LIVERMORE CARE HOME

Official classification

Type B

Official code

87355(e)(3)

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: (3) Request a transfer of a criminal record clearance as specified in Section 87355(c) This requirement is not met as evidenced by: Based on record review and interviews, Licensee did not comply with the regulation cited above, by not having S1 associated to the facility.

Official plan of correction

Administrator agree to associate S1 to the facility and sumbit proof to CCLD by 7/15/26.

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

Official classification

Type B

Official code

87506(d)

Regulation authority

CCR

What the official deficiency says

87506 Resident Records (d) All resident records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the following requirements: This requirement is not met as evidenced by: Based on interviews, Licensee did not comply with the regulation cited above, by not residents records available to the licensing agency to inspect, audit, and copy upon demand during normal business hours.

Official plan of correction

Administrator agree to sumbit all request documents sent to CCLD by 7/15/26, and have residents records avalible at the facility to the licnesing agency to review.

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

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

Incidental Medical and Dental Care. (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... This requirement is not met as evidence by: Based on observation, licensee did not comply with the section cited above by having unlocked medications which poses an immediate health and safety risk to the persons in care.

Official plan of correction

Caregiver locked up medications on the dining table in the hallway closet during inspection. Deficiency cleared. Civil penalty of $250 is being assessed for a repeat violation.

Deadline recorded: Jun 12, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

Incidental Medical and Dental Care. (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... This requirement is not met as evidence by: Based on observation, licensee did not comply with the section cited above by having unlocked medications which poses an immediate health and safety risk to the persons in care.

Official plan of correction

Caregiver locked up medications on the dining table in the hallway closet during inspection. Deficiency cleared. Civil penalty of $250 is being assessed for a repeat violation.

Deadline recorded: May 8, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87355(e)(2)

Regulation authority

CCR

What the official deficiency says

Criminal Record Clearance. (e) All individuals subject to a criminal record review ...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 or... This requirement is not met as evidence by: Based on record review, licensee did not comply with the section cited above by having uncleared staff at the facility which poses an immediate health and safety risk to the persons in care.

Official plan of correction

S2 left the facility during inspection. Facility will follow up with Guardian regarding S2's fingerprint clearance and send email communication with Guardian to CCLD by POC date. Civil penalty of $100 is being assessed.

Deadline recorded: May 11, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87355(e)(3)

Regulation authority

CCR

What the official deficiency says

Criminal Record Clearance. (e) All individuals subject to a criminal record review ...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 evidence by: Based on record review, licensee did not comply with the section cited above by not associating staff to the facility which poses a potential health and safety risk to the persons in care.

Official plan of correction

Facility will submit LIC9182 and a copy of S1's US issued ID to CCLD by POC date.

Deadline recorded: May 13, 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) 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)... This requirement is not met as evidence by: Based on record review, licensee did not comply with the section cited above by not submitting a written report when R1 was sent to the hospital which poses a potential health and safety risk to the persons in care.

Official plan of correction

Facility will review reporting requirements and submit self-certification to CCLD by POC date.

Deadline recorded: Jun 5, 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 by having unlocked knives and cleaning supplies in the kitchen which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 03/20/2026 Plan of Correction Administrator locked up the knives and cleaning supplies during inspection. Deficiency cleared. Civil penalty of $250 is being assessed for repeat violation.

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 observation, the licensee did not comply with the section cited above by having unlocked medication in the refrigerator and cabinet which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 03/20/2026 Plan of Correction Administrator locked up the medications during inspection. Deficiency cleared. Civil penalty of $250 is being assessed for repeat violation.

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 outdoor area with overgrown weeds, tree droppings, cigarette buds, a pile of items to be disposed, and screen door in disrepair which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 04/17/2026 Plan of Correction Administrator has agreed to trim the overgrown weeds, clean tree droppings and cigarette buds, dispose of the items, and repair screen door in bedroom 6. Administrator will submit picture proof to CCLD by POC date. Civil penalty of $250 is being assessed for repeat violation.

Official classification

Type B

Official code

1569.625(b)(1)

Regulation authority

HSC

What the official deficiency says

(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 record review, the licensee did not comply with the section cited above by not having initial training completed for S3 which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 04/10/2026 Plan of Correction Administrator has agreed to obtain initial training for S3 and submit training completion to CCLD by POC date.

Official classification

Type B

Official code

1569.625(b)(2)

Regulation authority

HSC

What the official deficiency says

(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. 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 annual training completed for S2 which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 04/10/2026 Plan of Correction Administrator has agreed to obtain annual training for S2 and submit training completion to CCLD by POC date.

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 refill medication for R2 which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 03/27/2026 Plan of Correction Administrator has agreed to obtain medication refill for R2's Furosemide and submit picture proof to CCLD by POC date.

