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Inspection visit

Routine inspection

GEM'S SENIOR LIVING ILicense 33641308412 citations on this visit
12 citations recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Cheryl Goodrich conducted an unannounced annual required visit on 6/16/2023 at 12:20 PM LPA was granted entry and met with Staff Rodrigo Baluyut (Rolly) who was informed of the purpose of the visit. At the time of the visit there was (1) staff and (3) clients present. Buildings and Grounds: The home is composed of six (6) bedroom, five (5) client bedrooms, one (1) staff bedroom, three (3) bathrooms, a laundry area located in the garage, kitchen and dining area, and a front/back yard area. The interior walkways of the home were observed to be clutter free with no obstruction. Smoke and Carbon Monoxide detectors were tested and operable. There are no pools or other bodies of water located at the home. According to Rolly, there are no weapons stored in the home. Rooms, furniture, beds, mattresses appeared to be in good repair. The bedrooms are furnished, and privacy is available. The dining and living room areas are clutter free and in good condition. The LPA tested the hot water temperature, which was registered at 114.3 degrees Fahrenheit, which is within regulatory limits. Outdoor areas had sufficient room for activities and leisure. A washing machine and dryer are available and in working order. Storage and Supplies : The first aid kit components was observed to be available and complete and found in the hallway closet. Cleaning supplies stored in the bathroom under the sink and locked in cabinets. Linens, and equipment appeared to be in good repair and sufficient for approved census. A Fire extinguisher was available and fully charged. Food Service: Utensils and dishware are sufficient for the requested capacity. The refrigerator and stove are in working order. Sharps stored in the kitchen pantry under the sink. Additional knives were found in accessible overhead cabinet near the stove which is not is not in compliance. Record Review and Resident/Staff Files: LPA reviewed all staff files and reviewed the facility's staff schedule. All staff have criminal clearance. Staff member providing care has all proper documentation. Three (3) client files were reviewed and 2/3 files had resident admission agreements, 1/3 files were missing all residents documents including current physician report. Health Related Services/ Incidental Medical Services: All client medication was stored in an unlocked in a file cabinet across from the refrigerator . LPA reviewed client medications for (2) clients and found all medication listed on centrally stored lists and all required labeling was found to be in place. The medications were not properly being administered and no medication log found. Disaster preparedness: LPA reviewed the facility's emergency and disaster plan. LPA reviewed documentation with no proof a any fire or earthquake drills, proof showing the emergency and disaster training, which did not met the department requirements. LPA observed all facility exits were clear from obstructions. LPA observed no emergency food supply or water in any location of the facility. Forms : The following signs were observed to be posted at the home: Emergency Disaster Plan (LIC 610E), Personal Rights, and Facility Sketch (LIC 999) Deficiencies were cited during this visit. An exit interview was conducted where a copy of this report was provided to staff Rodrigo Baluyut (Rolly).

Citations

12 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.

  • 1569.618(c)(3)Type A

    Based on observation and interview with staff and record review, the licensee did not comply with the section cited above in 1 out of 1 CPR records, which poses an immediate health, safety or personal rights risk to persons in care.

  • 87212(b)(1)Type A

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses an immediate health, safety or personal rights risk to persons in care.

  • 87212(b)(2)Type A

    Based on documents posted in the facility, interview with staff, and record review The documents present on site, and the testimony of the staff the licensee did not comply with the section cited above in 1 out of 1 documents which poses an immediate health, safety or personal rights risk to persons in care.

  • 87212(b)(2)(A)Type A

    Based on documents posted in the facility, interview with staff, and record review The documents present on site, and the testimony of the staff the licensee did not comply with the section cited above in 1 out of 1 documents which poses an immediate health, safety or personal rights risk to persons in care.

  • 87212(c)Type A

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses an immediate health, safety or personal rights risk to persons in care.

  • 87465(c)(2)Type A

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses an immediate health, safety or personal rights risk to persons in care.

  • 87465(c)(3)Type A

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses an immediate health, safety or personal rights risk to persons in care.

  • 87465(d)(1)Type A

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses an immediate health, safety or personal rights risk to persons in care.

  • 87465(d)(2)Type A

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses an immediate health, safety or personal rights risk to persons in care.

  • 87465(d)(3)Type A

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses an immediate health, safety or personal rights risk to persons in care.

  • 87465(h)(2)Type A

    Based on observations with medications stored in a file cabinet, the testimony from staff, the medications stored were in an unlocked cabinet which poses an immediate health, safety or personal rights risk to persons in care.

  • 87507(d)Type B

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the June 16, 2023 inspection of GEM'S SENIOR LIVING I?

This was a inspection inspection of GEM'S SENIOR LIVING I on June 16, 2023. 12 citations were issued: 11 Type A (serious) and 1 Type B.

Were any citations issued to GEM'S SENIOR LIVING I on June 16, 2023?

Yes, 12 citations were issued (11 Type A, 1 Type B). The first citation was for: "Based on observation and interview with staff and record review, the licensee did not comply with the section cited abov..."

What type of inspection was this?

This was a inspection inspection. inspection 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.