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Inspection visit

Health check

DUTCHOLLOW SUITES ILicense 5070049293 citations on this visit
3 citations recorded

Inspector’s narrative

What the inspector wrote

On 1/25/24 Licensing Program Analyst (LPA) Maja Jensen and Stanislaus County Ombudsman Josey Samson arrived at facility unannounced to conduct a quarterly visit. LPA Jensen met with Licensee Cecelia Candido and Co-Administrator Nikolas Adamsson and explained the purpose of today's visit. The Licensee was informed that at any time if she wishes to use an interpreter the Department will provide an interpreter upon request. The facility currently has a census of 2. LPA Jensen requested the file for Resident 2 (R2). LPA Jensen observed an Admission agreement dated 4/13/2018 stating that the resident has a double room. LPA Jensen also observed 2 receipts billing for a private room. One receipt for April through June and one receipt for April through May of 2018. LPA Jensen asked the Licensee why there are receipts in the file billing for a private room and an admission agreement stating there R2 will occupy a double room. The Licensee stated the receipts in question were never sent and were placed in the file in error. The Licensee confirmed that the resident has always occupied a double occupancy room. LPA Jensen requested the correct receipts and was advised no other receipts were ever sent or generated. LPA Jensen observed the Needs and Service Plan for R2 to be dated April 2, 2018. The Licensee produced an additional Needs and Service Plan dated 3/23/2019 with no signatures. LPA Jensen reviewed the Medication Administration Record (MAR) for R2, the MAR reflects that on January 11 through and including January 15, 2024, R2 did not receive a prescribed dopamine promoter. LPA Jensen was advised that the prescription medication ran out on January 10, 2024 and the facility placed 3 calls to the pharmacy for a refill but these calls were not documented. LPA Jensen reviewed the Centrally Stored Medication and Destruction Record which shows that the prescription was refilled 12/21/23 and was started on 1/7/24. There was no explanation as to why these records were in conflict. LPA Jensen tested the water in the bathroom toward the rear of the facility and the temperature was measured at 103 degrees. Technical assistance was provided.

Citations

3 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.

  • 1569.884Type B

    Contents of Residential Care Facility Admission AgreementsThe admission agreement shall include all of the following:(a) A comprehensive description of any items and services provided under a single fee, , such as a monthly fee for room, board... the resident shall receive a monthly statement itemizing all separate charges incurred by the resident. This requirement was not met as evidenced by Licensee's admission that file receipts were inaccurate and no other receipts were generated. This poses a potential risk to the health, safety and personal rights of residnets in care.

  • 87464(f)(4)Type A

    Basic ServicesBasic services shall at a minimum include:...assistance with taking prescribed medications...This requirement was not met as evidenced by: Based on LPA Jensen's review of the MAR, R2 did not receive a prescribed medication from 1/11/24 through 1/15/24. This poses an immediate risk to the health, safety and personal rights of residents in care.

  • 87467(a)(3)Type B

    Resident Participation in Decision MakingThe licensee shall arrange a meeting with the resident and appropriate individuals identified in Section 87467(a)(1) to review and revise the written record as specified, when there is a significant change in the resident’s condition, or once every 12 months, whichever occurs first. Significant changes shall include, but not be limited to occurrences specified in Section 87463, Reappraisals. This requirement was not met as evidenced by LPA Jensen's review of R2's file which contained a Needs and Service Plan conducted in 2018. This poses a potential risk to the health, safety and personal rights of residents in care.

FAQ · About this visit

Common questions about this visit

What happened during the January 25, 2024 inspection of DUTCHOLLOW SUITES I?

This was a other inspection of DUTCHOLLOW SUITES I on January 25, 2024. 3 citations were issued: 1 Type A (serious) and 2 Type B.

Were any citations issued to DUTCHOLLOW SUITES I on January 25, 2024?

Yes, 3 citations were issued (1 Type A, 2 Type B). The first citation was for: "Contents of Residential Care Facility Admission AgreementsThe admission agreement shall include all of the following:(a)..."

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.