Inspection Reports for Eben Haven
30792 Stone Creek Ct, Menifee, CA 92584, CA, 92584
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Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 1
Oct 3, 2024
Visit Reason
An unannounced visit was conducted on 10/03/2024 to perform a required annual inspection of the facility.
Findings
The inspection found the facility generally compliant with safety and care standards, but identified one deficiency related to discrepancies in the Medication Administration Records for two residents, posing a potential health and safety risk.
Deficiencies (1)
| Description |
|---|
| Medication Administration Record discrepancies found during the review of Resident 1 and Resident 2's medications and records, posing a potential health, safety or personal rights risk to persons in care. |
Report Facts
Deficiencies cited: 1
Plan of Correction Due Date: Oct 11, 2024
Staff present: 2
Residents present: 5
Fire extinguisher last serviced: Jun 4, 2024
Hospice waiver approved residents: 4
Residents receiving hospice services: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Angelica Alamillo | Caregiver | Met with during inspection and involved in medication administration |
| Adeola Ayodele | Facility Representative | Arrived during visit and received report |
| Janette Romero | Licensing Program Analyst | Conducted inspection and signed report |
| Tricia Danielson | Licensing Program Manager | Supervisor named in report |
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 0
Oct 20, 2023
Visit Reason
The visit was an unannounced annual inspection to ensure the facility is following California Code of Regulations, Title 22, Division 6.
Findings
No deficiencies were observed during the inspection. The facility was found to have proper infection control, environmental safety, personnel records, client records, food service, health-related services, and disaster preparedness in compliance with regulations.
Report Facts
Food supply duration: 7
Food supply duration: 2
Bathroom temperature: 110
Facility temperature: 73
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Odunjo | Administrator | Met during inspection and signed receipt of report |
| Cheryl Goodrich | Licensing Program Analyst | Conducted the inspection |
| Angelica Alamillo Ochoa | Caregiver | Met at front door and granted entry to Licensing Program Analyst |
| Jazmond D Harris | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
Oct 15, 2021
Visit Reason
Licensing Program Analyst Jesse Gardner made an unannounced visit to the facility to conduct an annual inspection with an emphasis on infection control.
Findings
The facility was observed to have sufficient hand hygiene supplies, cleaning and disinfecting provisions, and proper use of face coverings. The facility has a designated infection control lead responsible for tracking COVID-19 cases, maintaining PPE supplies, and ensuring staff training on infection control.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Angelica Alamillo | Caregiver | Met with Licensing Program Analyst during inspection and discussed infection control practices. |
| Jesse Gardner | Licensing Program Analyst | Conducted the unannounced annual inspection. |
| Elizabeth Odunjo | Administrator | Facility administrator named in the report header. |
Inspection Report
Complaint Investigation
Census: 5
Capacity: 6
Deficiencies: 0
Aug 12, 2021
Visit Reason
An unannounced complaint investigation visit was conducted in response to an allegation that staff failed to provide proper supervision, which resulted in a fall.
Findings
The investigation found the allegation to be unsubstantiated based on interviews and observations. Staff did not leave the resident unsupervised, and there was insufficient evidence to prove the alleged violation occurred.
Complaint Details
The complaint alleged staff failed to provide proper supervision resulting in a fall. The finding was unsubstantiated, meaning there was not a preponderance of evidence to prove the alleged violations did or did not occur.
Report Facts
Capacity: 6
Census: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Anna Bueno | Licensing Program Analyst | Conducted the complaint investigation |
| Elizabeth Odunjo | Administrator | Facility administrator met during the investigation |
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