Inspection Reports for Belmont Village Senior Living Rancho Palos Verdes
5701 Crestridge Rd, Rancho Palos Verdes, CA 90275, United States, CA, 90275
Back to Facility ProfileInspection Report Summary
Most inspections of Belmont Village Rancho Palos Verdes found no deficiencies, with the most recent reports from August 28, 2025, showing no deficiencies and several complaint investigations unsubstantiated. Earlier annual inspections in June 2025 and October 2022 were also clean, indicating consistent compliance with regulations. Some isolated deficiencies were noted in the past, including a pesticide stored improperly in the kitchen in June 2024 and incomplete CPR/First Aid certification for some staff in October 2023, both of which were relatively minor. More serious issues occurred in 2022 involving substantiated findings of resident injuries due to inadequate care and supervision, resulting in fines and immediate health and safety risks, but these have not recurred in recent inspections. Overall, the facility’s record shows improvement over time, with no recent enforcement actions or fines listed in the latest reports.
Deficiencies per Year
8
6
4
2
0
High
Moderate
Unclassified
Census Over Time
Census
Capacity
Inspection Report
Complaint Investigation
Capacity: 150
Deficiencies: 0
Aug 28, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint received on 2025-04-14 regarding allegations of inadequate laundry service, housekeeping, shower assistance, and facility sanitation at Belmont Village Rancho Palos Verdes.
Findings
The investigation found no sufficient evidence to substantiate any of the allegations. Records review, staff and resident interviews, and observations indicated that laundry, housekeeping, shower assistance, and sanitation services were provided as required. Therefore, all allegations were determined to be unsubstantiated.
Complaint Details
The complaint alleged that staff did not provide laundry service, housekeeping service, assistance with showering, and did not maintain the facility sanitary. After review of records, interviews with staff and residents, and observations, the allegations were found unsubstantiated due to lack of preponderance of evidence.
Report Facts
Facility capacity: 150
Complaint receipt date: Apr 14, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Felisa Shirley | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Stephanie Cifuentes | Licensing Program Manager | Oversaw the complaint investigation |
| Ralph Balbin | Executive Director | Facility representative interviewed during the investigation |
Inspection Report
Complaint Investigation
Capacity: 150
Deficiencies: 0
Aug 28, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint received on 2025-04-14 alleging that staff charged a resident for services not rendered.
Findings
The investigation included review of records, interviews with staff and residents, and facility tour. The allegation was found to be unsubstantiated due to insufficient evidence to prove the alleged violations did or did not occur. No deficiencies were cited.
Complaint Details
Allegation: Staff charged resident for services not rendered. Investigation included review of resident's Residence and Services Agreement, Resident Assessment and Service Plan, Statement of Account, and interviews with 10 staff and 9 residents. Six staff acknowledged charging for services not rendered, but most residents denied being charged. The allegation was unsubstantiated due to lack of preponderance of evidence.
Report Facts
Facility capacity: 150
Staff interviewed: 10
Residents interviewed: 9
Staff acknowledging charging for services not rendered: 6
Residents denying being charged for services not rendered: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ralph Balbin | Executive Director | Met with during investigation and named in report |
| Felisa Shirley | Licensing Program Analyst | Conducted the complaint investigation |
| Stephanie Cifuentes | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Annual Inspection
Census: 127
Capacity: 150
Deficiencies: 0
Jun 4, 2025
Visit Reason
An unannounced annual required visit was conducted using the CARE Inspection Tool to evaluate compliance with licensing requirements for the facility.
Findings
The facility was found to be clean, sanitary, and appropriately furnished with no observed deficiencies. All inspected areas including bedrooms, bathrooms, kitchen, and safety equipment were in compliance with regulations. No citations were issued during this visit.
