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Inspection visit

Follow-up on corrections

ALMAVIA OF SAN RAFAELLicense 2168018682 citations on this visit
2 citations recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Farhaan Sarangi conducted an unannounced case management visit to cite additional deficiencies discovered during a complaint investigation. LPA was greeted at the door by Administrator, Angela Boucher-Turin. LPA was granted access into the facility. During the complaint investigation dated for July 08, 2021, LPA learned that the facility did not submit an Unusual Incident Report (LIC 624) to Community Care Licensing. In addition, facility missed a Urinalysis lab appointment for R1. (See LIC 809D) The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted and appeal of rights provided.

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.

  • 87211Type B

    87211 Reporting Requirements:(a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following:(1) 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.(A) Death of any resident from any cause regardless of where the death occurred, including but not limited to a day program, a hospital, en route to or from a hospital, or visiting away from the facility.(B) Any serious injury as determined by the attending physician and occurring while the resident is under facility supervision.(C) The use of an Automated External Defibrillator.(D) Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident. This requirement was not met evidenced by:Based on interviews with facility staff, and research of incident reports submitted for Almavia of San Rafael to CCL, did not properly report an incident to the CCL as required by Title 22 regulation. This poses a potential health, safety or personal rights risk to persons in care.

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  • 87465Type A

    87465 Incidental Medical and Dental Care(a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following:(2) The licensee shall provide assistance in meeting necessary medical and dental needs. This includes transportation which may be limited to the nearest available medical or dental facility which will meet the resident's need. In providing transportation the licensee shall do so directly or make arrangements for this service. This requirement was not met as evidenced by:Based on an email conversation dated for July 23, 2021, it was disclosed that facility missed a Urinalysis order for R1 in May 2021. This poses an immediate health, safety or personal rights risk to persons in care.

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FAQ · About this visit

Common questions about this visit

What happened during the September 29, 2021 inspection of ALMAVIA OF SAN RAFAEL?

This was a other inspection of ALMAVIA OF SAN RAFAEL on September 29, 2021. 2 citations were issued: 1 Type A (serious) and 1 Type B.

Were any citations issued to ALMAVIA OF SAN RAFAEL on September 29, 2021?

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

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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