Crossroads

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Contact Information
Licensee Name
Crossroads, Incorporated
1269 N. Harvard Ave, Claremont, CA 91711
Facility Name
Identification Number
190205AN
Reviews & Findings
Dates of Review
16-Aug-16
Type of Review
COMPLIANCE REVIEW
Deficiencies

1) Title 9, Section 10564(e)(1) Personnel Requirements Class B

The above section states, in part, “(e) All personnel shall be in good health. (1) good physical health shall be
verified by a health screening, including a test tor tuberculosis, performed under licensed medical supervision not more than sixty (60) days prior to or seven (7) days after employment with tuberculosis testing renewable every year.”

The licensee was deficient in meeting the above regulation because employee #2 had an expired tuberculosis test in their personnel file.

2) Title 9, Section 10572(d) Health-Related Services Class B

The above section states, in part, (d) The following information shall be readily available:
(1) The name, address and telephone number of emergency agencies in department, crisis center or paramedical unit.
(2) The name and telephone number of an ambulance service.

The licensee was deficient in meeting the above regulation because there’s no emergency list readily available at the facility which included all of the above criteria.

3) Title 9, Section 10572(g) Health-Related Services Class B

The above regulation states, “Prescription medications which are not removed by the resident upon termination of services shall be destroyed by the facility administrator, or a designated substitute, and one other adult who is not a resident. Both shall sign a record to be retained for at feast one (1) year, which fists the following:
(1) Name of the resident.
(2) The prescription number and the name of the pharmacy.
(3) The drug name, strength and quantity destroyed.
(4) The date of destruction.

The licensee was deficient in meeting the above regulation because there was only one staff member signing the medication destruction record, instead of two staff members signing as required.

The above section states, in part, “(a) Facilities shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of residents, employees and visitors.”

The licensee was deficient in meeting the above regulation because the carpet upstairs had several stains throughout and bedroom #2 had a window on the south side of the room that was broken around the top left portion of the window frame.

5) Title 9, Section, 10584(e)(g) Fixtures, Furniture, Equipment and Supplies Class B

The above section states, in part, “(e) All toilets, hand washing and bathing facilities shall be maintained in safe and sanitary operating conditions… (g) The licensee shall provide clean linen in good repair, including mattress pads.”

The licensee was deficient in meeting the above regulation because upstairs bathroom #2 had a faucet that sprayed water instead of a consistent stream. In bedroom #2 one of the b fit the bed properly; it was loose and was not fitted around the mattress.

Detailed Information
Census Data

TOTAL OCCUPANCY:
Approved: 7
Census: 5

TREATMENT CAPACITY:
Approved: 6
Census: 4