Report Facts
Residents' service files reviewed: 6
Staff personnel files reviewed: 6
Medication Administration Records reviewed: 6
Resident bedrooms inspected: 8
Bathrooms inspected: 8
Facility capacity: 150
Current census: 127
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ralph Balbin | Executive Director | Met with Licensing Program Analyst during inspection and received the Facility Evaluation Report |
| Alfonso Iniguez | Licensing Program Analyst | Conducted the inspection visit |
| Eva M Alvarez | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Complaint Investigation
Census: 128
Capacity: 150
Deficiencies: 0
May 12, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to an allegation that staff charged a resident for services not rendered.
Findings
Based on records review, interviews with staff and residents, and observations, there was insufficient evidence to substantiate the allegation. The complaint was determined to be unsubstantiated with no deficiencies cited.
Complaint Details
The allegation was that staff charged a resident for services not rendered. Interviews revealed mixed responses from staff and residents, but no preponderance of evidence was found to prove the alleged violation. The complaint was unsubstantiated.
Report Facts
Capacity: 150
Census: 128
Staff interviewed: 10
Residents interviewed: 9
Staff responses: 6
Staff responses: 4
Resident responses: 6
Resident responses: 1
Resident responses: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ralph Balbin | Executive Director | Met with during the investigation and named in the exit interview |
| Felisa Shirley | Licensing Program Analyst | Conducted the complaint investigation |
| Stephanie Cifuentes | Licensing Program Manager | Named in the report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 130
Capacity: 150
Deficiencies: 0
Apr 24, 2025
Visit Reason
An unannounced complaint investigation visit was conducted in response to allegations received on 2025-04-14 regarding laundry service, housekeeping service, assistance with showering, and facility sanitation at Belmont Village Rancho Palos Verdes.
Findings
The investigation found no sufficient evidence to substantiate any of the allegations. Records, interviews with staff and residents, and observations indicated that laundry, housekeeping, showering assistance, and facility sanitation services were provided as required. All allegations were determined to be unsubstantiated.
Complaint Details
The complaint included allegations that staff did not provide laundry service, housekeeping service, assistance with showering, and did not maintain the facility sanitary. After review of records, interviews with staff and residents, and observations, the allegations were found unsubstantiated due to lack of preponderance of evidence.
Report Facts
Capacity: 150
Census: 130
Staff interviewed: 10
Residents interviewed: 9
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ralph Balbin | Executive Director | Met with during investigation and named in report |
| Felisa Shirley | Licensing Program Analyst | Conducted the complaint investigation |
| Stephanie Cifuentes | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Complaint Investigation
Census: 130
Capacity: 150
Deficiencies: 0
Dec 9, 2024
Visit Reason
The visit was an unannounced complaint investigation triggered by allegations including lack of supervision resulting in resident wandering away, staff not administering medication as prescribed, failure to provide medical attention, and confiscation of resident's belongings.
Findings
The investigation found all allegations to be unsubstantiated based on interviews with residents and staff, record reviews, and evidence. The resident who wandered was accompanied by staff and returned without harm. Medication administration and medical attention allegations were denied by staff and residents, and medication confiscation was conducted to prevent overdose and later returned to family.
Complaint Details
The complaint investigation was unsubstantiated for all allegations: lack of supervision, medication administration, medical attention, and confiscation of belongings. The preponderance of evidence standard was not met to prove violations.
Report Facts
Residents interviewed: 9
Staff interviewed: 6
Medication administration days alleged missed: 5
Estimated days of completion: 90
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ralph Balbin | Executive Director | Met during investigation and named in findings |
| Mario Leon | Licensing Program Analyst | Conducted the complaint investigation |
| Ulysses Coronel | Licensing Program Manager | Oversaw complaint investigation |
Inspection Report
Annual Inspection
Census: 129
Capacity: 150
Deficiencies: 1
Jun 7, 2024
Visit Reason
Unannounced annual required visit using the CARE Inspection Tool to evaluate compliance with licensing regulations and facility standards.
