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Inspection visit

Reference check

PACIFIC PINES ASSISTED LIVING FACILITYLicense 3655301843 citations on this visit
3 citations recorded

Inspector’s narrative

What the inspector wrote

On 10/03/2024 at 1:30PM, Licensing Program Analysts (LPAs) Renese Howell-Small and Melody Brown conducted an unannounced visit at this location to commence a health and safety check. LPAs Howell-Small and Brown identified themselves and discussed the purpose of the visit with House Manager, Douglas Hicks due to complaint # 56-AS-20240925153435. Fourteen (14) residents in care were present during visit. LPAs observed imminent health and/or safety concerns observed at the time of visit as LPAs conducted a medication audit for three (3) residents and noted that multiple medications were not given per their doctor’s order. Deficiency will be issued. LPAs observed health and/or safety hazards at this location as no sufficient staff coverage were observed to provide appropriate care and supervision to residents in care. During the visit, LPAs observed that only one (1) staff working from 6:00 AM to 2:00 PM and there are fourteen (14) residents of which three (3) residents are on hospice and three (3) residents have dementia. Deficiency will be issued. Furthermore, LPAs observed no emergency supplies available. Deficiency will be issued. Also, LPAs inspected the outside perimeter at this location and observed no health and/or safety hazards. LPAs inspected the food supplies at this location and observed an adequate supply of perishable and non-perishable food. The needs of the residents in care appear not being met during this inspection. An exit interview was conducted where this report, LIC809, LIC809D and Appeal Rights were discussed and provided to House Manager, Douglas Hicks.

Citations

3 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.

  • 1569.695(a)(2)Type B

    HSC 1569.695 Emergency Plans (a) In addition to any other requirement of this chapter, a residential care facility for the elderly shall have an emergency and disaster plan that shall include, but not be limited to, all of the following: (2) Plans for the facility to be self-reliant for a period of not less than 72 hours immediately following any emergency or disaster, including, but not limited to... This requirement is not met as evidenced by: Based on observation, interview and record review, the licensee did not comply with the section cited above by not ensuring that this location has the required emergency supplies/kits and emergency food which poses a potential health, safety, or personal rights risk to persons in care.

  • 87411(a)Type A

    87411 Personnel Requirements – General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs…This requirement is not met evidenced by:Based on observation, interview and records review, the Licensee did not comply with the section cited above by not ensuring that there are sufficient number of staff working at this location as evidenced of LPAs observed during the visit at this location that only one (1) staff working the morning shift from 06:00 AM to 02:00 PM which poses an immediate health, safety and personal rights risk to residents in care.

  • 87465(a)(4)Type A

    87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall... (4) The licensee shall assist residents with self-administered medications... This requirement is not met as evidenced by: Based on interview and records review, the Licensee did not comply with the section cited above by not ensuring that staff are providing the required medication assistance to Resident #1 (R1), Resident #2 (R2) and Resident #3 (R3) as prescribed by their physician which poses an immediate health, safety, or personal rights risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the October 3, 2024 inspection of PACIFIC PINES ASSISTED LIVING FACILITY?

This was a other inspection of PACIFIC PINES ASSISTED LIVING FACILITY on October 3, 2024. 3 citations were issued: 2 Type A (serious) and 1 Type B.

Were any citations issued to PACIFIC PINES ASSISTED LIVING FACILITY on October 3, 2024?

Yes, 3 citations were issued (2 Type A, 1 Type B). The first citation was for: "HSC 1569.695 Emergency Plans (a) In addition to any other requirement of this chapter, a residential care facility for t..."

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.