Official classification

Type B

Official code

87463(a)

Regulation authority

CCR

What the official deficiency says

(a) The pre-admission appraisal, as specified in Section 87457, Pre-Admission Appraisal, shall be updated, in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition, as defined in Section 87101, Definitions, and to keep the appraisal accurate. For the purposes of this section, the updated pre-admission appraisal shall be referred to as the reappraisal. 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 reappraisal or pre-placement appraisals for residents which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 04/10/2026 Plan of Correction Administrator has agreed to obtain current reappraisal and/or pre-placement appraisals for residents. Administrator will submit documents to CCLD by POC date.

Official classification

Type B

Official code

87625(b)(3)

Regulation authority

CCR

What the official deficiency says

Managed Incontinence. (b) In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for...(3) Ensuring that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence. This requirement is not me as evidence by: Based on interviews, licensee did not comply with the section cited above by having resident in soiled diapers which poses a potential health and safety risk to the persons in care.

Official plan of correction

Administrator has agreed to create a plan to address managing resident's incontinence care and submit written plan to CCLD by POC date.

Deadline recorded: Mar 31, 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

Maintenance and Operation. (a) The facility shall be clean, safe, sanitary and in good repair at all times...This requirement is not me as evidence by: Based on observation, licensee did not comply with the section cited above by having resident's room with strong urine smell which poses a potential health and safety risk to the persons in care.

Official plan of correction

LPA observed on 3/9/2026 visit that resident's rooms did not have urine smell. Deficiency cleared.

Deadline recorded: Mar 10, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87465(c)(2)

Regulation authority

CCR

What the official deficiency says

Incidental Medical and Dental Care. (c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication...(2) Once ordered by the physician the medication is given according to the physician's directions. This requirement is not me as evidence by: Based on record review, licensee did not comply with the section cited above by not following doctor's orders for R2's medication which poses a potential health and safety risk to the persons in care.

Official plan of correction

Administrator has agreed to conduct in-service training to staff on medication administration. Administrator will submit staff sign-in sheet and training material to CCLD by POC date.

Deadline recorded: Mar 31, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

Incidental Medical and Dental Care. (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... This requirement is not met as evidence by: Based on observation, licensee did not comply with the section cited above by having unlocked medications which poses an immediate health and safety risk to the persons in care.

Official plan of correction

Caregiver locked up medications and locked it up in hallway closet during inspection. Deficiency cleared. Civil penalty of $250 is being assessed for a repeat violation.

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

Official classification

Type B

Official code

87608(a)(5)(B)

Regulation authority

CCR

What the official deficiency says

Postural Supports. (a) Based on the individual's preadmission appraisal...Postural supports may be used under the following conditions. (5) Under no circumstances shall postural supports include...(B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care... This requirement is not met as evidence by: Based on observation, licensee did not comply with the section cited above by having full bed rails for R1 who is not on hospice care which poses a potential health and safety risk to the persons in care.

Official plan of correction

Caregiver removed the full bed rails during inspection. Deficiency cleared.

Deadline recorded: Jan 15, 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

Storage Space and Access. Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions,...knives, matches, tools, sharp objects...are in locked storage and are not left unattended if outside the locked storage. This requirement is not met as evidence by: Based on observation, licensee did not comply with the section cited above having cleaning supplies and knives unlocked which poses an immediate health and safety risk to the persons in care.

Official plan of correction

Staff locked up the items and knives drawer during inspection. Deficiency cleared Civil penalty of $250 is being assessed for a repeat violation.

Deadline recorded: Nov 15, 2025. 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 by having hot water measured at 128 degrees F which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 03/14/2025 Plan of Correction Facility has agreed to lower hot water temperature between 105 to 120 degrees and submit picture proof to CCLD by POC date.

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 lighters and cleaning supplies which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 03/14/2025 Plan of Correction Staff locked up the lighter and cleaning supplies during inspection. Civil penalty of $250 is being assessed for a repeat violation. Deficiency cleared.

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 observation, the licensee did not comply with the section cited above by having unlocked medications in the refrigerator and cabinet which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 03/14/2025 Plan of Correction Facility has agreed to purchase a lockbox to lock up the medications in the refrigerator and submit picture proof to CCLD by POC date.

Official classification

Type A

Official code

87355(e)(2)

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: (2) Obtain a California clearance or a criminal record exemption as required by the Department or This requirement is not met as evidenced by: Deficient Practice Statement Based on interviews and record review, the licensee did not comply with the section cited above by having uncleared staff work at the facility which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 03/14/2025 Plan of Correction S4 left the facility during inspection and administrator stated that S4 will not be returning to the facility until S4 is cleared and associated to the facility. Facility will submit a plan to get S4 fingerprint cleared prior to returning to the facility. Civil penalty of $100 is being assessed.

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 by having unlocked knives, tools, cleaning supplies, and lighters at the facility which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 03/27/2024 Plan of Correction Staff locked up the knives, tools, cleaning supplies, and lighters during inspection. Deficiency cleared.

Official classification

Type A

Official code

87465(c)(2)

Regulation authority

CCR

What the official deficiency says

(c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: (2) Once ordered by the physician the medication is given according to the physician's directions. 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 by not following doctor's order when giving R1's medication which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 03/27/2024 Plan of Correction Facility has agreed to conduct training for staff on medication administration and completing the MAR. Facility will submit training log to CCLD by POC date.

