ASTERA CARE HOME LLC

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 in overgrown weeds and bulk of fallen dried leaves in the side yard which pose a potential health, safety and/or personal rights risks to persons in care.

Official plan of correction

POC Due Date: 07/03/2026 Plan of Correction Administrator pulled out some of the weeds while LPA was at the facility. Administrator to have all the weeds pulled out and yard cleaned. PIctures to be submitted by 7/03/26.

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 residents are in locked storage... -This requirement is not met as evidenced by: -Based on observation, the licensee did not comply with the section in unlocked storage which posed an immediate safety and/or personal rights risks to persons in care.

Official plan of correction

Staff locked the storage. In addition, administrator to in-service the staff and submit copy of training topic with attendees signatures by 4/02/26.

Deadline recorded: Apr 2, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87457(c)

Regulation authority

CCR

What the official deficiency says

87457 Pre-Admission Appraisal (c) Prior to admission a determination of the prospective resident's suitability for admission shall be completed and shall include an appraisal of their individual service needs in comparison with the admission criteria .......... -This requirement is not met as evidenced by: -Based on records review, the licensee did not comply with the section above in not completing the Pre-Admission Appraisal for R1 and R2 which poses a potential health, safety and/or personal rights risks to persons in care.

Official plan of correction

One of the 2 residents is no longer at the facility. Administrator to do the Pre-Admission Appraisal for the other resident and submit copy by 4/15/26.

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

Official classification

Type B

Official code

87506(a)

Regulation authority

CCR

What the official deficiency says

87506 Resident Records (a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. -This requirement is not met as evidenced by: -Based on records review, the licensee did not comply with the section above in not completing the LIC601 for R1 which poses a potential personal rights risk to persons in care.

Official plan of correction

R1 is no longer at the facility. Administrator to read the Regulation and ensure compliance. Self-certtification to be submitted by 4/15/26.

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

Official classification

Type A

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

(e) Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degrees C) and not more than 120 degree F (49 degrees C). 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 hot water at 124 degrees Fahrenheit which poses an immediate health and/or personal rights risks to persons in care.

Official plan of correction

POC Due Date: 06/21/2024 Plan of Correction Administrator to have the temperature adjusted within Regulations range and submiit proof by 6/21/24,

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. 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 the following which pose an immediate health, safety and/or personal rights risks to persons in care: unlocked Ca-Rezz; ointment; razor

Official plan of correction

POC Due Date: 06/21/2024 Plan of Correction Staff locked the items In addition, adminsitrator to do in-service training and submit copy of training topic with attendees signatures by 6/21/24

Official classification

Type B

Official code

87303(f)(3)

Regulation authority

CCR

What the official deficiency says

(f) Solid waste shall be stored and disposed of as follows: (3) All containers, except movable bins, used for storage of solid wastes shall have tight-fitting covers on the containers; shall be in good repair; shall have external handles; and shall be leakproof and rodent-proof. 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 trash cans without lids in residents' rooms which pose a potential health and/or personal rights risks to persons in care.

Official plan of correction

POC Due Date: 07/05/2024 Plan of Correction Administrator to purchase trash cans with foot pedal operated lid and submit proof of purchase and picture by 7/05/24.

Official classification

Type B

Official code

1569.625(b)(1)

Regulation authority

HSC

What the official deficiency says

§1569.625 Staff training; legislative findings; contents (b)(1) The department shall adopt regulations to require staff members of residential care facilities for the elderly who assist residents with personal activities of daily living to receive appropriate training. This training shall consist of 40 hours of training. A staff member shall complete 20 hours, including six hours specific to dementia care, as required by subdivision (a) of Section 1569.626 and four hours specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696, before working independently with residents. The remaining 20 hours shall include six hours specific to dementia care and shall be completed within the first four weeks of employment. The training coursework may utilize various methods of instruction, including, but not limited to, lectures, instructional videos, and interactive online courses. The additional 16 hours shall be hands-on training. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview of staff and records review, the licensee did not comply with the section cited above in S2, S3 and S4 not having the required 40 hours of training which pose a potential health, safety and/or personal rights risks to persons in care. Staff only have total 21 hours of training on file.

Official plan of correction

POC Due Date: 07/05/2024 Plan of Correction Administrator to have the 3 staff complete the required training and submit proof by 7/05/24.

