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Inspection visit

Incident investigation

AT HAVEN HOME IILicense 2472091991 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

On 12/05/24, Licensing Program Analysts (LPAs) L. Salazar and M. Garza arrived to the facility unannounced to conduct the required Health & Safety inspection. LPAs were greeted by caregiver Kenny, stated the purpose of the visit, and were allowed entry into the facility. Licensee/Administrator was called and arrived to the facility shortly after LPAs arrival. LPA Salazar discussed the details of the visit with House Manager (HM). LPA requested additional information regarding 2 incident reports that were submitted for Resident R1. LPA reviewed R1's file and obtained LIC602A and hospital discharge summary. X-ray report dated 09/27/24 stated R1 had a right hip fracture, not a femur fracture, as stated in the incident report. LPA did not observe a Pre-Admission Appraisal (LIC603A) or Needs and Service appraisal in R1's file. R1's admission was 09/17/24. LPA will conduct interviews and return at a later date if additional information is provided. Based on LPA’s records review and interviews and in accordance with California Code of Regulations, Title 22, Division 6, Chapter 8, a deficiency is being cited on the attached 809-D. If not corrected this poses an immediate risk to residents in care. An exit interview was conducted with Licensee/Administrator. A copy of this report and appeal rights were discussed and provided at the time of visit. A plan of correction was developed by Licensee/Administrator and reviewed with LPA with a POC date of 12/06/24.

Citations

4 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.

  • 87457(c)(1)Type A

    Minimum appraisal documentation requirements

    87457 Pre-Admission Appraisal - General(c) Prior to admission a determination of the prospective resident's suitability for admission shall be completed and shall include an appraisal of his/her individual service needs in comparison with the admission criteria specified in Section 87455, Acceptance and Retention Limitations. (1) The appraisal shall include, at a minimum, an evaluation of the prospective resident's functional capabilities, mental condition and an evaluation of social factors as specified in Sections 87459, Functional Capabilities and 87462 Social Factors. This requirement was not met as evidenced by LPAs observation of resident's file. No pre appraisal or needs and service plan was obtained at the time of admission and not observed in file.

  • 87303(a)Type B

    Maintain facility in clean, safe, sanitary condition

    87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not met as evidence by LPA observation of Room 10 observed with hole behind door in need of repair. Clutter in garage in need of removal. Refrigerator in garage in need of cleaning/repair. Hood vent observed open and in need of repair under kitchen cupboard. Bottom kitchen cupboard door broken and in need of repair/replacement.Front door observed broken and not properly latching. This poses a potential health safety and or personal rights risk to residents in care.

  • 87465(h)(2)Type A

    Store centrally held medications in locked secure place

    87465 Incidental Medical and Dental Care...(h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement was not met as evidence by: LPA observation of medications observed unlocked/accessible in kitchen cupboard, kitchen refrigerator, in R6 closet and hallway cupboard. This poses an immediate health, safety and or personal rights risk to residents in care.

  • 87468.1(a)(6)Type B

    Freedom to leave and not be locked in

    87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (6) To leave or depart the facility at any time and to not be locked into any room, building, or on facility premises by day or night. This does not prohibit a licensee from establishing house rules, such as locking doors at night to protect residents, or barring windows against intruders, with permission from the Department. This requirement was not met as evidence by LPA observation of R1's window observed locked with board preventing from opening R1's exit door observed blocked with chair preventing from exiting. Front door observed with lock at bottom of door.

FAQ · About this visit

Common questions about this visit

What happened during the December 5, 2024 inspection of AT HAVEN HOME II?

This was an other inspection of AT HAVEN HOME II on December 5, 2024. 1 citation were issued: 1 Type A (serious).

Were any citations issued to AT HAVEN HOME II on December 5, 2024?

Yes, 1 citation was issued (1 Type A, 0 Type B). The first citation was for: "87457 Pre-Admission Appraisal - General(c) Prior to admission a determination of the prospective resident's suitability ..."

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.