Findings
The facility was found clean, sanitary, and appropriately furnished with no discrepancies in medication administration records. One deficiency was cited for storing a can of pesticide in the kitchen food pantry, posing an immediate health and safety risk.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Can of pesticide found on facility’s kitchen food pantry, violating food service requirements for separate storage of toxins and food supplies. | Type A |
Report Facts
Residents' service files reviewed: 8
Staff personnel files reviewed: 6
Medication Administration Records reviewed: 8
Fire/Disaster Drills last conducted: May 16, 2024
Plan of Correction Due Date: Jun 10, 2024
Water temperature range (°F): 113.5
Water temperature range (°F): 118.2
Room temperature range (°F): 76
Room temperature range (°F): 78
Bedrooms inspected: 9
Bathrooms inspected: 9
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ralph Balbin | Executive Director | Met with Licensing Program Analyst during inspection and involved in deficiency correction |
| Alfonso Iniguez | Licensing Program Analyst | Conducted the inspection and authored the report |
| Eva M Alvarez | Licensing Program Manager | Supervisor of the inspection |
Inspection Report
Complaint Investigation
Census: 122
Capacity: 150
Deficiencies: 0
Apr 17, 2024
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint received on 2022-12-29 alleging multiple deficiencies including unmet resident incontinence, dietary needs, failure to follow physician's orders, lack of clean linen, punishment of residents, inadequate housekeeping, and hydration issues.
Findings
The investigation involved interviews with staff and residents, and review of records. All allegations were found to be unsubstantiated due to insufficient evidence. Staff and residents denied the allegations, and documentation supported that care needs were met. No deficiencies were cited.
Complaint Details
The complaint included seven allegations: 1) Staff do not meet resident's incontinence needs; 2) Staff do not meet resident's dietary needs; 3) Staff do not follow resident's physician's order; 4) Staff did not provide resident with clean linen; 5) Staff punished resident for behavior; 6) Staff did not provide resident with housekeeping; 7) Staff do not ensure that resident is hydrated. All allegations were investigated and found unsubstantiated.
Report Facts
Capacity: 150
Census: 122
Number of allegations: 7
Staff interviewed: 5
Residents interviewed: 10
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Perry Scott | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Janae Hammond | Licensing Program Manager | Oversaw the complaint investigation |
| Ralph Balbin | Executive Director | Facility representative met during the investigation and exit interview |
Inspection Report
Complaint Investigation
Census: 125
Capacity: 150
Deficiencies: 0
Jan 5, 2024
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by an allegation that facility staff were not taking measures to prevent the spread of contagious diseases.
Findings
The investigation included interviews with the administrator, staff, and residents, a tour of the facility, and review of infection control plans and staff training records. The findings showed that the facility had current infection control and emergency plans, staff were trained and following proper infection precautions, and sanitation measures were observed. The allegation was found to be unsubstantiated due to insufficient evidence.
Complaint Details
The complaint alleged that facility staff were not taking measures to prevent the spread of contagious diseases. After investigation, including interviews and document review, the allegation was found to be unsubstantiated.
Report Facts
Staff interviewed: 11
Residents interviewed: 11
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ralph Balbin | Executive Director | Met with during the investigation and provided information on infection control protocols |
| Alfonso Iniguez | Licensing Program Analyst | Conducted the complaint investigation visit |
| Eva M Alvarez | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Annual Inspection
Census: 125
Capacity: 150
Deficiencies: 1
Oct 14, 2023
Visit Reason
An unannounced annual required visit was conducted using the CARE Inspection Tool to evaluate compliance with licensing requirements for the facility.
Findings
The facility was found to be generally well-maintained with adequate staffing, infection control practices, and safety measures. However, a deficiency was identified related to staff training where 3 out of 6 care staff did not have current CPR/First Aid certification on file.
Deficiencies (1)
| Description |
|---|
| 3 out of 6 care staff (#2, #4, #5) did not have current CPR/First Aid certification on file. |
Report Facts
Hospice residents: 16
Staff without current CPR/First Aid: 3
Staff reviewed: 6
Residents reviewed: 6
Fine amount: 100
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ralph Balbin | Executive Director | Met during inspection and exit interview |
| Ernand Dabuet | Licensing Program Analyst | Conducted the inspection and authored the report |
| Janae Hammond | Licensing Program Manager | Supervisor of the inspection |
Inspection Report
Complaint Investigation
Census: 138
Capacity: 150
Deficiencies: 0
Feb 21, 2023
Visit Reason
An unannounced complaint investigation was conducted in response to an allegation that staff abandoned a resident.
