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Inspection visit

Follow-up on corrections

PASADENA VILLA SENIOR LIVINGLicense 1986032862 citations on this visit
2 citations recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced Case Management Deficiencies in conjunction with a complaint visit (Complaint Control # 28-AS-20250820145116). The purpose of this visit is to issue deficiencies that were observed by LPA that are not part of the complaint allegation. The reason for the Case Management - Deficiencies was explained to Administrator Bryanna Luke. During the complaint visit on 09/15/2025, LPA discovered that Resident #1 (R1)'s several unwitnessed fall incidents including those that happened on 08/10/2025, 08/11/2025 and 08/28/2025, resulting in injuries and required emergency visit/hospitalization were not faxed to Community Care Licensing (CCL). Interviews with the Administrator and Staff #2 (S2) confirmed that the incident reports were not faxed to Community Care Licensing (CCL) due to a broken fax machine. Additionally, the Administrator and S2 acknowledged R1's frequent falls and the need for a higher level of care or 1:1 supervision, however, a re-appraisal to assess R1’s condition was not completed. Deficiencies noted on LIC 809D. Exit interview, a copy of this report along with the appeals rights were provided to Bryanna Luke, Administrator.

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)(D)Type B

    87211 Reporting Requirements..(a) Each licensee shall furnish to the licensing agency such reports..(1) A written report... for the resident within seven days of the occurrence of any of the events specified...report shall include the resident's name, age, sex and date of admission; date and nature of event;....(D) Any incident which threatens the welfare, safety or health of any resident.....This requirement is not met as evidenced by: Based on interviews, records review, the Administrator did not comply with the section cited above in which R1's unwitnessed fall incidents that happened on 08/10/2025, 08/11/2025 and 08/28/2025, resulting in injuries and hospitalization were not submitted and faxed to CCL which poses a potential health, safety or personal rights risk to residents in care.

  • 87463(b)(1)Type B

    87463 Reappraisals...(b) The reappraisal shall document significant changes in the resident's physical, mental, cognitive, behavioral, or functional condition....(1) Significant changes in condition, as defined in Section 87101, Definitions, include, but are not limited, to:..This requirement is not met as evidenced by: Based on interviews, records review, the Administrator did not comply with the section cited above in which a re-appraisal to assess R1’s condition was not completed which poses a potential health, safety or personal rights risk to residents in care.

FAQ · About this visit

Common questions about this visit

What happened during the September 15, 2025 inspection of PASADENA VILLA SENIOR LIVING?

This was a other inspection of PASADENA VILLA SENIOR LIVING on September 15, 2025. 2 citations were issued: 2 Type B.

Were any citations issued to PASADENA VILLA SENIOR LIVING on September 15, 2025?

Yes, 2 citations were issued (0 Type A, 2 Type B). The first citation was for: "87211 Reporting Requirements..(a) Each licensee shall furnish to the licensing agency such reports..(1) A written report..."

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.