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Inspection visit

Follow-up on corrections

VACAVILLE MEMORY CARELicense 4868036451 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA), Farhaan Sarangi arrived unannounced at Pacifica Senior Living Vacaville for the purpose of delivering complaint findings. LPA was greeted at the door by Administrator, Jeffery Gollihar, and was granted access into the facility. During the course of the investigation that was initiated on July 21, 2022, LPA reviewed documents and conducted interviews with staff and witnesses. LPA learned that R1 had a change of condition which was documented on a paper that was provided by the outside agency nurse that assessed R1 in Mid-July 2022. However, facility did not document the change of condition on an LIC 602/Physicians Report nor was an updated LIC 602/Physicians Report retained in the resident records (See LIC 809D) . Deficiencies are cited from the California Code of Regulations (CCRs), Title 22, Division 6, Chapter 8 and the Health and Safety Code. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview was conducted with the Administrator and appeal rights were given.

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.

  • 87506(b)(10)Type B

    87506(b)(10) Resident Records:(b) Each resident’s record shall contain at least the following information:(10): Reports of the medical assessment specified in Section 87458, Medical Assessment, and of any special problems or precautions.This requirement was not met as evidenced by:Based off of observation of facility records and interviews with staff members. LPA learned and identified that R1 did have a change of condition, and was not documented on a LIC 602/Physicians Report nor retained in resident records. This is a potential health, safety and personal rights risk to the residents in care.

FAQ · About this visit

Common questions about this visit

What happened during the October 21, 2022 inspection of VACAVILLE MEMORY CARE?

This was a other inspection of VACAVILLE MEMORY CARE on October 21, 2022. 1 citation were issued: 1 Type B.

Were any citations issued to VACAVILLE MEMORY CARE on October 21, 2022?

Yes, 1 citation was issued (0 Type A, 1 Type B). The first citation was for: "87506(b)(10) Resident Records:(b) Each resident’s record shall contain at least the following information:(10): Reports ..."

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.