Findings
The investigation included interviews and record reviews and found no preponderance of evidence to substantiate the allegation. The resident's family had sent a Notice to Vacate and decided not to have the resident return, and the facility did not refuse re-entry.
Complaint Details
The allegation was that staff abandoned a resident. The investigation was unsubstantiated due to lack of evidence.
Report Facts
Census: 138
Total Capacity: 150
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ana Soto | Licensing Program Analyst | Conducted the complaint investigation |
| Miki Lamm | Executive Director | Interviewed during investigation and participated in exit interview |
| Nina Khachatrian | Director of Resident Care Services | Interviewed during investigation |
Inspection Report
Complaint Investigation
Census: 106
Capacity: 150
Deficiencies: 0
Dec 22, 2022
Visit Reason
The visit was an unannounced complaint investigation to examine the allegation that facility staff denied a resident the presence of a visitor during activities of daily living (ADLs).
Findings
The investigation found no violation of Title 22 Regulations and no evidence supporting the allegation. The resident and staff interviews indicated that visitors are allowed during ADLs, though concerns about visitor interference were noted. The allegation was unsubstantiated and no deficiencies were cited.
Complaint Details
The complaint alleged that facility staff denied a resident visitor presence during ADLs such as diaper changes, bathing, and transfers. The resident stated no rights violations and no preference regarding visitor presence. Staff and other residents confirmed visitor policies and privacy preferences. Concerns about visitor interference and conduct were documented but did not substantiate the allegation.
Report Facts
Capacity: 150
Census: 106
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ernand Dabuet | Licensing Program Analyst | Conducted the complaint investigation visit |
| Janae Hammond | Licensing Program Manager | Named in report as Licensing Program Manager |
| Miki Lamm | Executive Director | Participated in the investigation and exit interview |
| Tiffany Alisaje | Memory Care Coordinator | Greeted the Licensing Program Analyst and participated in the investigation |
Inspection Report
Census: 107
Capacity: 150
Deficiencies: 0
Dec 19, 2022
Visit Reason
An unannounced Case Management inspection was conducted to evaluate infection control practices and overall facility compliance.
Findings
The facility had generally good infection control practices including PPE use, isolation rooms, and sanitizing stations, but lacked required infection control postings throughout the facility. The facility had adequate supplies of PPE and cleaning products. Two technical advisories were issued regarding posting reminders for cough etiquette, distancing, hand washing, and reporting respiratory illnesses.
Report Facts
PPE supply duration: 30
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Wendy Gibbs | Licensing Program Analyst | Conducted the unannounced Case Management inspection |
| Eva M Alvarez | Licensing Program Manager | Named as Licensing Program Manager on report |
| Miki Lamm | Met with Licensing Program Analyst during inspection | |
| Ruth Lamm Oberg | Administrator | Facility Administrator named in report |
Inspection Report
Complaint Investigation
Census: 104
Capacity: 150
Deficiencies: 0
Oct 30, 2022
Visit Reason
The inspection was an unannounced complaint investigation conducted in response to allegations received on 07/08/2022 regarding neglect and unmet needs of residents in care.
Findings
The investigation included interviews, record reviews, and observations. The findings concluded that the allegations of neglect and unmet needs were unsubstantiated as residents appeared well cared for, staff were reported to be helpful, and hospice and personal aides were assisting residents as needed.
Complaint Details
The complaint alleged that residents were being neglected and their needs were not being met. After investigation, including interviews with staff and residents and review of records, the allegations were found unsubstantiated due to lack of preponderance of evidence.
