Skip to main content
ReadyRule homepageReadyRule

Inspection visit

complaint

SOUTH PACIFIC VILLALicense 3746044781 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

[CONTINUED FROM LIC 9099] During a 07/22/2022 site visit, LPA, accompanied by staff, inspected the centrally stored medications and their packaging, which Licensee kept on hand and secured for residents. Of the six residents in care, LPA observed that two residents [Resident #1 (R1) and Resident #2 (R2) had at least one expired medication in Licensee’s central storage. Specifically: R1 had an unopened blister pack/card of as-needed (PRN) tablets which had expired in January 2022. R2 had an opened bottle of PRN tablets which had expired in February 2022. During LPA’s visit, staff confirmed that the medications in question were expired, and removed them from central storage (in preparation for discarding and ordering of replacements). Based interviews and LPA observation, a preponderance of evidence existed to show that Licensee centrally-stored an expired resident medication. The allegation was therefore Substantiated. One deficiency was cited per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D page). A Plan of Correction was jointly developed with the Licensee. An exit interview was conducted with Riosa, to whom a copy of this report, the LIC 9099-D, and the Licensee/Appeal Rights (LIC9058 03/22) were provided.

Citations

4 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.

  • 87468.2(a)(3)Type B

    87468.2 Additional Personal Rights of Residents in Privately Operated Facilities: “(a)…residents…shall have all of the following personal rights: (3)…Residents shall be free from interference, coercion, discrimination, and retaliation in exercising their rights.” This requirement was not met, as evidenced by: Based on records and interview, Licensee did not ensure that 2 of 6 residents (R1 and R2) were free from interference and retaliation in exercising their rights. This posed a potential personal rights risk to persons in care.

  • 87224(d)(1)(C)Type B

    87224 Eviction Procedures: “(d)(1) The notice to quit shall include the following information: (C) A statement informing residents of their right to file a complaint with the licensing agency, as specified in Section 87468, subsection (a)(4), including the name, address and telephone number of the licensing office with whom the licensee normally conducts business, and the State Long Term Care Ombudsman office.” Based on records and interview, for 1 of 6 residents (R1), Licensee did not ensure that their notice to quit included a statement informing them of their right to file a complaint with the licensing agency, including the name address and telephone number of the local licensing office and the State Long Term Care Ombudsman office. This posed a potential personal rights risk to persons in care.

    Read full inspector narrative
  • 87224(d)(1)(D)Type B

    87224 Eviction Procedures: “(d)(1) The notice to quit shall include the following information: (D) The following exact statement as specified in Health and Safety Code Section 1569.683(a)(4): "In order to evict a resident who remains in the facility after the effective date of the eviction, the residential care facility for the elderly must file an unlawful detainer action in superior court and receive a written judgment signed by a judge. If the facility pursues the unlawful detainer action, you must be served with a summons and complaint. You have the right to contest the eviction in writing and through a hearing." Based on records and interview, for 1 of 6 residents (R1), Licensee did not ensure that their notice to quit included the exact statement that is specified in California Health and Safety Code Section 1569.683(a)(4). This posed a potential personal rights risk to persons in care.

    Read full inspector narrative
  • 87465(h)(4)Type B

    87465 Incidental Medical and Dental Care: “(h)(4) All centrally stored medications shall be…maintained in compliance with state and federal laws.” This requirement was not met, as evidenced by: Based on interview and LPA observation, Licensee did not ensure that all centrally stored medications were maintained in compliance with state and/or federal laws. This posed a potential health and safety risk to 2 of 6 residents (R1 and R2) in care.

FAQ · About this visit

Common questions about this visit

What happened during the April 25, 2024 inspection of SOUTH PACIFIC VILLA?

This was a complaint inspection of SOUTH PACIFIC VILLA on April 25, 2024. 1 citation were issued: 1 Type B.

Were any citations issued to SOUTH PACIFIC VILLA on April 25, 2024?

Yes, 1 citation was issued (0 Type A, 1 Type B). The first citation was for: "87468.2 Additional Personal Rights of Residents in Privately Operated Facilities: “(a)…residents…shall have all of the f..."

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.

SourceView on CCLDView original report

Share this reportEmail

Next steps

If this is your facility,claim this pageand correct anything the record gets wrong. Free.

Researching this visit professionally?Book a 15-minute calland we will walk through what we have on file.

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