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Inspection visit

Routine inspection

MONTEVERDE MANOR IILicense 4156006608 citations on this visit
8 citations recorded

Inspector’s narrative

What the inspector wrote

On April 1, 2025 Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. LPA met with caregiver, ILdefonso Maning and explained the purpose of the visit. The administrator, Dino Martin arrived shortly thereafter and assisted with the inspection. 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. Chemicals, medication and sharps cabinets were observed to be locked and inaccessible to residents in care. A tour of the resident bedrooms and restrooms was conducted. The facility is approved for 1 bedridden resident in room 4, however, LPA observed resident #5 (R5) who is bedridden and is residing in room 1 that is a non-approved bedridden room. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. A comfortable temperature is maintained, and lighting is sufficient for comfort and safety. Toilet and bathing facilities are equipped with grab bars and nonskid flooring material. There are 5 residents present. Garage area was toured. LPA observed the facility has been converted into a storage space and for staff members to rest/sleep. LPA observed 2 beds in the garage with personal items around it and according to staff #1 (S1) staff members sleep and take rest breaks and the garage door has been broken for a long time. Fire extinguishers were inspected on 10/4/2024. Facility was not able to provide documentation to proof that emergency drills were completed accordingly. A review of (5) resident files was conducted and noted on the LIC 858. The following forms and documents were requested to be updated and submitted into CCL by 4/2/2025 - liability insurance Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in addition civil penalties. Civil penalty is being assessed today for the following repeat violations: - 87202(a)(2) Bedridden Persons - 87463(a) Reappraisals - 87305(a) Alterations to Existing Building - 1569.695(c) Other Provisions/Disaster Preparedness LPA will return on another day to complete the inspection. This report is reviewed and discussed with administrator. A copy of this report and the appeal rights were provided.

Citations

8 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(d)Type A

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as the administrator was not able to provide document to proof that this was completed which poses an immediate health, safety or personal rights risk to persons in care.

  • 87202(a)(2)Type A

    Facility must clear fire safety for bedridden persons

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as based on the LIC602, R5 bedridden is but residing in room #1 that is not approved for bedridden which poses an immediate health, safety or personal right risk to persons in care.

  • 87305(a)Type A

    Requirement for building permit before construction

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA observed the garage has been converted into a non-functioning garage as evidenced by 2 beds for staff to sleep/rest, many storage boxes, every cluttered the garage door is no longer working which poses an immediate health, safety or personal rights risk to persons in care.

  • 87456(a)(2)Type A

    Perform a pre-admission resident appraisal

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as R4 did not have a pre-admission appraisal which poses an immediate health, safety or personal rights risk to persons in care.

  • 87463(a)Type B

    Update reappraisal at required intervals

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as R1, R2 and R3 did not have an updated appraisal which poses/posed a potential health, safety or personal rights risk to persons in care.

  • 87507(a)Type A

    Must complete individual written admission agreements

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as R4's admission agreement was blank which poses an immediate health, safety or personal rights risk to persons in care.

  • 87608(a)(3)Type A

    Maintain physician order documentation in resident record

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as R1, R4 and R5 have bed rails without a written order from the physician which poses an immediate health, safety or personal rights risk to persons in care.

  • 1569.695(c)Type A

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as the administrator did not have documents to proof that drills were conducted accordingly 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 April 1, 2025 inspection of MONTEVERDE MANOR II?

This was an inspection of MONTEVERDE MANOR II on April 1, 2025. 8 citations were issued: 7 Type A (serious) and 1 Type B.

Were any citations issued to MONTEVERDE MANOR II on April 1, 2025?

Yes, 8 citations were issued (7 Type A, 1 Type B). The first citation was for: "Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as the ad..."

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.