SCOTT VILLA

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 paint of bathroom vanities/cabinets in 2 residents rooms heavily chipped which pose a potential personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/27/2026 Plan of Correction Administrator to have the cabinets replaced with a new one or repainted. Proof/pictures to be submitted by 5/27/26.

Official classification

Type B

Official code

87465(i)

Regulation authority

CCR

What the official deficiency says

87465 Incidental Medical and Dental Care (i) Prescription medications which are not taken with the resident upon termination of services, not returned to the issuing pharmacy, nor retained in the facility as ordered by the resident’s physician and documented in the resident’s record ... shall be destroyed in the facility by the facility administrator and one other adult who is not a resident..... -This requirement is not met as evidenced by:

Official plan of correction

BUA stated she'll conduct in-service training. In addition, BUA to complete the LIC622's Destruction page. Proof to be submitted by 2/26/25.

Deadline recorded: Feb 26, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87565(i)

Regulation authority

CCR

What the official deficiency says

CONTINUATION: -Based on records review, interview and observation, the licensee did not comply with the section above in not documenting on LIC622 the medications of R1 that were to be disposed.

Deadline recorded: Feb 27, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87705(d)

Regulation authority

CCR

What the official deficiency says

87705 Care of Persons with Dementia (d) The licensee shall ensure that the facility has an auditory device or other staff alert feature to monitor exits on exterior doors and perimeter fence gates ......... -This requirement is not met as evidenced by: -Based on observation, the licensee did not comply with the section above in auditory signal not in working conditon which poses an immediate safety risk to persons in care.

Official plan of correction

Corrected. Auditory signal fixed while LPA is at the facility.

Deadline recorded: Jan 30, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87211(b)

Regulation authority

CCR

What the official deficiency says

87211Reporting Requirements (b) Any suspected physical abuse that results 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 two (2) hours....... -This requirement is not met as evidenced by: -Based on records review and interview, the licensee did not comply with the section in not reporting to the agencies includin the Department the suspected abuse which posed an immediate safety and/or personal rights risks to person in care.

Official plan of correction

BAU and licensee to read the Regulations, do the following, and submit POC by 1/30/25: 1. Ensure that reporting is done within the required time frame. 2. Submit self-certification.

Deadline recorded: Jan 30, 2025. 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 evidenced by: -Based on observation, the licensee did not comply with the section above in extra hospital bed, detached baseboard and wall moulding with protruding nail in the resident's room which pose a potential risks to persons in care. This is a repeat violation.

Official plan of correction

Corrected. The following were done while LPA was at the facility: 1. Moulding and baseboard fixed/repaired. 2. Extra hospital bed was removed from the resident's room and disposed. The extra hospital bed was removed from the resident's room. A $250.00 civil penalty is assessed.

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

Official classification

Type B

Official code

87211(a)(1)(A)

Regulation authority

CCR

What the official deficiency says

87211 Reporting Requirements (a)(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 (A)Death of any resident from any cause regardless of where the death occurred.... -This requirement is not met as evidenced by: -Based on record review and interview, the licensee did not comply with the section above in not sending the Death Report for resident (R1) which posed a potential personal rights risk to person in care.

Official plan of correction

Corrected. BUA submitted the Death Report to LPA while LPA was at the facility.

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

Official classification

Type A

Official code

87705(f)(1)

Regulation authority

CCR

What the official deficiency says

(f) The following shall be stored inaccessible to residents with dementia: (1) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s). 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 razor in R5's ensuite toilet which poses an immediate safety risk to persons in care.

Official plan of correction

POC Due Date: 05/11/2024 Plan of Correction Administrator to in-service the staff and submit proof by 5/11/24.

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 evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above iin missing drawers and drawer knob in R5's room which poses a potential personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/24/2024 Plan of Correction Administrator to have the drawers fixed, and submit picture by 5/24/24.

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 quantity of all of R1's 9 medications received by the facility does not match the quantity listed on LIC622 which poses/posed a potential health and/or personal rights risk to person in care.

Official plan of correction

POC Due Date: 05/24/2024 Plan of Correction Administrator to reconcile record, and submit copy of corrected LIC622 by 5/24/24.

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 having the Lysol and Glade spray and shaving cream unlocked and readily accessible to residents which pose an immediate health and safety risks to persons in care.

Official plan of correction

POC Due Date: 05/06/2023 Plan of Correction Administrator locked the items. In addition, administrator to in-service the staff and submit copy of training topic with attendees signatures by 5/06/23.

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 staff's medication in unlocked cabinet in unlocked kitchen which poses an immediate health and safety risks to persons in care.

Official plan of correction

POC Due Date: 05/06/2023 Plan of Correction Administrator took the item. In addition, administrator to in-service the staff and submit copy of training topic with attendees signatures by 5/06/23.

Official classification

Type B

Official code

87705(j)

Regulation authority

CCR

What the official deficiency says

87705 Care of Persons with Dementia (j) The licensee shall have an auditory device or other staff alert feature to monitor exits, if exiting presents a hazard to any resident. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and interview, the licensee did not comply with the section cited above for all sliding doors without alarm and instead has a latch in one of them which pose a potential personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/12/2023 Plan of Correction Corrected. Auditory devices installed and latch emoved while LPA was at the facility.

Official classification

Type B

Official code

87703(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 evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. LPA observed a protruding pipe about 8 1/2 inches high from the ground in the front yard which a potential safety risk to persons in care.

Official plan of correction

POC Due Date: 05/12/2023 Plan of Correction Administrator to have the pipe fixed and submit picture by 5/12/23.

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...... -This requirement is not met as evidenced by: -Based on records review, the licensee did not comply with the section above for not having R1's documents properly filled up which poses personal rights risk to person in care,

Official plan of correction

Administrtor to have the documents corrected and submit copies by 2/23/23.

Deadline recorded: Feb 22, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.1(a)(2)

Regulation authority

CCR

What the official deficiency says

(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. 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 using two entrance doors for staffs , Administrator told LPAs that staffs are using two entry ways one in the front and one at the back & kitchen staff is not wearing mask which poses/posed a potential health, safety risk to persons in care.

Official plan of correction

POC Due Date: 06/02/2021 Plan of Correction Facility will train staff to use one entry way to enter the facility. Administrator will re-train all the staff to wear face mask at all times while working at the facility.

Official classification

Type B

Official code

87307(a)(3)(C)

Regulation authority

CCR

What the official deficiency says

(a) Living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents, staff, and others who may reside in the facility. The following provisions shall apply:(3) Equipment and supplies necessary for personal care and maintenance of adequate hygiene practice shall be readily available to each resident...(C) Clean linen, including blanket..... 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 2 Shared bathrooms ensuite bathroom have no paper towel for drying hands . One of this bathrooms have common hand towel which poses/posed a potential health, safety to persons in care.

Official plan of correction

POC Due Date: 06/02/2021 Plan of Correction Facility will provide paper towel to common bathrooms and residents bathrooms