Inspection Reports for Melrose Gardens

An unannounced annual inspection was conducted to evaluate the facility's compliance with licensing requirements and ensure the health and safety of residents.

The facility was found to be clean, well-maintained, and compliant with safety and health regulations. No immediate health or safety hazards were observed. Resident and staff records were complete and current. Fire safety systems and infection control measures were properly maintained.

An unannounced case management visit was conducted in conjunction with complaint investigation #31-AS-20250516141919 to address deficiencies related to a complaint involving an aggressive incident between two residents and failure to follow reporting requirements.

The investigation revealed that staff failed to report the incident to the Administrator and did not submit required incident reports to the Licensing Division, violating Title 22 reporting requirements. No immediate health or safety hazards were observed during the visit.

Complaint investigation #31-AS-20250516141919 was conducted due to an incident on 05/05/25 where Resident #2 committed an aggressive act upon Resident #1. Staff contacted physicians and family but failed to report the incident to the Administrator or submit required reports to the Licensing Division.

The visit was an unannounced complaint investigation regarding an allegation that staff did not prevent a resident from entering other residents' rooms.

The investigation found no health or safety issues and interviews with staff, residents, and the Executive Director indicated that residents have locks on their rooms and staff actively monitor wandering residents. The allegation was deemed unsubstantiated.

The complaint alleged that staff were aware of a resident entering another resident's room multiple times but neglected to address it. Interviews and observations did not support this claim, and the allegation was unsubstantiated.

An unannounced complaint investigation visit was conducted to investigate allegations that staff do not answer the facility telephone and that visitors are unable to enter or leave due to lack of front desk coverage.

The investigation found that the telephone was in working order, staff consistently covered the front desk, and interviews with staff and residents confirmed no issues with telephone answering or visitor access. The allegation was unsubstantiated.

The complaint alleged that staff do not answer the facility telephone during morning and afternoon hours and that visitors are unable to enter or leave due to lack of front desk coverage. The allegation was found to be unsubstantiated based on observations and interviews.

An unannounced annual inspection was conducted to evaluate the facility's compliance with licensing requirements and overall condition.

The facility was found to be clean, well-maintained, and compliant with safety and health regulations. No immediate health or safety hazards were observed. All required systems, including fire detection and infection control, were functioning properly.

The visit was a continuation of the required annual facility inspection to evaluate compliance with licensing regulations.

The inspection found that fire detection and protection systems were functional and properly maintained, medication storage and documentation were secure and complete, laundry and common areas were clean and safe, resident bedrooms and bathrooms met safety and comfort standards, and resident and staff records were complete and current. No immediate health or safety hazards were observed.

An unannounced annual inspection was conducted to evaluate the facility's compliance with licensing requirements and overall condition.

The facility was found to be clean and well-maintained, with proper infection control measures and safety systems in place. Resident records were complete and current, and the kitchen met all health and safety standards. The inspection was not fully completed due to time constraints and will be finished at a later date.

An unannounced complaint investigation visit was conducted to investigate allegations regarding food quality and quantity, staff communication with residents, and medication management.

The investigation found that the facility had sufficient food stock and residents reported food quality and quantity as good. Staff were not found to be rude to residents, and medication management issues were related to insurance coverage and physician restrictions. All allegations were deemed unsubstantiated.

The complaint included allegations that staff did not ensure good quality and quantity of food, were rude to residents, and did not properly manage medications. The investigation found these allegations unsubstantiated based on observations, interviews with staff and residents, and review of medication records.

The visit was conducted as a case management and complaint investigation related to complaint report #31-AS-20240425102904, with an initial complaint investigation visit conducted on 2024-04-30.

The report documents the delivery of an amended LIC 9099 Complaint Investigation Report to the Assistant Administrator, Jennifer Rivera, summarizing the complaint investigation findings.

Complaint investigation associated with complaint report #31-AS-20240425102904; initial investigation visit conducted on 2024-04-30. The amended complaint investigation report was delivered on 2024-05-29.

