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Inspection visit

Complaint

J AND V FAMILY CARE HOMELicense 4156007551 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

Based on information reported by and obtained from facility staff, San Mateo County Sheriff and Fire Dept. reports, this allegation is substantiated. The preponderance of evidence standard has been met. Resident #5 passed away on 6/21/22, according to Incident and Death Reports submitted to CCLD on 6/27/22. Additional information was provided by administrator by phone on 6/28/22 and in writing on 7/8/22. When paramedics arrived, staff provided them with the client folder of another resident in error, which included a POLST that specified "Do Not Attempt Resuscitation/DNR (Allow Natural Death)." According to administrator, staff was nervous and uneasy. R5 did not have a DNR on file. Deficiency of the CA Code of Regulations, Title 22 is cited on a following page.

Citations

1 citation 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.

  • 87411(a)Type A

    Facility personnel sufficiency and competence

    PERSONNEL REQUIREMENTS - GENERALFacility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs.This requirement was not met, as staff referenced on LIC812 failed to provide EMTs with acccurate client information on 6/21/22 during medical emergency of R5. Licensee failed to ensure that staff were competent to meet resident's needs, which posed an immediate health, safety and personal rights risk to clients in care. Because this error may have contributed to R5 death, LIC421M issued to assess immediate $500 civil penalty.

FAQ · About this visit

Common questions about this visit

What happened during the October 21, 2022 inspection of J AND V FAMILY CARE HOME?

This was a complaint inspection of J AND V FAMILY CARE HOME on October 21, 2022. 1 citation were issued: 1 Type A (serious).

Were any citations issued to J AND V FAMILY CARE HOME on October 21, 2022?

Yes, 1 citation was issued (1 Type A, 0 Type B). The first citation was for: "PERSONNEL REQUIREMENTS - GENERALFacility personnel shall at all times be sufficient in numbers, and competent to provide..."

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

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Next steps

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