BELLARA SENIOR LIVING

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

87309 Storage Space and Access (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 resident are in locked storage.... -This requirement is not met as evidenced by: -Based on observation, the licensee did not comply with the section above in the following unlocked in Memory Care apartments which posed an immediate risks to persons in care: razor, wound solution and cleanser; foot cream; rash ointment

Official plan of correction

Staff removed and locked the items. In addition, Executive Director to in-service the staff and submit copy of training topics with attendees signatures by 7/23/26. A $250.00 civil penalty is assessed.

Deadline recorded: Jul 23, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87463(b)

Regulation authority

CCR

What the official deficiency says

87463 Reappraisals (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.. .....and to keep the appraisal accurate -This requirement is not met as evidenced by: -Based on records review and interview, the licensee did not comply with the section above in not doing reassessments and/or updating the Care Plan for R1 and R2 which posed an immediate risks to the health, safety and/or personal rights risks to persons in care.

Official plan of correction

Executive Director to have the Care Plan updated and submit copies by 7/23/26.

Deadline recorded: Jul 23, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)(1)(D)

Regulation authority

CCR

What the official deficiency says

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports ...(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... (D) Any incident which threatens the welfare, safety or health of any resident...... -This requirement is not met as evidenced by: -Based on records review and interview, the licensee did not comply with the section above in not submitting incident reports.

Official plan of correction

Executive Director to do the following and submit proof by 8/05/26: 1. Submit incident reports. 2. In-service the staff and ensure reports are submitted within Regulations time frame.

Deadline recorded: Aug 5, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87355(e)

Regulation authority

CCR

What the official deficiency says

87355 Criminal Record Clearance (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: (2) Obtain a California clearance or a criminal record exemption as required by the Department -This requirement is not met as evidenced by: -Based on interviews and record review, the licensee did not comply with the section above in resident's 1:1 caregiver not fingerprinted which poses an immediate risks to persons in care.

Official plan of correction

Administrator not to have the individual work until fingerprinted and associated. Proof to be submitted by 4/02/26. A $500.00 civil penalty is assessed.

Deadline recorded: Apr 2, 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

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.......... -This requirement is not met as evidenced by: -Based on interviews and record review, the licensee did not comply with the section above in not submitting incident report and SOC341 which pose a potential personal rights risks to person in care.

Official plan of correction

Executive Director to submit report by 4/15/26.

Deadline recorded: Apr 15, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

87303 Maintenance and Operation (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 evidence by: Based on observation and interview, licensee did not comply with the section cited above by having inoperable delayed egress door which poses a potential health and safety risk to the residents in care.

Official plan of correction

Facility has agreed to submit proof that all delayed egress doors will be in operating condition by POC date.

Deadline recorded: Mar 17, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.269(a)(3)

Regulation authority

HSC

What the official deficiency says

§1569.269 Enumerated rights; severability (a) Residents of residential care facilities for the elderly shall have all of the following rights: (3) To confidential treatment of their records and personal information and to approve their release, except as authorized by law. -This requirement is not met as evidenced by: -Based on interviews, the licensee did not comply with the section above in providing R1's documents containing confidential information to Ombudsman Program when consent for release from R1 has not been obtained which posed a potential personal rights risk to person in care.

Official plan of correction

Executive Director stated and agreed to in-service the staff. Proof to be submitted by 1/07/26.

Deadline recorded: Jan 7, 2026. A deadline is not proof that correction was completed.

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 in unlocked cleaning agent which poses an immediate health, safety and/or personal rights risks to persons in care.

Official plan of correction

POC Due Date: 11/13/2025 Plan of Correction Staff locked the item. In addition, Executive Director stated will do the following and submit proof by 11/13/25: in-service the staff; have lock installed

Official classification

Type B

Official code

87608(a)(3)

Regulation authority

CCR

What the official deficiency says

87608 Postural Supports (a) Based on the individual's preadmission appraisal, and subsequent changes to that appraisal, the facility shall provide assistance and care for the resident in those activities of daily living which the resident is unable to do for himself/herself. Postural supports may be used under the following conditions. (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 record review, the licensee did not comply with the section cited above in having no doctor's order for resident's (R1) half bed rails which poses a potential safety and/or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/26/2025 Plan of Correction Executive Director stated he'll obtain doctor's order. Copy to be submitted by 11/26/25.

Official classification

Type B

Official code

87211(c)

Regulation authority

CCR

What the official deficiency says

87211 Reporting Requirements (c)Any suspected physical abuse that does not result in serious bodily injury of an elder or dependent adult shall be reported to the local ombudsman, the corresponding licensing agency, and the local law enforcement agency within twenty-four (24) hours as.. ...required by Welfare and Institutions Code Section 15630(b)(1). -This requirement is not met as evidenced by: -Based on records review and interviews, the licensee did not comply with the section above in not reporting the incident to appropriate agencies.

Official plan of correction

Executive Director to do the following and submit proof by 11/12/25: 1. Submit LIC624. 2. Submit SOC341 to appropriate agencies. 3. In-service the staff and submit copy of training topic with attendees signatures.

Deadline recorded: Nov 12, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87563(b)

Regulation authority

CCR

What the official deficiency says

87463 Reappraisals: (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: -Based on records review and interviews, the licensee did not comply with the section above in not updating R1 and R2's Care/Service Plan to reflect their current care and/or supervision needs.

Official plan of correction

Executive Director stated the following: 1. Update the Care Plan and discuss with the residents and residents' family. 2. Submit copies of the documents. 3. Ensure Care Plan is implemented/followed. Proof to be submitted by 11/12.25.

Deadline recorded: Nov 12, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.1(a)(9)

Regulation authority

CCR

What the official deficiency says

87468.1 Personal Rights of Residents in All Facilities (a) .......(9) To have communications to the licensee from their representatives answered promptly and appropriately. -This requirement is not met as evidenced by -Based on document review and interviews, the licensee did not comply with the section above in not reporting the incident to the residents' family and not responding timely.

Official plan of correction

Executive Director will do the following: and submit proof by 11/12/25: 1. In-service the staff. 2. Ensure proper and timely communication with the residents' families are accorded.

Deadline recorded: Nov 12, 2025. A deadline is not proof that correction was completed.