FLINTWOOD CARE HOME

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 as the hot water in the residents' bathroom measured to 125.5 degrees Fahrenheit, which poses an immediate health, safety, or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/02/2026 Plan of Correction On or before plan of correction due date, licensee will email CCL video proof of a lowered max temperature of the hot water in the residents' bathroom.

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 due to mutiple sharps and chemicals and prescription medications being unlocked in various areas of the facility, which poses an immediate health, safety, or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/02/2026 Plan of Correction Fixed on site. All sharps, chemicals, and prescription medications were moved to cabinets/drawers with locks.

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 as none of the residents had an updated Appraisal Needs And Services form, which poses a potential health, safety, or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/06/2026 Plan of Correction On or before plan of correction due date, licensee will email CCL copies of the updated Appraisal Needs And Services forms for both residents.

Official classification

Type A

Official code

87202(a)

Regulation authority

CCR

What the official deficiency says

(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the Administrator did not comply with the section cited above in having the left side gate with a sliding bolt lock which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 01/03/2025 Plan of Correction Administrator agrees to remove the sliding bolt lock and send proof to CCLD by POC date. Civil Penalty of $500 is assessed.

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 Administrator did not comply with the section cited above in having chemicals under the kitchen sink and bathroom sink unlocked and accessible to residents which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 01/03/2025 Plan of Correction Staff locked the chemicals during the visit. Deficiency cleared during the visit.

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 Administrator did not comply with the section cited above in having eye drops and insulin found in the fridge and medication found in R1’s closet unlocked and accessible to residents which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 01/03/2025 Plan of Correction Staff locked the medications during the visit. Deficiency cleared during the visit.

Official classification

Type A

Official code

87202(a)

Regulation authority

CCR

What the official deficiency says

(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: 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 admitting a bedridden resident without an approved bedridden fire clearance which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/17/2023 Plan of Correction Administrator will: 1) notify local fire department regarding bedridden resident 2) will submit request for bedridden fire clearance to LPA by POC date

Official classification

Type A

Official code

87204(a)

Regulation authority

CCR

What the official deficiency says

(a) A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including specification of the maximum number of persons who may receive services at any one time. An exception may be made in the case of catastrophic emergency when the licensing agency may make temporary exceptions to the approved capacity. 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 admitting a bedridden resident without an approved bedridden fire clearance which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/17/2023 Plan of Correction Administrator will notify local fire department regarding the bedridden resident staying in a nonambulatory room. Administrator will submit request for bedridden fire clearance.

Official classification

Type A

Official code

87411(d)

Regulation authority

CCR

What the official deficiency says

(d) All personnel shall be given on the job training or have related experience in the job assigned to them. This training and/or related experience shall provide knowledge of and skill in the following, as appropriate for the job assigned and as evidenced by safe and effective job performance: This requirement is not met as evidenced by: Deficient Practice Statement Based on file review, the licensee did not comply with the section cited above in not providing training to staff which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/15/2023 Plan of Correction Administrator will provide staff with training and submit proof to CCL by POC date.

Official classification

Type A

Official code

87613(a)(2)(B)

Regulation authority

CCR

What the official deficiency says

(2) Ensure that facility staff who will participate in meeting the resident's specialized care needs complete training provided by a licensed professional sufficient to meet those needs. (B) Training shall be completed prior to the staff providing services to the resident. This requirement is not met as evidenced by: Deficient Practice Statement Based on file review, the licensee did not comply with the section cited above in not having proof of training for resident with catheterwhich poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/29/2023 Plan of Correction By POC date, staff will undergo training on catheter management and submit proof to CCL.

Official classification

Type A

Official code

87411(c)(1)

Regulation authority

CCR

What the official deficiency says

(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 file review conducted, the licensee did not comply with the section cited above in having Administrator and caregiver working with expired First aid and CPR which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/24/2023 Plan of Correction Administrator and staff will complete First aid and CPR training and submit proof to CCL by POC date.