Official classification

Type B

Official code

1569.69(a)(2)

Regulation authority

HSC

What the official deficiency says

(a) Each residential care facility for the elderly licensed under this chapter shall ensure that each employee of the facility who assists residents with the self-administration of medications meets all of the following training requirements: (2) In facilities licensed to provide care for 15 or fewer persons, the employee shall complete 10 hours of initial training. This training shall consist of 6 hours of hands-on shadowing training, which shall be completed prior to assisting with the self-administration of medications, and 4 hours of other training or instruction, as described in subdivision (f), which shall be completed within the first two weeks of employment. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview and records review, the licensee did not comply with the section cited above in S2, S3 and S4 not having medication training on file which pose a potential health and/or personal rights risks to persons in care.

Official plan of correction

POC Due Date: 07/05/2024 Plan of Correction Administrator to have the 3 staff complete the training and submit proof by 7/05/24.

Official classification

Type B

Official code

87456(a)(2)

Regulation authority

CCR

What the official deficiency says

(a) Prior to accepting a resident for care and in order to evaluate his/her suitability, the facility shall, as specified in this article 8: (2) Perform a pre-admission appraisal. 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 5 out of 5 residents not having Pre-admission Appraisal which poses a potential health, safety and/or personal rights risks to persons in care.

Official plan of correction

POC Due Date: 07/05/2024 Plan of Correction Administrator to do the Pre-admission and submit self-certication indicating documents are completed.

Official classification

Type B

Official code

87457(c)(1)

Regulation authority

CCR

What the official deficiency says

(c) Prior to admission a determination of the prospective resident's suitability for admission shall be completed and shall include an appraisal of his/her individual service needs in comparison with the admission criteria specified in Section 87455, Acceptance and Retention Limitations. (1) The appraisal shall include, at a minimum, an evaluation of the prospective resident's functional capabilities, mental condition and an evaluation of social factors as specified in Sections 87459, Functional Capabilities and 87462, Social Factors. This requirement is not met as evidenced by: Deficient Practice Statement Based on records rreview, the licensee did not comply with the section cited above in 5 out of 5 residents not having LIC9172 Functional Capability Assessment on file which pose a potential health, safety and/or personal rights risks to persons in care.

Official plan of correction

POC Due Date: 07/05/2024 Plan of Correction Adiministrator to complete the LIC9172s and submit self-certification by 7/05/24,

Official classification

Type B

Official code

87458(c)

Regulation authority

CCR

What the official deficiency says

87458 Medical Assessment (c) The licensee shall obtain an updated medical assessment when required by the Department. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above in R4's LIC602 not consistent with R4's current condition of able to feed self which poses a potential personal rights risk to person in care.

Official plan of correction

POC Due Date: 07/05/2024 Plan of Correction Administrator to have the LIC602A updated and submit copy by 7/05/24,

Official classification

Type B

Official code

87615(a)(5)

Regulation authority

CCR

What the official deficiency says

87615 Prohibited Health Conditions (a) Persons who require health services for or have a health condition including, but not limited to, those specified below shall not be admitted or retained in a residential care facility for the elderly: (5) Residents who depend on others to perform all activities of daily living for them as set forth in Section 87459, Functional Capabilities. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, record review and interviiew of staff, the licensee did not comply with the section cited above in retaining R5 who is dependent on staff with all ADLs which poses a potential health, safety andor personal rights risk to person in care.

Official plan of correction

POC Due Date: 07/05/2024 Plan of Correction Administrator stated she'll submit exception request. Request letter to be submitted along with the following by 7/05/24: 1. LIC602A Physician's Report 2. LIC625 Appraisal/.Needs and Services Plan 3. LIC9172 functional Capabilty Assessment 4. . Proof of staff training. 5. Letter from resident's responsible person supporting R5's stay in the facility

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section above for having a shovel in the backyard, and lancets on the desk by the dining area which pose an immediate safety risks to persons in care.

Official plan of correction

POC Due Date: 06/08/2023 Plan of Correction Staff locked the items, In addition, administrator to do in-service training and submit copy of trianing topic with attendees signatures by 6/08/23.

