SILVERADO SENIOR LIVING-BERKELEY

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. This requirement is not met as evidenced by: Deficient Practice Statement Based on observations, the licensee did not comply with the section cited above by having items unlocked, such as a pocket knife and a staple remover, in room #27, Lysol wipes inside the rabbit cage on the second floor, and multiple razors in room #222, which pose an immediate safety risk to persons in care.

Official plan of correction

POC Due Date: 04/22/2026 Plan of Correction By POC date, the Administrator agrees to remove the unlock sharps and wipes from resident rooms and common area. Proof of correction will be sent to CCLD.

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement is not met as evidenced by: Deficient Practice Statement Based on observations, the licensee did not comply with the section cited above by having unlocked ointments found in the bathroom connecting rooms #3 and #4, ointments in the shared shower rooms, Flonase in room 202 upstairs, and A & D ointment in room #222 which poses an immediate safety risk to persons in care.

Official plan of correction

POC Due Date: 04/22/2026 Plan of Correction By POC date, the Administrator agrees to remove the medications from the rooms and send proof to CCLD by POC date.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement is not met as evidenced by: Deficient Practice Statement Based on observations, the licensee did not comply with the section cited above, as a resident's drawer was broken, the medication room had a hole in the wall, and multiple bathroom vents were not working properly, which poses a potential safety risk to persons in care.

Official plan of correction

POC Due Date: 05/05/2026 Plan of Correction By POC date, the Administrator agrees to repair the items and send proof of correction to CCLD.

Official classification

Type B

Official code

87307(d)(6)

Regulation authority

CCR

What the official deficiency says

(6) All outdoor and indoor passageways and stairways shall be kept free of obstruction. This requirement is not met as evidenced by: Deficient Practice Statement Based on observations, the licensee did not comply with the section cited above by having the side emergency exit door blocked with multiple items such as foldable tables, a vacuum, a whiteboard, and other debris which posed a potential safety risk to person in care.

Official plan of correction

POC Due Date: 04/24/2026 Plan of Correction The Administrator removed the items during the visit. Deficiency cleared.

Official classification

Type B

Official code

1569.618(c)(3)

Regulation authority

HSC

What the official deficiency says

(c)The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staff to provide CPR. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above by not having cpr certification for 7 of 7 staff members which poses a potential safety risk to persons in care.

Official plan of correction

POC Due Date: 04/29/2026 Plan of Correction By POC date, the Administrator agrees to have cpr certification for all the staff members and send proof to CCLD.

Official classification

Type B

Official code

87555(b)(8)

Regulation authority

CCR

What the official deficiency says

(8) All food shall be of good quality. Commercial foods shall be approved by appropriate federal, state and local authorities. Food in damaged containers shall not be accepted, used or retained. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by having moldy strawberries found in the kitchen walk-in fridge which posed a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 04/29/2026 Plan of Correction By POC date, the Administrator agrees to have an in-service and send proof to CCLD. In addition, kitchen staff discarded strawberries during the visit.

Official classification

Type B

Official code

87211(a)(1)

Regulation authority

CCR

What the official deficiency says

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age..This requirement is not met as evidence by: Based on interview and record review the Licensee did not comply with the section cited above in reporting R1’s incidents to CCLD, which poses a potential health and safety risk to persons in care.

Official plan of correction

By POC date, Administrator agreed to submit R1's incident report for hospitialization to CCLD.

Deadline recorded: Apr 16, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)(1)

Regulation authority

CCR

What the official deficiency says

Reporting Requirements. A written report shall be submitted to the licensing agency...within seven days of the occurrence of any of the events specified... This requirement is not met as evidence by: Based on investigation, licensee did not comply with the section cited above by not submitting incident reports to CCLD within seven days which poses a potential health and safety risk to the persons in care.

Official plan of correction

ADM agreed to conduct in-service staff retraining on reporting in a timely manner and submit to CCLD completed certifications as proof of correction.

Deadline recorded: Oct 15, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87705(c)(5)

Regulation authority

CCR

What the official deficiency says

(c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (5) Each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, both of which shall include a reassessment of the resident’s dementia care needs. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above by not having current medical assessment for residents which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 05/10/2024 Plan of Correction Administrator has agreed to obtain current medical assessments for residents (R1, R2, R3, R4, R5) and submit copies to CCLD by POC date.

Official classification

Type B

Official code

87411(c)(1)

Regulation authority

CCR

What the official deficiency says

(c) All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69 (1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above by not having current First Aid training for S2, S3, and S4 which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 05/10/2024 Plan of Correction Administrator has agreed to obtain current First Aid training for staff (S2, S3, S4) and submit copies to CCLD by POC date.

Official classification

Type B

Official code

1569.312

Regulation authority

HSC

What the official deficiency says

H & S §1569.312 (a) Basic services requirements Every facility required to be licensed under this chapter shall provide at least the following basic services: (a) Care and supervision as defined in Section 1569.2. -This requirement is not met as evidenced by: Based on interviews and record reviews conducted, R1 who has dementia and is unable to leave facility unassisted wandered off the facility without staff knowledge which poses a potential risk to the health and safety of clients under care. R1 was returned to the facility without any injury.

Official plan of correction

The Administrator has conducted training with staff on 1/9/2024 and provided CCL proof of training. In addition, the Administrator states that actual head counts are being conducted 3x a day in addition to the head counts being conducted by individual caregivers. The Administrator will send additional health and safety plans to CCL to ensure health and safety of residents by 4/30/2024.

Deadline recorded: Apr 17, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.2(a)(2)

Regulation authority

CCR

What the official deficiency says

Additional Personal Rights of Residents in Privately Operated Facilities (a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (2) To have their records and personal information remain confidential and to approve their release, except as authorized by law. This requirement is not met as evidenced by: Based on interviews conducted, R1’s medication information was disclosed during the meeting held with R1’s wife and 2 other individuals.

Official plan of correction

The Administrator states have been advised not to disclose any information to anyone who is not directly responsible for the care of the resident.

Deadline recorded: Apr 30, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87705

Regulation authority

CCR

What the official deficiency says

In addition to the requirements as specified in Section 87208, Plan of Operation, the plan of operation shall address the needs of residents with dementia, including: Safety measures to address behaviors such as wandering, aggressive behavior and ingestion of toxic materials. This requirement was not met as evidenced by the lack of timely response by staff to actively find resident (R1) when he eloped from the facility’s south side exit security door on 02/24/24.

Official plan of correction

By POC due date, DHS agreed to conduct in-service staff retraining on safety measures to timely implement proper resident elopement procedures in compliance with Title 22 Section 87705 Care of Persons with Dementia and submit to CCL completed staff retraining certifications as proof of correction.

Deadline recorded: Mar 29, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)(D)

Regulation authority

CCR

What the official deficiency says

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency ...: (1) A written report shall be submitted to the licensing agenc..... within seven days of the occurrence of any of the events(D) Any incident which threatens the welfar, safety or health of any resident.. -This requirement is not met as evidenced by: -Based on interview and records review, the licensee did not comply with the section above for not sending an incident report in timely manner when R1 pushed R2 which posed personal rights risk to persons in care

Official plan of correction

Excutive Director to conduct in-service training, and submit proof by 4/06/23.

Deadline recorded: Apr 6, 2023. A deadline is not proof that correction was completed.