Official classification

Type A

Official code

1569.626(a)

Regulation authority

HSC

What the official deficiency says

(a) All residential care facilities for the elderly shall meet the following training requirements, as described in Section 1569.625, for all direct care staff: This requirement is not met as evidenced by: Deficient Practice Statement Based on file review, the licensee did not comply with the section cited above in having staff work without any training completed which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/15/2023 Plan of Correction Administrator will have staff complete all required trainings and submit proof to CCL.

Official classification

Type A

Official code

1569.69(a)(4)

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: (4) The training shall cover all of the following areas: This requirement is not met as evidenced by: Deficient Practice Statement Based on file review, the licensee did not comply with the section cited above in having staff work without required medication training which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/15/2023 Plan of Correction Administrator will have staff complete medication training and submit proof to CCL.

Official classification

Type A

Official code

1569.69(d)

Regulation authority

HSC

What the official deficiency says

(d) Each residential care facility for the elderly that provides employee training under this section shall use the training material and the accompanying examination that are developed by, or in consultation with, a licensed nurse, pharmacist, or physician. The licensed residential care facility for the elderly shall maintain the following documentation for each medical consultant used to develop the training: This requirement is not met as evidenced by: Deficient Practice Statement Based on file review, the licensee did not comply with the section cited above in having staff work/manage medications without passing examination which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/15/2023 Plan of Correction Staff will complete training and pass examination. Proof of passing exam will be submitted to CCL.

Official classification

Type A

Official code

87606(c)

Regulation authority

CCR

What the official deficiency says

(c) To accept or retain a bedridden person, other than for a temporary illness or recovery from surgery, a facility shall obtain and maintain an appropriate fire clearance as specified in Section 87202(a). This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and file review, the licensee did not comply with the section cited above in admitting a bedridden resident without an approved fire clearance which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/17/2023 Plan of Correction Administrator will submit request for bedridden fire clearance by POC date.

Official classification

Type A

Official code

87606(f)(1)

Regulation authority

CCR

What the official deficiency says

(f) To accept or retain a bedridden person, a facility shall ensure the following: (1) The facility's Plan of Operation includes a statement of how the facility intends to meet the overall health, safety and care needs of bedridden persons. This requirement is not met as evidenced by: Deficient Practice Statement Based on file review, the licensee did not comply with the section cited above in not having plan of operation updated to meet the overall needs of bedridden resident which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/15/2023 Plan of Correction Administrator will submit updated plan of operation to CCL by POC date.

Official classification

Type B

Official code

1569.153(d)

Regulation authority

HSC

What the official deficiency says

(d) A written resident personal property inventory is established upon admission and retained during the resident’s stay in the residential care facility for the elderly. Inventories shall be written in ink, witnessed by the facility and the resident or resident’s representative, and dated. A copy of the written inventory shall be provided to the resident or the person acting on the resident’s behalf. All additions to an inventory shall be made in ink, and shall be witnessed by the facility and the resident or resident’s representative, and dated. Subsequent items brought into or removed from the facility shall be added to or deleted from the personal property inventory by the facility at the written request of the resident, the resident’s family, a responsible party, or a person acting on behalf of a resident. The facility shall not be liable for items which have not been requested to be included in the inventory or for items which have been deleted from the inventory. A copy of a current inventory shall be made available upon request to the resident, responsible party, or other authorized representative. The resident, resident’s family, or a responsible party may list those items which are not subject to addition or deletion from the inventory, such as personal clothing or laundry, which are subject to frequent removal from the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on file review, the licensee did not comply with the section cited above in not having SPV for one resident which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/15/2023 Plan of Correction Administrator will get SPV completed and submit to CCL a copy of the completed form.

Official classification

Type B

Official code

87308(c)

Regulation authority

CCR

What the official deficiency says

(c) General storage space shall be maintained for equipment and supplies as necessary to ensure that space used to meet other requirements of these regulations is not also used for 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 using the shower room as storage for wheelchair and other supplies which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/29/2023 Plan of Correction Administrator will clear the shower room and submit photo proof to CCL.

