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Inspection visit

Routine inspection

MONTEVERDE MANOR IILicense 41560066010 citations on this visit
10 citations recorded

Inspector’s narrative

What the inspector wrote

Unannounced annual visit made out to this facility on 10/15/2023 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility caregivers, Sonny Maning and Marife Maning, who were requested to go ahead and contact the facility designated Administrator to inform him/her that CCL was present at this time. The facility Administrator, Mary Juinio, arrived later to this facility while this LPA was conducting this annual visit. A brief interview was conducted with the facility Administrator at this time. Current census was 5 residents. It was learned that there was (1) resident under the care of hospice at this time. This facility was approved for a hospice waiver to be able to accept and retain up to (3) residents under hospice care at any given time. It was learned that there were (2) residents deemed to be bedridden at this time. There was (1) resident under the care of home health at this time. A tour of this facility was conducted. Administrator certificate was observed to be present and in compliance at this time for facility designated Administrator Dino Martin. The administrator certificate was due to expire on 12/28/2024 and in compliance at this time. Kitchen area was toured. Cabinets and drawers were reviewed. Food supply was reviewed for adequate 2-day perishable and 7-day nonperishable quantities at this time. A tour of the dining area, living area, and all other areas intended for resident use was conducted. Medication cabinet, located in the kitchen area, was reviewed. Policies and procedures involving dispensing, documenting, and overall administration of resident medications was discussed with the facility caregiver Sonny Maning. A tour of the resident bedrooms and restrooms was conducted. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. Hot water temperature was taken and measured to make sure that it was within the allowed range of 105-120 degrees. Linen closet, located in the hallway, was observed to contain a sufficient supply of towels, blankets, and linens to meet the needs of the residents at this time. Garage area was toured. This area also housed the washing machine and dryer for this facility's use at this time. Laundry area was toured. Cabinets storing detergents and bleach were observed to be locked and made inaccessible to the residents at this time. Fire extinguishers (2), located in facility entrance walkway garage area, were reviewed to see if they had been annually inspected, or recently purchased, by the local fire extinguisher company at this time. They were observed to have been annually inspected on 09/29/2022 by All Peninsula Fire Extinguisher Co. Exterior grounds of this facility were toured. A review of the facility perimeter fence, side gates, and exits was conducted. A review of (5) facility resident records was conducted. A review of (4) facility staff records was conducted. The following forms and documents were requested to be updated and submitted into CCL: LIC 308 LIC 400 LIC 500 LIC 610 The following deficiencies were observed and cited on the following LIC 809-D pursuant to Title 22 Rules and Regulations, Health and Safety Codes. Appeal Rights were printed and a copy was given to the facility co-Administrator at this time. Exit Interview

Citations

10 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.

  • 87202(a)Type A

    Maintain fire clearance before retaining specified persons

    Based on observation and record review, the licensee did not comply with the section cited above since this facility only has an approved bedridden fire clearance to accept and retain (1) bedridden resident in Room #4 only. This Licensee currently has (2) bedridden residents in care at the time of this annual visit which posed an immediate health, safety or personal rights risk to persons in care.

  • 87303(a)Type B

    Maintain facility in clean, safe, sanitary condition

    Based on observation, the licensee did not comply with the section cited above in that there were cracks in the kitchen and restroom flooring. Unused building materials and items were left in the exterior of this facility blocking side exits as well which poses/posed a potential health, safety or personal rights risk to persons in care.

  • 87303(c)Type B

    Keep window screens clean and in repair

    Based on observation, the licensee did not comply with the section cited above in that there were missing window screens and other screens that were in need of repair/replacement which poses/posed a potential health, safety or personal rights risk to persons in care.

  • 87303(e)(3)Type A

    Mark taps at high-temperature threshold

    Based on observation, the licensee did not comply with the section cited above in that the hot water that was measured in the resident restrooms were found to be at 122.2 degrees which posed an immediate health, safety or personal rights risk to persons in care.

  • 87411(c)(1)Type A

    First aid training requirements

    Based on record review, the licensee did not comply with the section cited above in [1] out of [4] staff persons did not have updated and certified First Aid training which posed an immediate health, safety or personal rights risk to persons in care.

  • 87412(a)Type B

    Maintain required personnel records for staff

    Based on record review, the licensee did not comply with the section cited above in [3] out of [5] facility personnel files were missing required forms and documents which poses/posed a potential health, safety or personal rights risk to persons in care.

  • 87412(a)(11)Type A

    Include required health screening documents

    Based on record review, the licensee did not comply with the section cited above in [3] out of [4] staff persons did not have a completed health screening report which posed an immediate health, safety or personal rights risk to persons in care.

  • 87458(a)Type A

    Obtain baseline medical assessment before resident admission

    Based on record review, the licensee did not comply with the section cited above in [1] out of [5] facility resident files did not have an annually updated medical assessment as required for residents diagnosed with dementia which posed an immediate health, safety or personal rights risk to persons in care.

  • 87465(h)(5)Type A

    Keep prescriptions in original containers

    Based on observation and record review, the licensee did not comply with the section cited above since it was learned that medications were pre-poured for 48 hours in advance with incomplete documentation of medications when dispensed to the residents. This posed an immediate health, safety or personal rights risk to persons in care.

  • 87506(a)Type B

    Maintain separate complete record for each resident

    Based on record review, the licensee did not comply with the section cited above in [3] out of [5] facility resident files were missing required forms and documents which poses/posed a potential health, safety or personal rights risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the October 15, 2023 inspection of MONTEVERDE MANOR II?

This was an inspection of MONTEVERDE MANOR II on October 15, 2023. 10 citations were issued: 6 Type A (serious) and 4 Type B.

Were any citations issued to MONTEVERDE MANOR II on October 15, 2023?

Yes, 10 citations were issued (6 Type A, 4 Type B). The first citation was for: "Based on observation and record review, the licensee did not comply with the section cited above since this facility onl..."

What type of inspection was this?

This was an inspection. 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.