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Inspection visit

complaint

MIRACLE ASSISTED LIVING FACILITYLicense 1976096403 citations on this visit
3 citations recorded

Inspector’s narrative

What the inspector wrote

Hospital records noted R1 presented with 4 pressure injuries. On 11/4/2021 the hospital completed a referral for home health care. Hospital records also documented that facility was instructed to reposition R1 every 2 hours. On 11/5/2021 a Initial Evaluation/Assessment was completed by Infinite Home Health. Upon completion of the evaluation/assessment R1 was diagnosed with a stage 2 pressure ulcer of right ankle, and a stage 4 pressure ulcer rt lateral malleolus. Home health records document that after every visit the facility home health staff “reinforced frequent change of position and diaper.” Staff verbalized an understanding to the home health nurse. R1 was again hospitalized on 11/13/2021 at which time R1’s pressure injuries were assessed and documented to have worsened and the following pressure injuries were noted: unstageable left heel, stage 4 right lateral malleolus and a healing Stage 2 right elbow. On 12/2/2021 from approximately 1:30 to 2:30 pm Investigator Zertuche conducted interviews with the assistant administrator Rima Araronyan, facility staff and residents. When interviewed Ms. Araronyan denied knowledge of the pressure injuries being over stage 2. Additionally, Ms. Araronyan admitted that staff did not reposition the resident because he was refusing and was able to turn himself, however facility and medical records document that R1 has no movement on his right side at baseline and was bed bound. Staff did not document the refusal, did not notify R1’s physician or home health agency. On 2/3/2022 LPA Avetisyan called Canyon Oaks Nursing and Rehabilitation and spoke with the Case Manager who confirmed that R1 did not have any pressure injuries when discharged from their facility. Information obtained during the course of the investigation confirmed that R1 developed pressure injuries while living at the facility. On 11/5/2021 the right lateral malleolus pressure injury was diagnosed as a stage 4 which is a prohibited health condition. Licensee/administrator and staff failed to follow hospital/home health instructions to reposition R1 which resulted in the pressure injuries worsening therefore the allegation is Substantiated. Per California Code of Regulations (CCR), Title 22, see LIC 9099-D for deficiencies cited. An immediate civil penalty of $500 is also assessed. The licensee was informed that a civil penalty might be assessed based on the Health and Safety Code 1569,49(e) or (f), or 1548(e) or (f), 1568.0822(e) or (f).

Citations

9 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.

  • 87202Type A

    All facilities shall maintain a fire clearance. Prior to accepting persons over 60 years of age none ambulatory and/or bedridden the licensee shall notify the licensing agency and obtain an appropriate fire clearance. This requirement is not met as evidenced by: Based on observation, interview and record review, the licensee did not comply with the section cited above by retaining 1 bedriddent resident in room with non ambulatory fire clearance and 1 non ambulatory resident in room with ambulatory fire clearance which poses an immediate health, safety or personal rights risk to persons in care.

  • 87204(a)Type A

    (a) A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including specification of the maximum number of persons who may receive services at any one time. This requirement was not met as evidenced by: Based on information obtained on 11/17/2021 and interviews the licensee/administrator did not comply with the cited section by operating over capacity. Admitting and retaining 7 residents when their licensed capacity is for 6 residents which posed an immediate health and safety and personal rights risk to clients in care.

  • 87207Type A

    No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility.This Requirement was not met as evidenced by: Based on the information obtained by LPA during the 11/17/2021 visit the Administrator designee Rima Araronyan did not comply with he cited section by asking Resident 2 (R2) to provide false/misleading statements to LPA regarding his identity and the room he resides in which posed an immediate personal rights violation to residents in care.

  • 87355(e)(2)Type A

    Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c). This requirement is not met as evidenced by Based on interviews, and record review, the licensee & administrator did not comply with the section cited by allowing S1 to work at the facility prior to transferring her criminal record clearance to this facility. which poses an immediate health and safety risk to residents in care.

  • 87609(b)(4)(A)(B)(C)Type B

    (b) Incidental medical care may be provided to residents through a licensed home health agency provided the following conditions are met:(4) (A)(B)(C) The licensee and home health agency agree in writing on the responsibilities of the home health agency, and those of the licensee in caring for the resident’s medical condition(s)........ This requirement was not met as evidenced by: Record Review and Interview conducted. The licensee did not comply with the cited section by not completing a written agreement with the home health agency related to the condition and care of the pressure injuries which posed a potential health and safety and personal rights risk to R1.

  • 87613(2)(A)(B)Type B

    (a) Prior to admission of a resident with a restricted health condition, the licensee shall: (2) (A)(B) Ensure that facility staff who will participate in meeting the resident’s specialized care needs complete training provided by a licensed professional sufficient to meet those needs.... This requirement was not met as evidenced by: Based on interview and record review the licensee did not comply with the cited section by not ensuring staff providing care to R1 received training related to R1's specialized care needs which posed an immediate health and safety and personal rights risk to R1.

  • 87464(f)(1)Type A

    Basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c).This requirement was not met as evidenced by: Based on the information obtained during the course of the investigation the licensee failed to comply with the cited section by not following instructions provided by physician/skilled medical professional related to the care of R1 which resulted in R1 developing prohibited health conditions and posing an immediate health and safety and person rights risk to R1.

  • 87615(a)(1)Type A

    Persons who require health services for or have a health condition including, but not limited to, those specified below shall not be admitted or retained in a residential care facility for the elderly: (1) Stage 3 and 4 pressure injuries.This requirement was not met as evidenced by: Based on information obtained during the investigation the licensee did not comply with the cited section by retaining R1 at the facility with a stage 4 pressure injury which posed an immediate health and safety and personal rights risk to R1.

  • 87616(a)Type A

    As specified in Section 87209, Program Flexibility, the licensee may submit a written exception request if he/she agrees that the resident has a prohibited and/or restrictive health condition but believes that the intent of the law can be met through alternative means. This requirement was not met as evidenced by: Based on information obtained during the investigation, the licensee did not comply with the cited section by not submitting an exception request to retain R1 at the facility with a prohibited health condition, which posed an immediate health and safety and personal rights risk to R1.

FAQ · About this visit

Common questions about this visit

What happened during the March 14, 2022 inspection of MIRACLE ASSISTED LIVING FACILITY?

This was a complaint inspection of MIRACLE ASSISTED LIVING FACILITY on March 14, 2022. 3 citations were issued: 3 Type A (serious).

Were any citations issued to MIRACLE ASSISTED LIVING FACILITY on March 14, 2022?

Yes, 3 citations were issued (3 Type A, 0 Type B). The first citation was for: "All facilities shall maintain a fire clearance. Prior to accepting persons over 60 years of age none ambulatory and/or ..."

What type of inspection was this?

This was a complaint inspection. Complaint inspections are triggered when someone reports a concern about the facility to CCLD.

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.