Report Facts
Capacity: 150
Census: 104
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ana Soto | Licensing Program Analyst | Conducted the complaint investigation |
| Miki Lamm | Executive Director | Interviewed during the investigation and participated in exit interview |
| Janae Hammond | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Complaint Investigation
Census: 104
Capacity: 150
Deficiencies: 0
Oct 30, 2022
Visit Reason
The inspection was an unannounced complaint investigation conducted in response to a complaint received on 08/11/2022 regarding multiple allegations about the facility's care and services.
Findings
The investigation found no substantiated evidence to support the allegations. Interviews, observations, and record reviews indicated that residents' hygiene needs were met, food service was adequate, rooms were clean, privacy was maintained, residents were not overcharged, staff did not coerce residents, and records were provided as requested.
Complaint Details
The complaint included allegations of inadequate food service, dirty resident rooms, lack of privacy, overcharging, staff coercion, and failure to provide records. The investigation concluded these allegations were unsubstantiated due to lack of evidence.
Report Facts
Facility capacity: 150
Resident census: 104
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ana Soto | Licensing Program Analyst | Conducted the complaint investigation |
| Miki Lamm | Executive Director | Interviewed during investigation |
| Nina Khatchatrian | Director of Resident Care Services | Interviewed during investigation |
Inspection Report
Complaint Investigation
Census: 104
Capacity: 150
Deficiencies: 0
Oct 30, 2022
Visit Reason
The inspection was an unannounced complaint investigation triggered by a complaint received on 08/16/2022 alleging that staff do not respond to residents' call buttons timely.
Findings
The investigation included interviews and record reviews and found that staff generally respond timely to call buttons, with some delays due to staff assisting other residents or being on break. The allegation was determined to be unsubstantiated due to lack of preponderance of evidence.
Complaint Details
The complaint alleged that staff do not respond to residents' call buttons timely. Interviews with staff and residents indicated timely responses, and the allegation was unsubstantiated.
Report Facts
Capacity: 150
Census: 104
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ana Soto | Licensing Program Analyst | Conducted the complaint investigation |
| Miki Lamm | Executive Director | Met with during investigation and exit interview |
| Janae Hammond | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 104
Capacity: 150
Deficiencies: 0
Oct 30, 2022
Visit Reason
The inspection was an unannounced complaint investigation conducted in response to allegations received on 2022-09-08 regarding staff disconnecting a resident's telephone, over medicating a resident, restricting visitation, and restricting phone calls to a resident.
Findings
The investigation included interviews and record reviews and found no evidence to substantiate the allegations. The facility staff and residents consistently reported no disconnection of phones, no overmedication, no visitation restrictions, and no interference with phone calls. The allegations were determined to be unsubstantiated due to lack of preponderance of evidence.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included staff disconnecting a resident's telephone, over medicating a resident, restricting visitation, and restricting phone calls. Interviews with staff, residents, and review of medication administration records did not support the allegations.
Report Facts
Capacity: 150
Census: 104
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ana Soto | Licensing Program Analyst | Conducted the complaint investigation |
| Miki Lamm | Executive Director | Facility representative met during investigation and exit interview |
| Janae Hammond | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Annual Inspection
Census: 104
Capacity: 150
Deficiencies: 0
Oct 30, 2022
Visit Reason
An unannounced annual required and infection control visit was conducted to evaluate the facility's compliance with regulations and infection control practices.
Findings
The facility was found to be in good repair with no observed deficiencies. Infection control practices were properly followed, including sanitizing stations, PPE availability, and vaccination status of residents and staff. No citations were issued.
Report Facts
Residents ambulatory: 9
Residents non-ambulatory: 95
Residents bedridden: 0
Bedrooms: 138
Bathrooms: 145
Fire extinguishers: 12
Hot water temperature range: 105
Hot water temperature range: 120
PPE supply duration: 30
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Miki Lamm | Executive Director | Met during the inspection and exit interview |
| Ana Soto | Licensing Program Analyst | Conducted the inspection visit |
| Janae Hammond | Licensing Program Manager | Named in the report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 106
Capacity: 150
Deficiencies: 1
Oct 12, 2022
Visit Reason
The inspection was an unannounced complaint investigation conducted in response to allegations received on 2022-10-05 regarding the facility not addressing an ants issue and parking lot lights not working.
