Inspection Reports for Kaego‘s Richman Gardens by SCH

An unannounced plan of correction (POC) visit was conducted to follow up on citations issued on 10/17/2024 and 12/23/2024.

The previously cited fire safety deficiency (delayed egress installation) has been corrected and is now operational. The licensee has complied with the plan of correction and was advised to remain in compliance with previously cited items.

An unannounced collateral visit was conducted in conjunction with complaint 22-AS-20220304102138 to evaluate the facility's compliance with licensing requirements.

The Licensing Program Analyst toured the facility, interviewed staff and a resident, but was unable to review facility, resident, and staff records from March 2022 as they were not available. An exit interview was conducted with the Administrator.

The visit was triggered by complaint 22-AS-20220304102138. No substantiation status is provided in the report.

This unannounced inspection was conducted as a Required – 1 Year Inspection to evaluate compliance with licensing requirements.

The inspection found that the facility generally met infection control, safety, and operational standards; however, deficiencies were cited for failure to update pre-admission appraisals for five residents within the past year.

Unannounced plan of correction (POC) visit to follow up on citations issued on 12/23/2024.

All citations issued on 12/23/2024 regarding Basic Services, False Claims, Care of Persons with Dementia, and Storage Space have been cleared with proof of correction provided by the licensee. The licensee has complied with the plan of correction.

The inspection was an unannounced complaint investigation visit triggered by allegations received on 09/06/2023 regarding inadequate supervision, failure to respond to alarms, unsecured exterior gates, and misinformation provided to a resident's authorized representative.

The investigation substantiated that staff failed to provide adequate supervision resulting in a resident wandering away and sustaining multiple injuries. Staff also failed to respond to facility alarms, did not securely lock the exterior gate, and provided false information to the resident's family. These deficiencies posed immediate health and safety risks to residents.

The complaint investigation was substantiated. Allegations included inadequate supervision causing resident elopement and injuries, failure to respond to alarms, unsecured exterior gates, and providing false information to the resident's authorized representative. The resident sustained multiple fractures and injuries after wandering away from the facility. Staff admitted to turning off alarms and providing false statements under pressure from management.

An unannounced plan of correction (POC) visit was conducted to follow up on citations issued on 2024-10-17.

The citation regarding Maintenance and Operation was cleared with removal of the delayed egress push lever, but the citation regarding Fire Safety was not cleared as exit gates remain secured with locks or keypads, posing an immediate health and safety risk. A civil penalty was assessed.

An unannounced case management visit was conducted in conjunction with a complaint visit #22-AS-20230906160954 to assess compliance with regulations.

The inspection found that all exit gates were locked, posing an immediate health and safety risk, and the exit gate on the north side had a broken delayed egress push lever, indicating the facility was not in good repair.

The visit was conducted in conjunction with complaint visit #22-AS-20230906160954.

This unannounced Plan of Correction (POC) inspection was conducted to verify correction of deficiencies issued during the Required – 1 Year Inspection conducted on August 13, 2024.

The previously cited Type A violation related to hot water temperatures in three buildings was cleared. Water temperatures were tested and found within acceptable ranges. No deficiencies were observed during this inspection.

This unannounced inspection was conducted by Licensing Program Analyst Sean Haddad for the purpose of a Required – 1 Year Inspection to evaluate compliance with licensing regulations.

The inspection found that the facility is generally well maintained with adequate supplies, safety measures, and proper operation of appliances. However, a deficiency was cited due to hot water temperatures exceeding the regulatory limits in multiple buildings, posing an immediate safety risk.

This unannounced inspection was conducted to investigate a complaint alleging that facility staff were not providing records to a resident's responsible person(s).

The investigation found that the facility did not timely provide Resident #1's Resident File in response to a request dated December 28, 2023, failing to meet the requirement to provide access within two business days. The allegation was substantiated based on interviews, document reviews, and a witness statement.

The complaint alleged that facility staff were not providing records to resident's responsible person(s). The allegation was substantiated after investigation, with evidence showing the facility did not provide the requested Resident File within the required timeframe.

This unannounced Case Management – Other inspection was conducted for the purpose of delivering amended findings for Complaint Control No. 22-AS-20221212121518 based on appeal.

During the inspection, the Licensing Program Analyst and the Administrator discussed the previously delivered findings and the amended findings. The amended report was delivered and discussed with the facility representative.

Inspection was related to Complaint Control No. 22-AS-20221212121518 and involved delivery of amended findings based on appeal.

This unannounced complaint investigation was conducted due to allegations that the licensee had liability insurance that did not include required coverage for resident injuries and misrepresented to the Department that they had liability insurance.

The investigation found that between 08/26/2022 and 12/06/2022, the facility did not have its own liability insurance coverage compliant with Title 22 Regulations due to policy exclusions and shared coverage with other facilities. The allegation that the licensee misrepresented having liability insurance was substantiated, while the allegation that the licensee had no current liability insurance was unsubstantiated.

The complaint was substantiated regarding the licensee not having required liability insurance coverage between 08/26/2022 and 12/06/2022. The allegation that the licensee misrepresented having liability insurance was substantiated. The allegation that the licensee had no current liability insurance was unsubstantiated.

This unannounced Plan of Corrections inspection was conducted to verify correction of deficiencies issued during the post licensing inspection conducted on 2022-12-13.

Two Type B violations related to staff training and resident files were cited and have been cleared based on documentation provided by the licensee prior to the due date.

This unannounced case management inspection was conducted to follow up on a self-reported incident involving Resident #1 attacking Resident #2 with a dresser drawer on 11/13/22.

The inspection found that Resident #2 had minor bruises but was otherwise in good health and able to walk. Resident #1 had a history of dementia with behavioral disturbances and was sometimes agitated and aggressive. The facility had attempted to have Resident #1's medications reassessed but did not receive a response. Further investigation may be required.

This unannounced inspection was conducted for the purpose of a post licensing inspection of the facility.

The inspection found the facility to be generally clean, organized, and compliant with safety requirements, but deficiencies were cited related to staff training documentation and resident appraisal records.

This unannounced case management inspection was conducted to follow up on a self-reported incident involving Resident #1 attacking Resident #2 with a dresser drawer on 2022-11-13.

The inspection found that Resident #2 had minor bruises but was otherwise in good health and able to walk. No health and safety issues were observed during the visit. Further investigation may be required.

The incident involved Resident #1 attacking their roommate Resident #2, resulting in police involvement and Resident #1's removal from the facility. Resident #2 did not remember the incident and was interviewed by the Long Term Care Ombudsman.

The inspection was conducted as a pre-licensing inspection for a Residential Care Facility for the Elderly, following an application submitted on 05/11/2022 and a change of ownership with persons in care.

The facility was inspected and found to be a small commercial facility with 13 bedrooms and 5 bathrooms, all in good condition with operational fixtures and safety equipment. Resident and staff files were reviewed, and fire clearance was approved. The facility was deemed ready for licensure pending final approval.