Official classification

Type B

Official code

87412(a)

Regulation authority

CCR

What the official deficiency says

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: This requirement is not met as evidenced by: Deficient Practice Statement Based on file review conducted, the licensee did not comply with the section cited above in not having complete personnel records which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/29/2023 Plan of Correction Administrator will review all staff files and ensure records are complete. Administrator will send self-certification stating all staff records are complete.

Official classification

Type B

Official code

1569.267(d)

Regulation authority

HSC

What the official deficiency says

(d) The licensee shall provide initial and ongoing training for all members of its staff to ensure that residents’ rights are fully respected and implemented. This requirement is not met as evidenced by: Deficient Practice Statement Based on file review conducted, the licensee did not comply with the section cited above in not having proof of staff training on residents' rights which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/15/2023 Plan of Correction Staff will undergo training on Residents' Rights and submit proof to CCL.

Official classification

Type B

Official code

87219(a)

Regulation authority

CCR

What the official deficiency says

(a) Residents shall be encouraged to maintain and develop their fullest potential for independent living through participation in planned activities. The activities made available shall include: 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 not providing activities to residents which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/15/2023 Plan of Correction Administrator will submit to CCL calendar of activities and ensure activities are provided to residents.

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 file review, the licensee did not comply with the section cited above in not conducting drills every quarter which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/29/2023 Plan of Correction Administrator will complete all the required drill and make sure the proof of training are on file. Administrator will submit to CCL proof.

Official classification

Type B

Official code

1569.695(e)(2)

Regulation authority

HSC

What the official deficiency says

(e) A facility shall have all of the following information readily available to facility staff during an emergency: (2) An appraisal of resident needs and services plan for each resident. 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 not having Appraisal Needs and Services for one resident which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/29/2023 Plan of Correction Administrator wil complete needs and services plan for the resident and submit a copy to CCL by POC date.

Official classification

Type B

Official code

87613(a)(2)

Regulation authority

CCR

What the official deficiency says

87613 General Requirements for Restricted Health Conditions (2) Ensure that facility staff who will participate in meeting the resident’s specialized care needs complete training provided by a licensed professional sufficient to meet those needs. This requirement is not met as evidenced by: Licensee did not comply with section cited by not providing appropriate training to R1 who has catheter.

Official plan of correction

Administrator and staff will undergo training on R1's catheter and submit proof to CCL by POC date.

Deadline recorded: Nov 29, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87705(c)(7)

Regulation authority

CCR

What the official deficiency says

87705 Care of Persons with Dementia (7) An activity program shall address the needs and limitations of residents with dementia and include large motor activities and perceptual and sensory stimulation. This requirement is not met as evidenced by: Licensee did not comply with section cited for failing to provide residents with activities.

Official plan of correction

Administrator will create activity calendar and make sure facility provides activities. A copy of the calendar will be sent to CCL by POC date.

Deadline recorded: Nov 29, 2023. 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) 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 cleaning supplies, gardening tool, and paint thinner which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 05/12/2022 Plan of Correction Administrator has locked up the gardening tool and paint thinner. Administrator has agreed to repair the lock under the kitchen sink and submit picture proof to CCLD by POC date.

Official classification

Type A

Official code

87468.1(a)

Regulation authority

HSC

What the official deficiency says

87468.1 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 does not prohibit a licensee from establishing house rules, such as locking doors at night to protect residents, or barring windows against intruders, with permission from the Department. 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 safety lock high on the front door which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 05/12/2022 Plan of Correction Administrator have removed security lock 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 record review, the licensee did not comply with the section cited above by not having chest x-ray for S1 which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 05/25/2022 Plan of Correction Administrator has agreed to obtain negative TB test or chest x-ray for S1 and submit a copy to CCLD by POC date.