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Inspection visit

Incident investigation

COUNTRY CLUB MANORLicense 3427003011 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

On 7/5/23, Licensing Program Analyst (LPA) Tung Truong arrived at this facility unannounced to conduct a case management visit to follow up on an incident report. LPA met with Licensee Mark Cimino and explained the purpose of today’s visit. The purpose of this case management visit is to follow up on concerns learned from an incident report the facility submitted to the Department on 6/21/23. The facility reported that on 6/20/23, resident (R1) ran into the kitchen, grabbed the knives and started throwing them at the kitchen staff. Based on interviews and records review, it was determined that the facility did not ensure that knives were kept locked and inaccessible to residents. LPA observed the knives were not kept locked and is accessible to residents. Deficiencies were observed and cited on the LIC 809-D pursuant to the California Code of Regulations, Title 22, and California Health and Safety Code. An exit interview was conducted, a copy of this report, LIC 809-D and appeal rights were left at the facility. Failure to correct any deficiencies by plan of correction due date(s) may result in civil penalties.

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.

  • Notify agency before locking doors or gates

    87705 Care of Persons with Dementia. (f) The following shall be stored inaccessible to residents with dementia: (1) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s).This requirement is not met as evidence by: Based on interviews and records review, the licensee did not comply with the regulation cited above. LPA observed knives were not stored inaccessible to residents which poses an immediate health and safety risk to residents in care.

FAQ · About this visit

Common questions about this visit

What happened during the July 5, 2023 inspection of COUNTRY CLUB MANOR?

This was an other inspection of COUNTRY CLUB MANOR on July 5, 2023. 1 citation were issued: 1 Type A (serious).

Were any citations issued to COUNTRY CLUB MANOR on July 5, 2023?

Yes, 1 citation was issued (1 Type A, 0 Type B). The first citation was for: "87705 Care of Persons with Dementia. (f) The following shall be stored inaccessible to residents with dementia: (1) Kniv..."

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.