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Inspection visit

Follow-up on corrections

GRACE RETIREMENT VILLAGELicense 3060900494 citations on this visit
4 citations recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit to deliver findings on an investigation completed by the Department. LPA was greeted and granted entry into the facility by Assistant Administrator Anna Jung and explained the reason for the visit. During the course of the investigation, the following deficiencies were observed and are being cited via this case management deficiency. During course of the investigation it was determined Resident 1 (R1) was admitted to the facility on April 30, 2022. However, R1’s admission agreement was signed and dated April 29, 2022. Facility AD Hyo Sok Kim admitted she had filled out R1’s paperwork prior to R1 being admitted and assessed. Despite being provided with R1’s history of exit seeking and behaviors, R1 was failed to be properly assessed and later it was determined R1 was not a good fit for the facility. Licensee Eric Doan stated the facility had not received R1’s paperwork prior to being admitted and that the hospital had dropped R1 off after hours and on the weekend. This was a false statement as investigation revealed that the facility did in fact receive R1’s paperwork prior to R1 being admitted. They were expecting R1 in advance of them being placed with the facility but failed to properly conduct an assessment. On May 1, 2022, R1 eloped from the facility at approximately 11:30 AM after becoming agitated with the Staff 2 (S2). No staff followed behind R1. S2 awaited until 1:49 PM, approximately 3 hours later, to notify La Habra Police R1 was missing. The following deficiencies are being cited per Title 22 Division 6. An exit interview was conducted, and a copy of this report and appeal rights were left at the facility.

Citations

5 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.

  • 87405(h)(1)Type A

    Administrator- Qualifications and Duties. The administrator shall have the responsibility to: Administer the facility in accordance with these regulations and established policy… This regulation was not met as evidenced by: Based on interviews conducted and records reviewed the Licensee did not ensure the facility was following regulatory and policy regarding acceptance and retention due to failure to evaluate R1 for suitability prior to accepting them and providing required supervision. This poses an immediate risk to resident’s health and safety.

  • 87456(a)Type A

    (a) Evaluation of Suitability for Admission. Prior to accepting a resident for care and in order to evaluate his/her suitability, the facility shall, as specified in this article 8:..conduct an interview…perform a pre-admission appraisal…obtain and evaluate a recent medical assessment…This regulation was not met as evidenced by: Based on interviews conducted and records reviewed the Licensee did not evaluate R1 for suitability prior to accepting them. This poses an immediate risk to resident’s health and safety.

  • 87506(a)Type B

    Resident Records. The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility…This regulation was not met as evidence by: Based on interviews conducted and records reviewed the Licensee did not maintain a complete record for R1 as evidenced by incomplete appraisal and unsigned physician report. This poses a potential risk to resident’s health and safety.

  • 87464(f)(1)Type A

    Basic Services (f)Basic services shall at a minimum include: Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This regulation was not met as evidence by: Based on interviews conducted and records reviewed the Licensee did not provide care and supervision to R1 resulting in R1 eloping from the facility and dying. Prior to being admitted the facility was made aware of R1’s exit seeking behaviors and still chose to admit R1 to the facility. This poses an immediate risk to health risk to residents in care. An immediate civil penalty of $500 is being assessed.

  • 87207Type A

    False Claims. No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility. This regulation was not met as evidence by: Based on interviews conducted and records reviewed the Licensee provided false statements to the Department by stating they had not received R1’s paperwork prior to being admitted and was dropped off at the facility blindly without Licensee consent. Statements were proven to be false. This poses an immediate risk to resident’s safety.

FAQ · About this visit

Common questions about this visit

What happened during the November 9, 2023 inspection of GRACE RETIREMENT VILLAGE?

This was a other inspection of GRACE RETIREMENT VILLAGE on November 9, 2023. 4 citations were issued: 3 Type A (serious) and 1 Type B.

Were any citations issued to GRACE RETIREMENT VILLAGE on November 9, 2023?

Yes, 4 citations were issued (3 Type A, 1 Type B). The first citation was for: "Administrator- Qualifications and Duties. The administrator shall have the responsibility to: Administer the facility in..."

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.