Official classification

Type A

Official code

87309(b)

Regulation authority

CCR

What the official deficiency says

(b) Medicines shall be stored as specified in Section 87465(c) and separately from other items specified in (a) above. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above for Pepto Bismol in the refrigerator, wound cleanser and antifungal powder in one of the resident's rooms, Glucose test solution by the dining area which poses an immediate health and/or personal rights risks to persons in care.

Official plan of correction

POC Due Date: 06/08/2023 Plan of Correction Staff locked the items, In addition, administrator to add to in-service training, and submit copy of trianing topic with attendees signatures by 6/08/23

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

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 for broken toilet paper holder in one of the ensuite bathrooms which poses a potential personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/21/2023 Plan of Correction Administrator to have the holder fixed or replaced, and submit picture by 6/21/23.

Official classification

Type B

Official code

1569.695(c)

Regulation authority

HSC

What the official deficiency says

(c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of residents is not required during a drill. While a facility may provide an opportunity for residents to participate in a drill, it shall not require any resident participation. Documentation of the drills shall include the date, the type of emergency covered by the drill, and the names of staff participating in the drill. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview and record review, the licensee did not comply with the section cited above for not doing the disaster drill which poses a potential safety risk to persons in care.

Official plan of correction

POC Due Date: 06/21/2023 Plan of Correction Administrator to conduct drill, and submit proof by 6/21/23.

Official classification

Type A

Official code

87465(e)

Regulation authority

CCR

What the official deficiency says

87465 Incidental Medical and Dental Care (e) For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician, on a prescription blank, maintained in the residents file, and a label on the medication. Both the physician's order and the label shall contain at least all of the following information. This requirement is not met as evidenced by: Deficient Practice Statement Based on records review, the licensee did not comply with the section cited above in 3 out 3 residents not having complete doctor's order for medications which facility administers. It's not clear whether or not all the medications are needed which pose an immediate health and.or personal rights risks to persons in care.

Official plan of correction

POC Due Date: 06/08/2023 Plan of Correction Administrator to obtain doctor's orders for all medications. If medications are no longer needed by the residents, to obtain discontinued order(s), Proof to be submitted by 6/08/23.

Official classification

Type B

Official code

1569.625(b)(1)

Regulation authority

HSC

What the official deficiency says

§1569.625 Staff training; legislative findings; contents (b) (1) The department shall adopt regulations to require staff members of residential care facilities for the elderly who assist residents with personal activities of daily living to receive appropriate training. This training shall consist of 40 hours of training. A staff member shall complete 20 hours, including six hours specific to dementia care, as required by subdivision (a) of Section 1569.626 and four hours specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696, before working independently with residents. 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 4 out of 4 staff not completing the required 4 hours of postural support, restricted health condiition and hospice care training which poses a potential health, safety and/or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/21/2023 Plan of Correction Administrator to have the staff complete the training, and submit copy by 6/21/23.

Official classification

Type B

Official code

87506(a)

Regulation authority

CCR

What the official deficiency says

87506 Resident Records (a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. 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 3 out 3 residents not having medications properly and completely recorded on LIC622s which pose a potential personal rights risk to persons in care. The quanity of medications received/refilled are also not recorded.

Official plan of correction

POC Due Date: 06/21/2023 Plan of Correction Administrator to complete the LIC622s and self-certify they are done. Self-certification to be submitted by 6/21/23.

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 3 out of 4 resident's beds having half bed rails but no doctor's orders on file pose a potential safety and/or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/21/2023 Plan of Correction Administrator to obtain doctor's orders, and submit copies by 6/21/23.

Official classification

Type B

Official code

87615(a)(5)

Regulation authority

CCR

What the official deficiency says

87615 Prohibited Health Conditions (a) Persons who require health services for or have a health condition including, but not limited to, those specified below shall not be admitted or retained in a residential care facility for the elderly: (5) Residents who depend on others to perform all activities of daily living (ADL) for them as set forth in Section 87459, Functional Capabilities 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 1 out of 4 residents who depends on the staff with ADL which poses a potential health, safety and/or personal rights risk to person in care.

Official plan of correction

POC Due Date: 06/21/2023 Plan of Correction Administrator to submit exception request along with supporting documents including but not limited to LIC602A Physiician's Report, Appraisal/Needs and Services Plan; staff training, letter of support from responsible person.