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 by having room 4's screen door in disrepair and dog feces in backyard which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 04/19/2024 Plan of Correction Facility has agreed to repair screen door in room 4 and clean up the dog feces in the backyard. Facility will submit picture proof to CCLD by POC date.

Official classification

Type B

Official code

1569.625(b)(2)

Regulation authority

HSC

What the official deficiency says

(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. 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 annual training for staff which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 04/19/2024 Plan of Correction Facility has agreed to obtain annual training for S2 and S3 and submit training documents to CCLD by POC date.

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 record review, the licensee did not comply with the section cited above by not having initial training for staff which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 04/19/2024 Plan of Correction Facility has agreed to obtain initial training for S2 and S3 and submit documents of training to CCLD by POC date.

Official classification

Type B

Official code

87458(b)(1)

Regulation authority

CCR

What the official deficiency says

(b) The medical assessment shall include, but not be limited to: (1) A physical examination of the resident indicating the physician's primary diagnosis and secondary diagnosis, if any and results of an examination for communicable tuberculosis, other contagious/infectious or contagious diseases or other medical conditions which would preclude care of the person by 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 TB test results for R3 and R4 which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 04/19/2024 Plan of Correction Facility has agreed to obtain TB test results for R3 and R4 and submit copies of documentation to CCLD by POC date.

Official classification

Type B

Official code

87467(a)(3)

Regulation authority

CCR

What the official deficiency says

(a) Prior to, or within two weeks of the resident's admission, the licensee shall arrange a meeting with the resident, the resident's representative, if any, appropriate facility staff, and a representative of the resident's home health agency, if any, and any other appropriate parties, to prepare a written record of the care the resident will receive in the facility, and the resident's preferences regarding the services provided at the facility. (3) The licensee shall arrange a meeting with the resident and appropriate individuals identified in Section 87467(a)(1) to review and revise the written record as specified, when there is a significant change in the resident's condition, or once every 12 months, whichever occurs first. Significant changes shall include, but not be limited to occurrences specified in Section 87463, Reappraisals. 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 needs and service plans for three residents which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 04/19/2024 Plan of Correction Facility has agreed to obtain current needs and service plan for R1, R2, and R3, 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 staff which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 04/19/2024 Plan of Correction Facility has agreed to obtain current first aid training for S2 and S3 and submit copies of completion to CCLD by POC date.

Official classification

Type B

Official code

87468.2(a)

Regulation authority

CCR

What the official deficiency says

(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: 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 baby monitors in resident's rooms which poses a potential personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/19/2024 Plan of Correction Facility has agreed submit a written plan to install a signal system in place of the baby monitors. Facility will submit plans to CCLD by POC date.

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 observation, the licensee did not comply with the section cited above by having unlocked medications which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 02/17/2023 Plan of Correction Staff locked up the medication during inspection. Deficiency cleared.

Official classification

Type A

Official code

87608(a)(5)(B)

Regulation authority

CCR

What the official deficiency says

(B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails. 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 full bed rails for R1 who was not on hospice care which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 02/17/2023 Plan of Correction Staff removed the full bed rails for R1 during inspection. Deficiency cleared.

Official classification

Type B

Official code

87411(f)

Regulation authority

CCR

What the official deficiency says

(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure. A report shall be made of each screening, signed by the examining physician. The report shall indicate whether the person is physically qualified to perform the duties to be assigned, and whether he/she has any health condition that would create a hazard to him/herself, other staff members or residents. A signed statement shall be obtained from each volunteer affirming that he/she is in good health. Personnel with evidence of physical illness or emotional instability that poses a significant threat to the well-being of residents shall be relieved of their duties. 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 health screening and TB test for S1 which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 02/24/2023 Plan of Correction Administrator has agreed to submit S1's TB test and health screening to CCLD by POC date.

Official classification

Type B

Official code

87555(b)(8)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (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 store bought eggs unrefrigerated which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 02/17/2023 Plan of Correction Caregiver discarded the eggs during inspection. Deficiency cleared.

Official classification

Type B

Official code

87555(b)(26)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises. 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 one week supply of non-perishable food which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 02/24/2023 Plan of Correction Administrator has agreed to purchase additional nonperishable foods and submit picture proof to CCLD by POC date.

Official classification

Type A

Official code

87468.1(a)(6)

Regulation authority

CCR

What the official deficiency says

Personal Rights of Residents in All Facilities (6) To leave or depart the facility at any time and to not be locked into any room, building, or on facility premises by day or night... 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 door chain located at the top of the front door which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 03/17/2022 Plan of Correction Staff removed the door chains during visit. Deficiency cleared during inspection.

Official classification

Type B

Official code

87555(b)(26)

Regulation authority

CCR

What the official deficiency says

General Food Service Requirements (26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises. 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 one week of nonperishable foods which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 03/21/2022 Plan of Correction Administrator has agreed to purchase additional nonperishable food supplies and submit receipt to CCLD by POC date.