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Inspection visit

Complaint

MADISON SQUARE SENIOR LIVING IILicense 3450029401 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

LIC 9099-C... Allegation: Facility failed to meet reporting requirements. The Department investigated the following allegation. Based on interview conducted with Administrator on 9/19/2024, interview revealed that there has been a few recent falls. R1 had a fall a day prior to LPAs' visit who then was sent out to the emergency room for evaluation. Interview revealed that R1's family member was notified but LIC 624 UNUSUAL INCIDENT/INJURY REPORT has not been submitted to Licensing yet. Interview with Administrator further revealed that R2 had a fall on 08/24/2024, where R2 had a nose bleed. Administrator contacted R2's responsible party and was asked to not send R2 out for evaluation. Administrator stated LIC 624 UNUSUAL INCIDENT/INJURY REPORT was not submitted to Licensing regrading this incident. Based on Title 22 Section 87211, facility is required to provide written report to Licensing Division within seven days of occurrence. Based on the allegation, facility failed to meet reporting requirements , the allegation is SUBSTANTIATED - A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. The following allegation cited above is substantiated, please see LIC9099-D. $250 repeated violation civil penalty assessed as facility was cited on 12/14/2023 for the same deficiency. Exit interview conducted and a copy of the report and appeal rights was provided.

Citations

2 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.

  • 87211(a)(1)(D)Type B

    87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. (D) Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident.This requirement is not met as evidenced by: Based on file review and interview, Licensee did not comply to the section cited above as Licensee stated LIC 624 was not submitted for R2 for an incident that occurred on 08/24/2024, which poses a potential risk to residents in care.

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  • Request transfer of criminal record clearance

    87411 Personnel Requirements - General (g) Prior to employment or initial presence in the facility, all employees and volunteers subject to a criminal record review shall: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c)This requirement is not met as evidenced by: Based on observation, Licensee did not comply with the section as LPAs observed S1 to be working at the facility without a criminal clearance transfer associated to the facility, which poses a potential health and safety risk to residents in care.

FAQ · About this visit

Common questions about this visit

What happened during the September 19, 2024 inspection of MADISON SQUARE SENIOR LIVING II?

This was a complaint inspection of MADISON SQUARE SENIOR LIVING II on September 19, 2024. 1 citation were issued: 1 Type B.

Were any citations issued to MADISON SQUARE SENIOR LIVING II on September 19, 2024?

Yes, 1 citation was issued (0 Type A, 1 Type B). The first citation was for: "87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may ..."

What type of inspection was this?

This was a complaint inspection. Complaint inspections are triggered when someone reports a concern about the facility to CCLD.

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