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Inspection visit

Follow-up on corrections

HUMBLE HAVEN RCFE IVLicense 1976103332 citations on this visit
2 citations recorded

Inspector’s narrative

What the inspector wrote

On 05/17/24, Licensing Program Analyst (LPA) Ernand Dabuet conducted a case management inspection visit at this facility. LPA met with caregivers Jasmin, Joselito, and Jennifer Bihasa and explained the purpose of the visit. During a complaint investigation visit on 05/17/24, LPA Dabuet was informed that (4) out of (6) residents are in hospice care. The residents on hospice are (R1), (R2), (R4), and (R5). The facility is approved by the Community Care Licensing Department (CCLD) for (3) hospice residents. The licensee shall not operate a facility beyond the conditions and limitations specified on the license. On 05/17/24, between 11:15 am - 11:35 am, LPA Dabuet reviewed staff files and observed that staff #2 and #3 had no current First Aid/CPR certificate for training. (S2-S3) communicated that they have not renewed their required training for First Aid/CPR. Based on interviews, observation, and record reviews the licensee violated Title 22 Regulations. California Code of Regulations (Title 22, Division 6, Chapter 8), deficiencies were observed, and citations were issued (ref. LIC 9099-D). An exit interview was conducted and a copy of the Evaluation Report and Appeal Rights were provided to Jasmin Bihasa. Note: *Citations not cleared by the due date will be a $100 fine assessed for each citation until it is cleared. Civil penalties will continue to accrue until Proof of Corrections (POC) are cleared. *

Citations

2 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.

  • 87204(a)Type B

    (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... An exception may be made in the case of catastrophic emergency when the licensing agency may make temporary exceptions to the approved capacity.This requirement is not met as evidenced by: Based on [(observation) (interview) (record review)], the licensee did not comply with the section. The facility is approved for (3) hospice waiver and is now operating with (4) hospice residents beyond the conditions and limitations specified on the license. This violation which poses an potential health, safety or personal rights risk to persons in care.

  • 87411(c)(1)Type B

    (c) All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69.(1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross.This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above . LPA identified staff #2 & #3 did not have a current First Aid/CPR Training. This violation 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 May 17, 2024 inspection of HUMBLE HAVEN RCFE IV?

This was a other inspection of HUMBLE HAVEN RCFE IV on May 17, 2024. 2 citations were issued: 2 Type B.

Were any citations issued to HUMBLE HAVEN RCFE IV on May 17, 2024?

Yes, 2 citations were issued (0 Type A, 2 Type B). The first citation was for: "(a) A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including sp..."

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.