Inspection Reports for Merrill Gardens at Monterey

The inspection was an unannounced required annual inspection conducted to evaluate compliance with licensing requirements at Merrill Gardens at Monterey.

The facility was found to be in good condition with no deficiencies issued. Resident rooms, common areas, dining, kitchen, medication storage, and outdoor areas were all observed to be safe, clean, and properly maintained.

An unannounced complaint investigation visit was conducted in response to multiple allegations received on 2024-05-31 regarding staff qualifications, resident assessments, food service, activities, cleanliness, appointment reminders, shower assistance, pet care, and meeting residents' needs.

All allegations investigated were found to be unsubstantiated due to lack of preponderance of evidence. Interviews with residents and staff, review of documentation, and observations indicated that staff were qualified, residents were properly assessed, food service was adequate, activities were provided, rooms were kept clean, appointments were managed, showers were given as requested, pets were not the facility's responsibility, and residents' needs were met.

The complaint investigation was unsubstantiated. Allegations included unqualified staff left in charge, improper resident assessments, inadequate resident checks, insufficient food service, lack of activities, unclean rooms, failure to remind about appointments, failure to ensure showers, failure to care for resident's dog, and failure to meet residents' needs. None were substantiated based on evidence gathered.

The inspection was an unannounced complaint investigation visit conducted to investigate allegations that staff did not ensure the elevator was in good repair and that special food service was not served with accuracy for residents in care.

The investigation found that although there was an issue with one elevator being out of service temporarily, another elevator was available and accommodations were made for residents. The food service delivery during the elevator outage was reported to be prompt and accurate. There was insufficient evidence to substantiate the allegations, and no deficiencies were cited.

The complaint investigation was unsubstantiated as there was no preponderance of evidence to prove the alleged violations occurred. The elevator issue was temporary and managed appropriately, and the food service was delivered accurately.

The visit was an unannounced Case Management inspection conducted to review facility compliance and investigate a reported medication error.

The facility reported a medication error where Resident 1 was given medication intended for another resident, resulting in hospitalization. Staff involved received training and were removed from medication technician in training duties. Deficiencies were cited related to incidental medical and dental care per Title 22 regulations.

The inspection was an unannounced required annual inspection conducted to evaluate compliance with licensing regulations.

The facility was generally found to be clean, safe, and well-maintained with proper emergency preparedness. However, two residents with dementia did not have the required annual medical assessment and reappraisal completed as mandated by Title 22 regulations.

The inspection was an unannounced complaint investigation triggered by a complaint received on 2024-02-28 regarding a resident being trapped in the elevator due to the facility not obtaining back-up power.

The investigation found that on 2024-02-04, a resident was trapped in the elevator for approximately two hours during a power outage. The elevator was opened by emergency responders, was properly serviced and maintained, and no resident was injured. The allegation was unsubstantiated due to lack of preponderance of evidence.

The complaint alleged a resident was trapped in the elevator due to lack of back-up power. The allegation was unsubstantiated after investigation.

The inspection was an unannounced complaint investigation triggered by a complaint received on 2023-11-15 regarding allegations that facility staff were not assisting residents with activities of daily living and not meeting the needs of residents in care.

The investigation substantiated that facility staff were not assisting residents with eating and other activities of daily living as required by California Code of Regulations Title 22. At least one resident out of 114 was not provided necessary assistance, presenting a risk to health and safety.

The complaint was substantiated based on interviews, observations, and records review. The allegations that staff were not assisting residents with activities of daily living and not meeting residents' needs were confirmed.

The inspection was conducted to address deficiencies observed during the investigation of a complaint received on 2023-11-15 against the facility.

The inspection found that the facility failed to include the responsible party in a resident reappraisal conducted on 2023-11-19, and failed to provide timely written notice of a rate increase to the resident's representative within two business days after a change in level of care.

The visit was complaint-related, investigating complaint control number 24-AS-20231115122107 received on 2023-11-15. The deficiencies were substantiated as described.