Unannounced complaint investigation visit conducted due to an allegation that staff do not allow a resident to have visitors.

The investigation found no issues with visitation rights; the facility does not prohibit residents' visitation. The family member in question was temporarily unable to visit due to medical restrictions at another facility. The allegation was unsubstantiated.

The complaint alleged that staff prohibited a resident from having visitors. The investigation revealed that the family member was restricted from visiting by their own facility's medical team pending a medical evaluation. The allegation was unsubstantiated.

This case management visit was conducted in conjunction with a complaint investigation to address deficiencies unrelated to the complaint.

Deficiencies were observed including a non-working parking lot buzzer, trash containers blocking an exit door, cigarette butts scattered around, and old broken furniture with sharp corners obstructing the parking and recreational area posing health and safety hazards. The parking lot and recreational areas were not maintained as required.

The visit was complaint-related; deficiencies unrelated to the complaint were observed and cited.

Unannounced complaint investigation visit conducted due to a complaint received on 2024-01-12 regarding untimely medication refills for residents.

The investigation found that medication for Resident #1 was not refilled in a timely manner, resulting in a medication gap from 01/03/2024 to 01/08/2024. Additionally, staff continued to initial medication administration records for Resident #1 after the resident had relocated, indicating inaccurate documentation. These findings were substantiated and posed immediate health and safety risks.

Complaint was substantiated. Allegation was that staff did not order resident’s medication refills in a timely manner. Investigation confirmed medication refill delays and inaccurate medication administration record keeping.

The visit was an unannounced complaint investigation triggered by allegations that staff did not prevent a resident from handling another resident roughly, did not prevent threatening comments between residents, and did not provide a comfortable environment for a resident.

The investigation found that although an incident of verbal and physical abuse occurred between two residents who are a married couple, staff intervened promptly to prevent escalation and assisted the residents. Interviews and record reviews supported that staff took appropriate actions and the allegations were unsubstantiated. No immediate health and safety issues were noted.

The complaint involved allegations of staff failing to prevent rough handling and threatening comments between residents, and not providing a comfortable environment. The allegations were found to be unsubstantiated based on interviews, observations, and record reviews.

The visit was an announced Pre-Licensing inspection conducted to evaluate the facility's readiness for licensing and compliance with regulatory requirements.

The facility was found to be clean, well-maintained, and appropriately equipped with no deficiencies noted. All safety systems, medication storage, resident and staff records, and common areas were observed to be in compliance with regulations.

The visit was a Pre-Licensing reinspection to inspect the facility and ensure compliance with California Code of Regulations, Title 22, Division 6.

The inspection found that all four emergency exits equipped with delayed egress systems were operational and functioning properly. The facility was in compliance with Title 22 Regulations and had no deficiencies.

The inspection was a subsequent pre-licensing visit conducted to evaluate the facility's compliance with regulations prior to licensing approval.

The inspection found that 2 out of 6 exit doors equipped with the Delayed Egress Locking System (DELS) were not operational or functioning properly, resulting in non-compliance with Title 22 Regulations at the time of the visit.

The visit was an announced pre-licensing inspection to ensure the facility's compliance with California Code of Regulations, Title 22, Division 6.

The facility was generally clean, well-maintained, and equipped with operational safety features; however, it was found not in compliance due to delayed egress doors on the 1st and 2nd floor exit doors lacking proper fire clearance as per the fire clearance dated 12/08/2022.

The visit was conducted as a pre-licensing inspection and Component II evaluation via telephone call to verify the applicant and administrator's understanding of Title 22 and facility operation requirements.

The Component II evaluation was successfully completed, confirming the applicant and administrator's understanding of facility operation, staff qualifications, training, applicant and administrator qualifications, grievances, complaints, community resources, food service, medication management, and application document review.

The visit was conducted as part of a Change of Ownership (CHOW) application process for the facility.

The applicant and administrator participated in a telephone call with the analyst to confirm understanding of facility operation, staff qualifications, program policies, and application document requirements. Component II of the evaluation was successfully completed with no deficiencies noted.