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Inspection visit

Incident investigation

AT HAVEN HOMELicense 2472089591 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

On 09/25/2024, Licensing Program Analyst (LPA) V Gorban arrived at the facility unannounced to conduct a case management inspection. LPA met with Administrator and announced the purpose of the inspection. During this visit LPA toured the facility inside and out to conduct residents safety check. The purpose of the visit was to follow-up on an incident which occurred on 9/18/2024. On 9/18/2024, Resident (R1) is a dementia resident, was found on the floor in her room. This incident was documented and reported to Regional Office, responsible party for R1 was notified. Due to violation of Title 22 regulation deficiency is cited on attached LIC809- D During this visit LPA requested facility files for review. Exit interview conducted, report signed and copy of this report with appeal rights provided to administrator for facility records. fa

Citations

1 citation 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.

  • 87705(b)Type B

    87705 Care of Persons with Dementia. (b) In addition to the requirements as specified in Section 87208, Plan of Operation, the plan of operation shall address the needs of residents with dementia.This requirement was not observed as evidensed by: Based on interrviewes and record reviews facility staff failed to follow title 22 regulation resulted in dementia resident unassisted falling ans breaking her pelvis.Resident was taking the following day to the hospital were was diagnosed with broken pelvis, which poses health and safety risc to persons in care

FAQ · About this visit

Common questions about this visit

What happened during the September 25, 2024 inspection of AT HAVEN HOME?

This was an other inspection of AT HAVEN HOME on September 25, 2024. 1 citation were issued: 1 Type B.

Were any citations issued to AT HAVEN HOME on September 25, 2024?

Yes, 1 citation was issued (0 Type A, 1 Type B). The first citation was for: "87705 Care of Persons with Dementia. (b) In addition to the requirements as specified in Section 87208, Plan of Operatio..."

What type of inspection was this?

This was an 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.