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Inspection visit

Incident investigation

ROSEHAVEN 1License 3060038932 citations on this visit
2 citations recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced case management visit to follow up on incident report submitted to Community Care Licensing on 11/17/2021. LPA was greeted and granted entry into the facility by Caregiver Dominga Santillian and explained the reason for the visit. Administrator/ Licensee Jay Pichika arrived during the visit. Incident report dated 11/17/2021 indicated Resident 1 (R1) was taken to the urgent care due to possible UTI and Depakote overdose. Administrator stepped out of urgent care for a zoom meeting. Urgent care determined R1 needed to be seen at the emergency room and was unsuccessful in reaching the administrator. Per witnesses, urgent care reached out to facility staff as well as responsible party to advise of the situation. Administrator states being unable to answer phone due to the administrator's zoom call. Administrator made contact after the zoom call and R1 was sent to the emergency room. R1 was diagnosed with a urinary tract infection. R1's levels of Depakote were deemed to be acceptable and facility continues to follow the medication orders on file as responsible party is in contact with physician to change the order to a lower dose. Witnesses interviewed indicate R1 is currently incontinent and incontinence care is not being provided at night. Based on the observations made during today's visit, the following violations are being cited per California Code of Regulations, Title 22, Division 6, Chapter 8. An exit interview was conducted and a copy of this report as well as appeal rights were discussed and provided with facility representative.

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.

  • 87307(d)(2)Type B

    The following space and safety provisions shall apply to all facilities:The premises shall be maintained in a state of good repair and shall provide a safe and healthful environment.This requirement is not being met as evidenced by: Based on observation, LPA observed live and dead cockroaches in the kitchen and resident bedroom. This poses a potential health and safety risk to residents in care.

  • 87464(f)(1)Type A

    Basic services shall at a minimum include:Care and supervision as defined in Section 87101(c)(3) and Health and Safety Codesection 1569.2(c). This requirement is not being met as evidenced by: Based on interviews conducted, Licensee failed to ensure R1 was provided care and supervision. Licensee was unable to receive urgent care's calls due to an appointment Administrator was on. R1 was being transferred to the emergency room. This poses an immediate health and safety risk to residents in care.

  • 87468.1(a)(1)Type B

    Residents in all residential care facilities for the elderly shall have all of the following personal rights:To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement is not being met as evidenced by: Based on interviews conducted, Licensee failed to ensure incontinence care is being provided as needed. This poses a potential health and safety risk to residents in care.

  • 87468(c)(2)(A)Type B

    Licensees shall prominently post personal rights, nondiscrimination notice, and complaint information in areas accessible to residents...Licensees may use the Residential Care Facility for the Elderly (RCFE) Complaint Poster (PUB 475) ... The poster that is posted shall be 20" x 26" in size and be posted in the main entryway of the facility. This req is not being met as evidenced by: Based on observation, Licensee failed to ensure the "Let Us No" poster is posted in the entrance of the facility in regulation size, 20" X 26." This poses a potential health and safety risk to residents in care.

FAQ · About this visit

Common questions about this visit

What happened during the November 23, 2021 inspection of ROSEHAVEN 1?

This was a other inspection of ROSEHAVEN 1 on November 23, 2021. 2 citations were issued: 1 Type A (serious) and 1 Type B.

Were any citations issued to ROSEHAVEN 1 on November 23, 2021?

Yes, 2 citations were issued (1 Type A, 1 Type B). The first citation was for: "The following space and safety provisions shall apply to all facilities:The premises shall be maintained in a state of g..."

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.