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Inspection visit

complaint

CALIFORNIA MISSION INNLicense 198603161
Clean visit · 0 citations

Inspector’s narrative

What the inspector wrote

Allegation: " Staff did not adequately supervise resident resulting in a fall." Based on interviews conducted the findings indicate that resident (R1) sustained a fall on December 26, 2020. The resident was sitting in a sofa in the Memory Care Unit TV room and fell asleep. Staff (S3) was present during the incident and stated that R1 rolled over while sleeping and fell. The resident hit its forehead and got a bump. It resulted in a bruise to the eyelid area. After the incident staff immediately put an ice pack on the resident and notified the med-tech on duty. A body check was perform and the resident was not sent out to a hospital for an evaluation. The resident did not have history of falls. Staff interviewed stated the incident was not related to lack of staff supervision. According to staff, the staff-to-resident ratio in the Memory Care Unit is 1 to 7. At the time of the incident there was one (1) staff and six (6) residents in the TV room. There is insufficient evidence to prove the alleged allegation. Based upon records review, interviews conducted, and observations made the findings indicate that, although the allegation(s) may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are Unsubstantiated. An exit interview was conducted with Business Director Haigaz Kazazian. A copy of the report was issued.

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.

  • 87211(a)(1)Type B

    87211(a)(1). Reporting Requirements. 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 specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. Based on record review and interviews conducted the facility failed to report a fall incident involving resident (R1). The incident occurred on 12/26/2020. The facility did not submit the incident report to Licensing or furnish a copy when requested for complaint control #: 28-AS-20210105160055. This poses a potential health and safety risk to residents in care.

  • 87705(f)(1)Type A

    87705(f)(1). Care of Persons with Dementia. The following shall be stored inaccessible to residents with dementia: (1) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s).This requirement was not met by evidence of: Based on records review and interviews conducted on 12/19/2020 the facility failed to store hand sanitizer in a locked PPE cart and resident (R1) drank the hand sanitizer bottle. Items that could constitue a danger to Dementia residents must be inaccessible.This poses an immediate healthy & safety risk.

FAQ · About this visit

Common questions about this visit

What happened during the June 22, 2021 inspection of CALIFORNIA MISSION INN?

This was a complaint inspection of CALIFORNIA MISSION INN on June 22, 2021. The inspection found no deficiencies and no citations were issued.

Were any citations issued to CALIFORNIA MISSION INN on June 22, 2021?

No citations were issued during this inspection. The facility was found to be in compliance with all applicable regulations.

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.