The visit was an unannounced complaint investigation triggered by a complaint received on 2023-05-26 regarding allegations of staff sharing resident's personal information and failure to prevent resident intimidation.

The investigation found no preponderance of evidence to substantiate the allegations. Staff denied sharing personal information, and witnesses denied resident intimidation. The facility was toured to ensure no immediate health or safety risks were present.

The complaint involved allegations that facility staff shared a resident's personal information with another resident and that staff did not prevent a resident from intimidating others. The allegations were unsubstantiated due to lack of corroborating evidence.

Unannounced complaint investigation conducted due to a complaint received on 05/25/2023 regarding unlawful eviction.

The investigation found that the allegation of unlawful eviction was unsubstantiated. The facility was unable to accept a resident back due to the resident having an indwelling catheter, which is against regulatory requirements.

The complaint was unsubstantiated based on interviews, documentation, and investigation findings. The resident was not accepted back due to medical requirements, not unlawful eviction.

The inspection was an unannounced required annual inspection conducted to evaluate compliance with licensing regulations.

The facility was found to be in compliance with no deficiencies cited. The inspection included a tour of the facility, review of emergency preparedness, medication storage, resident and staff files, and verification of safety features.

Unannounced complaint investigation visit conducted in response to allegations received on 05/08/2020 regarding inadequate fluid provision, falsification of medication administration records and medication label instructions, and failure to administer medications according to physician orders.

The investigation found the allegations of inadequate fluid provision, falsification of medication administration records, and falsification of medication label instructions to be unsubstantiated based on interviews with staff and residents. However, the allegation that staff did not administer medications according to physician orders was substantiated with documented medication errors for two residents in April and May 2020. No deficiencies were cited per Title 22 Regulations.

Complaint received on 05/08/2020 with allegations including inadequate fluids to residents, falsification of medication administration records, falsification of medication label instructions, and failure to administer medications according to physician orders. The first three allegations were unsubstantiated; the last was substantiated with documented medication errors for Resident 1 and Resident 2.

The visit was a Case Management follow-up on an incident report regarding medication administration.

The Licensing Program Analyst found that a resident (R1) did not receive their prescribed medication due to the licensee receiving another resident's medication, posing an immediate health, safety, or personal rights risk.

The inspection visit was an unannounced complaint investigation triggered by a complaint received on 2021-07-08 regarding staff treatment of residents, garbage container covers, and insect presence.

The investigation found insufficient evidence to substantiate the allegations. Staff treatment of residents with dignity was unknown, garbage containers had tight fitting covers, and the facility was actively treating insect problems with pest control services.

The complaint was unsubstantiated based on interviews, observations, and record reviews. Allegations included staff not treating residents with dignity, garbage containers lacking tight fitting covers, and presence of insects.

The inspection visit was an unannounced complaint investigation triggered by a complaint received on 2021-10-25 regarding the emergency backup power not operating during a power outage.

The investigation found that during the power outage lasting about 1.5 to 3 hours, the facility provided glow sticks, flashlights, flood lights, and checked on residents frequently. The facility has a contract for a backup generator for extended outages. The allegation was unsubstantiated due to lack of preponderance of evidence.

The complaint alleged that emergency backup power did not operate during a power outage. The allegation was unsubstantiated after investigation.

The inspection was an unannounced required 1-year infection control visit to evaluate compliance with infection control policies and procedures.

The facility was found to be in compliance with infection control regulations, with no citations issued. The inspection included a tour of the facility, review of policies, and observation of staff and resident practices related to infection control.

The visit was a Technical Assist (TA) conducted via Zoom to provide technical assistance for Infection Prevention and Control guidelines for Adult and Senior Care facilities.

The Licensing Program Analyst reviewed the facility's policies and procedures related to infection control, including screening, disinfecting, staffing, training, emergency medical care, PPE usage, and resident activities. Recommendations were made to improve PPE donning and doffing signage, hand sanitizing, trash disposal, and mask changing protocols.