble pack.R1's Bedtime Medication- Senna 8.6 mg (Take 1 tablet by mouth at bedtime) on the Nov 2024 medication sheet for 11/18 was already intialed by staff as being given despite still being in the bubble pack. R1's Bedtime Medication - Mirtazapine 7.5 mg( Take 1 tablet by mouth at bedtime) on the Nov 2024 medication sheet for 11/18 was already initialed by staff as being given despite still being in the bubble pack. R2's AM Medication (Take 1 tablet for Hypertension) on the Nov 2024 medication sheet for 11/18 was initialed by staff as being given despite still being in the bubble pack which poses an immediate health, safety or personal rights risk to persons in care.

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  • Passageways and stairways kept clear

    Based on observation, the licensee did not comply with the section cited above In the backyard LPA observed with Administrator Carrillo a mattress with metal frame in the back yard near the laundry area which poses/posed a potential health, safety or personal rights risk to persons in care.

  • 87608(a)(5)(A)Type B

    Based on observation, interview, and record review, the licensee did not comply with the section cited above Administrator Carrillo was unable to provide a document from the physician for bed rails approval for C2-C3 which poses/posed a potential health, safety or personal rights risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the November 18, 2024 inspection of CARRILLO MANOR?

This was an inspection of CARRILLO MANOR on November 18, 2024. 5 citations were issued: 3 Type A (serious) and 2 Type B.

Were any citations issued to CARRILLO MANOR on November 18, 2024?

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 in LPA observed with Administrator Carril..."

What type of inspection was this?

This was an inspection. Inspections are conducted by CCLD as part of their licensing oversight.

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