Findings
The allegation regarding ants was unsubstantiated after interviews, record reviews, and observations showed no live ants present and pest control treatment had been conducted. The allegation about parking lot lights was substantiated, with 8 out of 12 light poles and one main entrance light found not working, and a citation was issued.
Complaint Details
The complaint investigation was triggered by allegations that the facility was not addressing an ants issue and that the parking lot lights were not working. The ants allegation was unsubstantiated, while the parking lot lights allegation was substantiated with a citation issued.
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Based on 8 of 12 parking lot light poles are out and 1 main entrance light out too. | Type B |
Report Facts
Capacity: 150
Census: 106
Parking lot lights out: 8
Main entrance light out: 1
Plan of Correction Due Date: Oct 25, 2022
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Miki Lamm | Executive Director | Interviewed during complaint investigation and exit interview |
| Ana Soto | Licensing Program Analyst | Conducted the complaint investigation |
| Janae Hammond | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Complaint Investigation
Census: 115
Capacity: 150
Deficiencies: 0
Sep 7, 2022
Visit Reason
An unannounced complaint investigation was conducted due to an allegation that staff do not provide comfortable accommodations to the residents while in care.
Findings
The investigation found that the main A/C unit was working in all common areas and residents had individual PTAC units in their rooms which they could control. Interviews with residents and staff confirmed the facility and rooms were at a comfortable temperature. The allegation was unsubstantiated due to lack of preponderance of evidence.
Complaint Details
The complaint alleged that staff do not provide comfortable accommodations to residents. The allegation was unsubstantiated after investigation.
Report Facts
Capacity: 150
Census: 115
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ana Soto | Licensing Program Analyst | Conducted the complaint investigation |
| Miki Lamm | Executive Director | Interviewed during the investigation and participated in exit interview |
Inspection Report
Complaint Investigation
Census: 111
Capacity: 150
Deficiencies: 3
Apr 1, 2022
Visit Reason
Unannounced complaint investigation visit conducted due to allegation that a resident developed multiple pressure wounds while in care.
Findings
The investigation substantiated the allegation that Resident #1 developed multiple pressure ulcers, including Stage 3 and Stage 2 wounds, due to failure to provide timely home health services and appropriate care. The facility failed to ensure proper treatment and documentation, posing immediate health and safety risks.
Complaint Details
The complaint investigation was substantiated. Resident #1 developed multiple pressure wounds while in care. The facility failed to provide timely home health services due to insurance and agency availability issues, resulting in serious bodily injury. An immediate civil penalty of $500 was warranted.
Severity Breakdown
Type A: 1
Type B: 2
Deficiencies (3)
| Description | Severity |
|---|---|
| On 11/28/19 Resident was admitted to hospital with pressure injuries of left heel, right heel, and sacral region indicating failure to provide adequate care. | Type A |
| Facility failed to provide reappraisal relating to pressure injuries, posing a potential health and safety risk. | Type B |
| Facility failed to seek appropriate health care needs from October 2019 to November 2019, posing a potential health and safety risk. | Type B |
Report Facts
Civil penalty amount: 500
Deficiency count: 3
Plan of Correction due dates: Type A deficiency due 04/02/2022; Type B deficiencies due 04/08/2022
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jey Cardenas | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Angela J Kendrick | Licensing Program Manager | Oversaw the complaint investigation |
| Nina Khatchatrian | Director of Resident Care Services | Facility representative met during exit interview |
| Miki Lamm | Administrator | Interviewed regarding resident care and home health services |
Inspection Report
Complaint Investigation
Census: 111
Capacity: 150
Deficiencies: 6
Apr 1, 2022
Visit Reason
This was an unannounced complaint investigation visit triggered by allegations including a resident sustaining serious injury from falling resulting in hospitalization, unexplained injury, failure to reevaluate resident after falling, insufficient staffing, and failure to ensure resident safety by not using fall preventive measures.
