Deficiencies: Serious - Type A Violations

Understanding Inspection and Enforcement

Title 22, §87758

A Type A violation is considered the most serious type of deficiency.  It is described as a deficiency that "poses an immediate or substantial threat to the health, safety and/or rights of the residents if not corrected".  Examples cited in Title 22  "include, but are not limited to", the following issues:

  • Criminal record clearances
  • Fire clearances
  • Night supervision
  • Food service, storage and preparation
  • Limitations on number, types and/or ambulatory status of residents
  • Telephone service
  • Health conditions of residents (bedridden, prohibited conditions, communicable diseases)
  • Resident rights
  • Safety of accommodations
  • Use of restraints 
  • Medical and dental care of residents
  • Medication
  • Water temperature
  • Hygiene accommodations (bathrooms, etc)
  • Relocation orders

During CARR's file review and review of the regulations, we've noticed that facilities receiving a Type A citation receive no other consequence than to create and adhere to a plan of correction. 

Title 22 authorizes LPAs to issue a penalty of $50 per day (maximum up to $150), per cited violation only if the violation is not corrected by the date specified in the plan of correction.  Based on CARR's file review, this practice is rare.  Very often there was no documentation of any follow-up visits to verify if the corrections had taken place.  More common, the file contained a faxed transmittal or mailed-in letter of self-certifying through receipts, photographs or letters of promise that the corrections had been made. CCLD also provides a LIC 9098 allowing a Licensee to self-certify that corrections have been made; with a self-certification in hand, the LPA is saved a return trip to the facility to validate the correction has been made. 

Of the Type A citations listed above, it appears violations of criminal record clearances most consistently resulted in civil penalties ($100/day).  For all other common Type A citations, civil penalties were rarely, if ever assessed.

CARR suggests consumers be watchful for repeated citations for violation of the same regulation - from one inspection to the next.  These patterns should be discussed to your satisfaction with the Licensee if you are considering the facility for placement of your resident. 

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