Hazardous items and storageType A
- 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 observation, the licensee did not comply with the section cited above by having unlocked cleaning chemicals such as Lysol Spray, Clorox, medications, scissors, etc. all around the facility which poses an immediate health and safety rights risk to persons in care.
Official plan of correction
POC Due Date: 03/19/2026 Plan of Correction By POC date, the Administrator agrees to lock the items and send proof to CCLD.
Licensing and administrationType B
- Official classification
- Type B
- Official code
- 1569.605
- Regulation authority
- HSC
What the official deficiency says
On and after July 1, 2015, all residential care facilities for the elderly, except those facilities that are an integral part of a continuing care retirement community, shall maintain liability insurance covering injury to residents and guests in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in the total annual aggregate, caused by the negligent acts or omissions to act of, or neglect by, the licensee or its employees. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, licensee did not comply with the section cited above by not having sufficient coverage on the liability insurance which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 03/23/2026 Plan of Correction By POC date, the Administrator agrees to send proof of liability insurance to CCLD.
Facility condition and maintenanceType B
- 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 observation, the licensee did not comply with the section cited above by having the freezer in the garage in disrepair, the old patio cushions in trash bags, and one of the rooms without a bed which poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 03/26/2026 Plan of Correction By POC date, the Administrator agrees to fix the freezer, schedule a bulk pick up, and obtain a bed for the room. Proof of correction will be sent to CCLD.
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 87412(g)
- Regulation authority
- CCR
What the official deficiency says
(g) All personnel records shall be maintained at the facility. 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 S2 and S3 complete records in the facility which poses a potential safety risk to persons in care.
Official plan of correction
POC Due Date: 04/01/2026 Plan of Correction By POC date, the Administrator agrees to have the staff files completed and send proof to CCLD.
Background checksType B
- Official classification
- Type B
- Official code
- 87355(e)(3)
- Regulation authority
- CCR
What the official deficiency says
(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (3) Request a transfer of a criminal record clearance as specified in Section 87355(c) or 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 S3 associated with the facility which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 03/26/2026 Plan of Correction By POC date, the Administrator agrees to associate S3 and send proof to CCLD.
Food serviceType B
- Official classification
- Type B
- Official code
- 87555(b)(28)
- Regulation authority
- CCR
What the official deficiency says
(28) All food shall be protected against contamination. Contaminated food shall be discarded immediately upon discovery. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in spoiled bell peppers, bread, juices, and other food items with best by dates from 2025 which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 03/26/2026 Plan of Correction By POC date, the Administrator agrees to discard the spoiled food items and send proof to CCLD.
Medical and dental careType B
- Official classification
- Type B
- Official code
- 87465(a)(4)
- Regulation authority
- CCR
What the official deficiency says
(4) The licensee shall assist residents with self-administered medications as needed. 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 not having a doctor's order for R1's medications and does not have 2 of their medications in the facility. LPAs also observed that R2 does not have a doctor's order for all of the medications which poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 03/25/2026 Plan of Correction By POC date, the Administrator agrees to obtain doctor's order for R1 and R2 and obtain the medications for R1. Proof of correction will be sent to CCLD.
Admission, assessment, and evictionType B
- Official classification
- Type B
- Official code
- 87463(b)
- Regulation authority
- CCR
What the official deficiency says
(b) The reappraisal shall document significant changes in the resident's physical, mental, cognitive, behavioral, or functional condition, including those required to be documented as specified in Section 87466, Observation of the Resident. 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 the Appraisal Needs and Services Plan (LIC625) which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 04/01/2026 Plan of Correction By POC date, the Administrator agrees to have the LIC625 and send proof to CCLD.
Health conditions and treatmentsType B
- Official classification
- Type B
- Official code
- 87608(a)(3)
- Regulation authority
- CCR
What the official deficiency says
(3) A written order from a physician indicating the need for the postural support shall be maintained in the resident’s record. The licensing agency shall be authorized to require other additional documentation if needed to verify the order. 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 not having doctor's order for the half bed rails for 2 of 2 residents which posesa potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 03/25/2026 Plan of Correction By POC date, the Administrator agrees to obtain a doctor's order for the half bed rail and send proof to CCLD.