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Inspection visit

Follow-up

COUNTRY CLUB MANORLicense 342700301
Clean visit · 0 citations

Inspector’s narrative

What the inspector wrote

LPA's Brandon Panariello and Kevin Gould conducted an unannounced case management inspection on 4/6/23 at 12:55pm. LPAs met with the Regional Director of Operations (RDO) of Cimino Care to discuss and obtain additional information regarding the reported incident. LPAs conducted interviews with two staff members. LPAs were informed the facility suspected and has obtained evidence the former administrator was falsifying employee time sheets and not meeting requirements to ensure three facility staff members obtained. LPAs provided RDO with LIC 855 Declaration forms to have filled out by any staff with knowledge of the alleged violations and returned to the department. LPAs have requested the facility staff files for 6 identified staff members. Facility was unable to provide at the time of inspection due to being removed for an internal investigation by the facility. For appointing a new administrator for the facility, LPAs have requested the following documents to be filled out by the appropriate corporate individuals. LIC 200 - Facility Application Form, LIC 308 - Designation of Facility responsibility, LIC 500 - Personnel Record, LIC 501 - Personnel Report, College Transcripts and board resolution designating new administrator and current Administrator Certificate. Per California Code of Regulations, Title 22, there were no deficiencies issued during today's inspection. An Exit interview was conducted with the regional director and a copy of this report was left at the facility.

Citations

1 citation 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.

  • Assist residents with self-administered medication

    Incidental Medical and Dental Care. (a) A plan for incidental medical and dental care shall be developed by each facility...(4) The licensee shall assist residents with self-administered medications as needed. This requirement was not as evidenced by: Licensee did not ensure a proper medication order was followed for R1. This posed an immediate health and safety risk to resident in care.

FAQ · About this visit

Common questions about this visit

What happened during the April 6, 2023 inspection of COUNTRY CLUB MANOR?

This was an other inspection of COUNTRY CLUB MANOR on April 6, 2023. The inspection found no deficiencies and no citations were issued.

Were any citations issued to COUNTRY CLUB MANOR on April 6, 2023?

No citations were issued during this inspection. The facility was found to be in compliance with all applicable regulations.

What type of inspection was this?

This was an other inspection. other inspections are conducted by CCLD as part of their licensing oversight.

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Data from CCLD public records. Last updated . If you believe any information is inaccurate, report it here.