Findings
The investigation substantiated multiple allegations including that Resident #1, a high-risk fall resident with dementia, was left unsupervised resulting in a serious injury and hospitalization due to a subdural hematoma. The facility lacked sufficient staffing, failed to use fall preventive measures such as an alarm floor mat, and failed to reevaluate the resident after the fall. One allegation regarding staff not timely responding to a resident's call for help was found unsubstantiated.
Complaint Details
The complaint investigation was substantiated for allegations that Resident #1 sustained serious injury from falling resulting in hospitalization, sustained unexplained injury, facility failed to reevaluate resident after falling, lacked sufficient staffing, and failed to ensure safety by not using fall preventive measures. One allegation regarding staff not timely responding to resident's call for help was unsubstantiated.
Severity Breakdown
Type A: 1
Type B: 5
Deficiencies (6)
| Description | Severity |
|---|---|
| Any violation that the department determines resulted in the injury or illness of a resident. On 3/3/2020 R1 was left unsupervised and fell, resident sustained injury which resulted in subdural hematoma, likely exacerbated by fall. This poses an immediate health and safety risk to residents in care. | Type A |
| Personal Rights- To be accorded safe, healthful & comfortable accommodations not met as evidenced by unexplained injuries sustained by Resident #1 on 3/3/2020. | Type B |
| Personnel Requirement - Facility personnel shall at all times be sufficient in numbers and competent. Facility was unable to find/secure a private PAL for R1 on 3/3/2020. | Type B |
| Reappraisals - The pre-admission appraisal shall be updated in writing. R1 was hospitalized due to a fall on 1/11/2020 but appraisal was not updated. | Type B |
| All personnel shall be given on the job training. Facility failed to ensure safety of resident by not using fall preventatives on 3/3/2020. | Type B |
| Provide or ensure the provision of services to the residents. Administrator did not ensure that staff provided R1 with the services needed to meet resident's needs. | Type B |
Report Facts
Capacity: 150
Census: 111
Civil penalty: 500
Plan of Correction Due Dates: Apr 2, 2022
Plan of Correction Due Dates: Apr 8, 2022
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Nina Khatchatrian | Director of Resident Care Services | Assisted Licensing Program Analyst during the visit and was present during exit interview |
| Lamm Oberg | Administrator | Interviewed regarding staffing and care plan issues related to Resident #1 |
| Jey Cardenas | Licensing Program Analyst | Conducted the complaint investigation visit and authored the report |
| Angela J Kendrick | Licensing Program Manager | Oversaw the complaint investigation |
Inspection Report
Complaint Investigation
Census: 112
Capacity: 150
Deficiencies: 0
Sep 2, 2021
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 2020-10-05 regarding resident injury, medication mismanagement, and inadequate staffing at Belmont Village Rancho Palos Verdes.
Findings
The investigation found insufficient evidence to substantiate the allegations of resident fracture due to neglect, medication mismanagement, and inadequate staffing. Interviews, record reviews, and observations indicated no violations or neglect by facility staff.
Complaint Details
The complaint included allegations that a resident sustained a fracture while in care, staff mismanaged residents' medications, and the facility did not maintain adequate staffing to meet residents' needs. The investigation was unsubstantiated based on interviews with staff, residents, family, and review of medical and staffing records.
Report Facts
Capacity: 150
Census: 112
Staffing counts: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jose Calderon | Licensing Program Analyst | Conducted the complaint investigation and interviews |
| Miki Lamm | Administrator | Facility administrator interviewed during investigation |
Inspection Report
Complaint Investigation
Census: 109
Capacity: 150
Deficiencies: 0
Aug 18, 2021
Visit Reason
The inspection was an unannounced complaint investigation triggered by an allegation that a resident suffered multiple falls while in care.
