Inspection Reports for Rodriguez Care Home, LLC
1647 Paaaina Pl, Pearl City, HI 96782, HI, 96782
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Inspection Report
Annual Inspection
Deficiencies: 4
Mar 14, 2025
Visit Reason
The inspection was conducted as an annual licensing inspection of Rodriguez Care Home to ensure compliance with state licensing requirements.
Findings
The inspection identified deficiencies including unavailable fieldprint clearance for a substitute care giver, lack of a thermometer in the kitchen refrigerator, obstructed emergency evacuation pathway, and unavailable monthly fire drill records.
Deficiencies (4)
| Description |
|---|
| Fieldprint clearance unavailable for substitute care giver |
| Kitchen refrigerator does not have a thermometer |
| Emergency evacuation pathway obstructed by picture, dustpan, and broom |
| Monthly fire drills unavailable for review |
Report Facts
Plan of correction completion date: 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Teresita B. Rodriguez | Licensee/Administrator | Signed plan of correction and future plan |
Inspection Report
Annual Inspection
Deficiencies: 15
Mar 19, 2024
Visit Reason
Annual inspection of Rodriguez Care Home conducted on March 19, 2024, to assess compliance with state licensing regulations.
Findings
Multiple deficiencies were identified related to personnel certification, nutrition, food sanitation, medication storage and administration, records and reports, and physical environment. Plans of correction were submitted addressing each deficiency.
Deficiencies (15)
| Description |
|---|
| Primary Caregiver (PCG), Substitute Caregiver (SCG) #1-3 – Valid first aid certification unavailable for review. |
| Primary Caregiver (PCG), Substitute Caregiver (SCG) #1-3 – Valid cardiopulmonary resuscitation (CPR) certification unavailable for review. |
| Resident #1,2 – Physician prescribed diets (chopped texture, nectar consistency and DASH diet) provided not consistent with diet requirements (e.g., chopped size larger than ¼ inch and sodium content measurement not provided). |
| Special diet menus unavailable for Resident #1 (chopped texture, nectar consistency), Resident #2 (regular diet, pureed consistency), Resident #4 (DASH diet low salt, low cholesterol). |
| Resident #1 – Thick-It being used to thicken liquids to nectar consistency; however, physician’s order unavailable for thickener. |
| Toxic cleaning chemicals and agents stored unsecured in all bathrooms. |
| Residents’ medications stored unsecured in medication cart. |
| Resident #1 – Thick-It used to thicken liquids daily is not reflected in medication administration record (MAR) or daily treatment record. |
| Resident #1 – Admission assessment unavailable for admission on 1/20/24. |
| Resident #1 – Initial tuberculosis (TB) clearance unavailable for review. |
| Resident #1 – Current TB clearance unavailable for review. |
| Resident #1 – Emergency Information Sheet unavailable for review. |
| Resident #1-3 – Three (3) non-self-preserving (NSP) residents residing in facility, exceeding maximum permitted of two (2) NSP residents. |
| Bathroom trashcans (3) do not include covered lids. |
| PCG – No documented evidence PCG completed special diet training course. |
Report Facts
Non-self-preserving residents: 3
Bathroom trashcans without lids: 3
Inspection Report
Annual Inspection
Deficiencies: 8
Mar 23, 2023
Visit Reason
The inspection was conducted as the annual survey of Rodriguez Care Home to assess compliance with regulatory requirements.
Findings
The report identifies several deficiencies including lack of initial tuberculosis clearance for staff, medication order discrepancies, missing documentation of primary care assessments, incomplete resident register records, failure to notify physician of significant weight loss, a chirping smoke detector, incomplete continuing education hours for staff, and lack of case management waiver documentation. Plans of correction and future plans were provided for each deficiency.
Deficiencies (8)
| Description |
|---|
| Substitute Care Giver #1 and Household Member #1 had no initial (2-Step) tuberculosis clearance. |
| Medication order and medication administration record (MAR) did not match for Resident #1. |
| No documentation of primary care giver’s assessment of Resident #1 upon 11/8/2022 readmission. |
| Resident register did not reflect discharge and readmission dates for Resident #1. |
| No documented evidence the resident’s physician was notified in December 2022 regarding significant weight loss of Resident #1. |
| Smoke detector above Bedroom #1 was chirping. |
| Substitute Care Giver #1 completed only 11 of 12 required continuing education hours within last year. |
| Case management services for expanded resident discontinued without case management waiver obtained from the department. |
Report Facts
Medication order discrepancy: 1
Continuing education hours completed: 11
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jessica Chambers | OHCA Nurse Consultant | Named in case management waiver paperwork submission |
| Reina Lyn Sahagun | Licensee/Administrator | Signed the plan of correction document |
Inspection Report
Annual Inspection
Deficiencies: 0
Mar 15, 2022
Visit Reason
Annual inspection of Rodriguez Care Home conducted on March 15, 2022.
Findings
No deficiencies were found during the annual inspection; the facility was compliant with all applicable rules and criteria.
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