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Inspection visit

Follow-up on corrections

SHEPHERD'S INNLicense 2752008673 citations on this visit
3 citations recorded

Inspector’s narrative

What the inspector wrote

On 3/06/2022, Licensing Program Analyst (LPA) Jaclyn Avila conducted an unannounced complaint investigation visit and met with Lita Williams, administrator. Prior to initiating the complaint visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N95 Upon arrival at approximately 11:30 AM, LPA observed a large pumpkin outside of the facility entrance. The pumpkin obstructed the pathway of an exit door to a resident bedroom. LPA entered the facility and did not observe any staff or residents wearing face coverings. LPA was not screened for COVID 19 symptoms. LPA met with Licensee/Administrator Lita Williams to conduct a complaint investigation. LPA requested a copy of the facility map which Lita was unable to produce. LPA requested Lita provide LPA with a tour of the facility, LPA observed the following deficiencies: At 11:51AM, LPA toured resident's (R1) room and observed a commode blocking the exterior exit door. LPA opened the door and observed the large pumpkin obstructing the exit. The pumpkin took up half of the width of the door way. At 11:53 AM, LPA observed cleaning supplies accessible to residents in care. The chemicals consisted of Bleach, Gain, Windex, Tide Pods, etc. These items are kept in a cabinet above the washer and dryer in a hallway that consist of 3 resident rooms. The cabinet had the ability to lock however was not secured. At 11:57 AM, LPA observed a fire extinguisher in the hallway near the laundry room that had not been signed off as inspected monthly however it was serviced in the last year. Cont'd on LIC 809-C At 11:57 AM, LPA observed a fire extinguisher in the hallway near the laundry room that had not been signed off as inspected monthly however it was serviced in the last year. At 11: 59 AM LPA toured a bedroom being occupied by a resident (R2) on hospice . Below the residents bed was an open faced heater that was not screened. LPA observed a camera on the R2's dresser facing R2. LPA observed that it was plugged in with the light on. Lita stated that it was not in use due to it not being allowed. Lita then unplugged the camera. At 12:03 PM, LPA observed the corresponding monitor on a table in the dining room that was plugged in and on. The monitor has the ability to monitor auditory and visually. At 12:01 PM, LPA requested Lita to open a cabinet that is the dining room that would be accessible to residents in care. In this cabinet, LPA observed supplements such as Collagen, Lutemax, and Magnesium. LPA observed a Coach paper bag that contained prescription medications for staff (S1). At 12:04 PM, LPA observed razors and Clorox wipes on the kitchen counter. In a desk located across from the kitchen bar, LPA requested Lita open the top drawer as its accessible to residents in care. LPA located several kitchen knives in that drawer. At 12:06 PM, Lita shared that she has difficulty with opening locks so she instead has used a D-shaped carabiner which hooks around the cabinet handles however does not have a locking mechanism. Lita opened this cabinet and inside were pre poured medications. LPA reviewed regulation 87465 -Incidental Medical and Dental Care- (h)The following requirements shall apply to medications which are centrally stored:(5)Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. At approximately 12:50 PM, Lita walked away to obtain documents and left a cabinet containing medications opened and accessible. LPA requested an updated copy of the LIC 610E Emergency Disaster Plan for Residential Care Facilities for the Elderly. The most recent copy Lita could produce was from 2011. LIC 610E due by COB on 3/7/2022. T he follow ing deficiencies were cited per Title 22 of the California Code of Regulation (See LIC 9099D or 809D). Appeal Rights were explained and provided to the facility representative listed above and an Exit Interview was conducted. If any of the cited deficiencies are not corrected by the noted due dates; civil penalties may be assessed.

Citations

3 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.

  • 87307(d)(6)Type A

    87307-Personal Accommodations and Services-(d) The following space and safety provisions shall apply to all facilities:(6) All outdoor and indoor passageways and stairways shall be kept free of obstruction.This requirement is not met as evidenced by: Based upon observation the Licensee failed to keep both the exterior and interior passage way to an emergency exit free from obstructionThis poses an immediate Health, Safety and/or Personal Rights risk to Residents in care.

  • 87309(a)Type A

    87309 (a)- Storage Space-Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients.This requirement is not met as evidenced By: Based upon observation the Licensee failed to keep disinfectans and cleaning solutions stored inaccessible to residents in careThis poses an immediate Health, Safety and/or Personal Rights risk to Residents in care.

  • 87465(h)(2)Type A

    87465(h)(2)-Incidental Medical and Dental Care-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. This requirement is not met as evidenced by: Based upon observation and interview the Licensee failed to keep medication centrally stored and locked so that it is no accessible to 5 of 5 residents in care.This poses an immediate Health, Safety and/or Personal Rights risk to Residents in care.

FAQ · About this visit

Common questions about this visit

What happened during the March 6, 2022 inspection of SHEPHERD'S INN?

This was a other inspection of SHEPHERD'S INN on March 6, 2022. 3 citations were issued: 3 Type A (serious).

Were any citations issued to SHEPHERD'S INN on March 6, 2022?

Yes, 3 citations were issued (3 Type A, 0 Type B). The first citation was for: "87307-Personal Accommodations and Services-(d) The following space and safety provisions shall apply to all facilities:(..."

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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