Findings
The investigation found no preponderance of evidence to substantiate the allegation of abuse or theft. Resident falls were confirmed but were attributed to the resident moving independently without waiting for staff assistance. Staff response times were within 5 to 10 minutes after call button activation. The allegation was determined to be unsubstantiated.
Complaint Details
The complaint alleged that a resident suffered multiple falls and had money and personal items stolen. Interviews with witnesses, staff, and residents, as well as review of hospital and care records, indicated the resident had dementia and falls were not due to staff abuse. No evidence supported theft claims. The allegation was unsubstantiated.
Report Facts
Capacity: 150
Census: 109
Investigation date: Aug 18, 2021
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jose Calderon | Licensing Program Analyst | Conducted the complaint investigation and interviews |
| Miki Lamm | Administrator | Facility administrator interviewed during the investigation |
Inspection Report
Annual Inspection
Census: 104
Capacity: 150
Deficiencies: 0
Jun 8, 2021
Visit Reason
An unannounced annual required visit was conducted with a primary focus on infection control measures.
Findings
The facility was found to be clean, appropriately furnished, and in good repair with no deficiencies cited under California code of regulation title 22, division 6, chapter 8. Infection control practices including screening protocols, sanitizing stations, face coverings, isolation room, and PPE supply were observed and found adequate.
Report Facts
Non-ambulatory residents: 98
Ambulatory residents: 6
Memory Care Unit residents: 66
Bedrooms: 130
Common bathrooms: 8
Pool size (feet): 4
Client rooms checked: 10
PPE supply duration (days): 30
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jose Calderon | Licensing Program Analyst | Conducted the inspection and observed infection control practices |
| Miki Lamm | Administrator | Facility administrator met during the inspection and received the report |
Inspection Report
Complaint Investigation
Census: 166
Capacity: 150
Deficiencies: 0
Apr 27, 2021
Visit Reason
An unannounced complaint investigation was conducted following allegations of physical abuse, harassment, and neglect of residents at the facility.
Findings
The investigation found no evidence to substantiate the allegations of physical abuse, harassment, or neglect. Interviews with staff and residents, as well as record reviews, did not reveal any reports or documentation supporting the claims. The allegations were determined to be unsubstantiated.
Complaint Details
The complaint investigation was initiated due to allegations that residents were physically abused, harassed, and neglected. After interviews with staff, residents, and review of records, no evidence was found to support these allegations, resulting in an unsubstantiated finding.
Report Facts
Capacity: 150
Census: 166
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jose Calderon | Licensing Program Analyst | Conducted the complaint investigation and interviews |
| Miki Lamm | Administrator | Interviewed during the investigation |
| Ruth Lamm Oberg | Administrator | Interviewed during the investigation |
| Janae Hammond | Licensing Program Manager | Oversaw the complaint investigation |
Inspection Report
Complaint Investigation
Census: 120
Capacity: 150
Deficiencies: 0
Mar 15, 2021
Visit Reason
The inspection was an unannounced complaint investigation triggered by an allegation that staff did not seek medical attention for a resident.
Findings
The investigation found no preponderance of evidence to prove the alleged violation occurred; the allegation was unsubstantiated. The resident had COVID-19 but was asymptomatic and received excellent medical care, including hospital evaluation for an unwitnessed fall unrelated to COVID-19.
Complaint Details
The complaint alleged that staff failed to seek medical attention for a resident who tested positive for COVID-19. Interviews with the resident's responsible party, administrator, staff, and other residents indicated the resident was asymptomatic and received excellent medical care. The facility timely reported a COVID-19 outbreak to authorities. The allegation was unsubstantiated due to lack of evidence.
Report Facts
Capacity: 150
Census: 120
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jose Calderon | Licensing Program Analyst | Conducted the complaint investigation and interviews |
| Ruth Lamm | Administrator | Interviewed during the investigation and exit interview |
| Miki Lamm | Met with during the investigation and telephonic exit interview | |
| Janae Hammond | Licensing Program Manager | Named in report as Licensing Program Manager |
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