Inspection Reports for Gold Medal Senior Living Estates
4010 Garey Ave, Claremont, CA 91711, United States, CA, 91711
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Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 3
Sep 13, 2024
Visit Reason
The visit was a required unannounced annual inspection to evaluate compliance with licensing regulations and assess facility conditions.
Findings
The inspection found deficiencies including lack of grab bars in two bathrooms, unlocked scissors in bathroom #1, and one staff member and one resident without fingerprint clearance. Civil penalties were assessed and plans of correction were required.
Severity Breakdown
Type A: 3
Deficiencies (3)
| Description | Severity |
|---|---|
| Two out of three bathrooms did not have grab bars in showers, posing an immediate health and safety risk. | Type A |
| Unlocked scissors were observed in bathroom #1, posing an immediate health and safety risk. | Type A |
| One staff member and one resident did not have fingerprint clearance, posing an immediate health and safety risk. | Type A |
Report Facts
Capacity: 6
Census: 5
Staff files reviewed: 4
Client files reviewed: 4
Fire/earthquake drill date: Aug 4, 2024
Plan of Correction Due Date: Sep 14, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Christian Gutierrez | Licensing Program Analyst | Conducted the annual inspection and authored the report |
| Tony Vasallo | Supervisor | Named in relation to findings and plans of correction |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
Oct 31, 2023
Visit Reason
The visit was an unannounced subsequent visit to conclude the required Annual inspection of the facility.
Findings
No deficiencies were observed during the visit. The inspection included review of residents' medications, staff interviews, and attempted resident interviews.
Report Facts
Residents' medications reviewed: 4
Staff interviewed: 2
Residents attempted to interview: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Victoria Serna | House Manager | Met with Licensing Program Analyst during the inspection and participated in exit interview |
| Valeria Maldonado | Licensing Program Analyst | Conducted the unannounced annual inspection visit |
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 4
Oct 23, 2023
Visit Reason
The Licensing Program Analyst conducted an unannounced required annual inspection using the Compliance and Regulatory Enforcement (CARE) Tool to evaluate the facility.
Findings
The inspection found several deficiencies including a staff bedroom located inside the kitchen posing health and safety risks, non-operational sink faucet in bathroom #2, lack of hot water in bathroom #3, and incomplete personnel records for the facility administrator. The inspection was not fully completed due to time constraints, with some domains and interviews pending.
Deficiencies (4)
| Description |
|---|
| Staff bedroom located inside the kitchen, posing an immediate health, safety or personal rights risk to persons in care. |
| Sink faucet in bathroom #2 is not operational, posing a potential health, safety or personal rights risk to persons in care. |
| Bathroom #3 sink faucet not delivering any hot water, posing a potential health, safety or personal rights risk to persons in care. |
| Facility administrator not maintaining a personnel file, posing a potential health, safety or personal rights risk to persons in care. |
Report Facts
Capacity: 6
Census: 4
Plan of Correction Due Date: Oct 24, 2023
Plan of Correction Due Date: Nov 3, 2023
Plan of Correction Due Date: Nov 3, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Victoria Serna | Care Manager | Met with Licensing Program Analyst during inspection and exit interview |
| Fernando Fierros | Supervisor | Named as supervisor on the report |
| Valeria Maldonado | Licensing Program Analyst | Conducted the inspection and authored the report |
| Toni C Santos | Administrator | Facility administrator noted as lacking a personnel file |
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 1
Oct 28, 2022
Visit Reason
An unannounced annual visit was conducted focusing on infection control, medication, and food review to ensure compliance with licensing requirements.
Findings
The facility was found to be operating within the scope of its license with adequate safety and hygiene measures. However, one deficiency was noted where medication was not administered as prescribed for one out of five residents reviewed.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Medication was not given as prescribed for 1 out of 5 residents; specifically, medication capsules for Quetiapine Fumarate and Simvastatin were still in the medication bubble pack past the prescribed dates. | Type A |
Report Facts
Residents medication reviewed: 5
Staff files reviewed: 5
Deficiencies cited: 1
POC Due Date: Oct 29, 2022
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Toni Santos | Administrator | Named in relation to administrator certificate and medication administration deficiency |
| Luis Mora | Licensing Evaluator | Conducted the inspection and signed the report |
| Wei Siew Ho | Supervisor | Supervisor overseeing the inspection |
| Victoria Serna | Care Manager | Met with Licensing Program Analyst during the inspection |
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 0
Oct 25, 2021
Visit Reason
An unannounced Annual Required / Infection Control Visit was conducted to evaluate the facility's compliance with regulations.
Findings
The facility was found to be in good repair with no observed deficiencies. Infection control practices were followed, including sanitizing stations, visitor logs, temperature checks, and use of PPE. No citations were issued.
Report Facts
PPE supply duration: 30
Hot water temperature: 110
Facility capacity: 6
Resident census: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Toni Santos | Administrator | Met with Licensing Program Analyst during inspection and involved in facility tour and exit interview |
| Alma Gonzalez | Licensing Program Analyst | Conducted the unannounced annual inspection visit |
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