CALIFORNIA MENTOR-MARINEVIEW HOME

Official classification

Type A

Official code

87465(a)(4)

Regulation authority

CCR

What the official deficiency says

(a) A plan for incidental medical and dental care shall be developed by each facility... (4) The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Based on interview and record review the Licensee did not comply with the section cited above in that R1's morning medications were not given which poses an immediate health risk to person in care.

Official plan of correction

By POC date, the Administrator agrees to implement a plan to make sure medication is being administered and submit plan to CCLD.

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

Official classification

Type B

Official code

87468.2(a)(4)

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: (4) To care, supervision.. This requirement was not met as evidence by: Based on record review and interview, the licensee did not comply with the section cited above by R1 leaving the facility unassisted which posed a potential health and safety risk to residents in care.

Official plan of correction

By POC date, The Administrator agrees to review resident's physician's report, creating a plan on increasing safety checks with residents with elopement or wandering, and conducting an in-service training with staff regarding supervision and elopement and send a copy of the training to CCLD.

Deadline recorded: Jun 3, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87411(a)

Regulation authority

CCR

What the official deficiency says

87411 Personnel Requirements - General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs... This requirement was not met as evidence by: Based on interview the Licensee did not comply with the section cited above in that the facility did ensure that there was staff sufficient in numbers to accommodate R1's emergency needs which poses a potential safety risk to persons in care.

Official plan of correction

By POC date, the administrator agrees to implement a plan that ensures there are enough staff on shift in case of an emergency and send the plan to CCLD.

Deadline recorded: Feb 20, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(a)(4)

Regulation authority

CCR

What the official deficiency says

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility [...](4) The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Based on interview and record review the Licensee did not comply with the section cited above in that R1's afternoon medication was not given which poses an immediate health risk to person in care.

Official plan of correction

By POC date, the Administrator agrees to implement a plan to make sure medication is being administered and submit plan to CCLD.

Deadline recorded: Feb 14, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)

Regulation authority

CCR

What the official deficiency says

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including... This requirement is not met as evidenced by: Based on interview the Licensee did not comply with the section cited above in that the facility did not report to licensing about the facility being without electricity and the heater breaking which poses a potential safety risk to persons in care.

Official plan of correction

By POC date, the Administrator agrees conduct an in-service training with staff that goes over the regulation 87211 and send proof of the in-service to CCLD.

Deadline recorded: Feb 20, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

80019(e)(3)

Regulation authority

CCR

What the official deficiency says

80019 Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall prior to working [...] (3) Request a transfer of a criminal record clearance as specified in Section 80019(f) or.. This requirement was not met as evidence by: Based on record review the Licensee did not comply with the section cited above in not having S1 fingerprint cleared and associated to the facility which poses an immediate health and safety risk to persons in care.

Official plan of correction

By POC date, the Administrator agreed to fingeprint and associate S1 to the facility and send proof to CCLD. *Civil Penalty of $500 is being assessed on today's date*

Deadline recorded: Dec 29, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

1569.17(c)(1)(A)

Regulation authority

HSC

What the official deficiency says

(c)(1)(A) Subsequent to initial licensure, a person specified in subdivision (b) who is not exempted from fingerprinting shall obtain either a criminal record clearance or an exemption, pursuant to subdivision (f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in a facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, and record review, the licensee did not comply with the section cited above in not having S1 and S2 fingerprinted and associated to the facility which poses an immediate health, safety or personal rights risk to persons in care

Official plan of correction

POC Due Date: 09/22/2025 Plan of Correction By POC date, Licensee agreed to have S1 and S2 fingerprinted and associated to the facility and submit copy of fingerprint document to CCLD.

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 in that S1, S2, S3, S4 and S5 had missing 20 hr annual training which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 09/26/2025 Plan of Correction By POC date, Administrator agreed to submit documentation of completed 20 hr annual training to CCLD.

Official classification

Type B

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 record review, the licensee did not comply with the section cited above in that 3/5 staff members did not have first aid certification on file which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 10/03/2025 Plan of Correction By POC date, the Administrator agrees to schedule all staff members to recieve first aid training and submit documentation of first aid certifications to CCLD by POC date.

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 that the facility did not have a current fire drill since the last drill was conducted in 2023 which poses a potential health and safety rights risk to persons in care.

Official plan of correction

POC Due Date: 09/26/2025 Plan of Correction By POC date, the Administrator has agreed to conduct emergency disaster fire drills quarterly and will send a copy of the most recent drill to CCLD by POC date. Administrator has agreed to conduct a fire drill in the facility by 9/26/2025.

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 water temperature observed at 139.4 degrees Fahrenheit which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 09/22/2025 Plan of Correction By POC date, the administrator agrees to submit weekly temperate checks and send a copy via email. Administrator agrees to submit proof of maintence staff adjusting the water temperate between 105 and 120 degrees Fahrenheit and submit to CCLD.

Official classification

Type A

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

Maintenance and Operation (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 degree C) and not more than 120 degree F (49 degree C). This requirement is not met as evidenced by: -Based on observation, the licensee did not comply with the section above. Hot water temperature was measured at 150.3 degrees in the kitchen and 146.6 degrees Fahrenheit in the restroom which poses immediate safety risk to persons in care.

Official plan of correction

Administrator agreed to adjust hot water temperature and submit a picture to CCLD by POC date.

Deadline recorded: Apr 23, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87407(k)

Regulation authority

CCR

What the official deficiency says

Administrator Recertification Requirements (k) Whenever a certified administrator assumes or relinquishes responsibility for administering a residential care facility for the elderly, he or she shall provide written notice, within thirty (30) days, to: This requirement is not met as evidenced by: -Based on observation, the Administrator is not listed as the current administrator of the facility.

Official plan of correction

Administrator agreed to submit documents required for the administrator switch and submit proof of the documents to CCLD by POC date.

Deadline recorded: Apr 29, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87303(g)(1)

Regulation authority

CCR

What the official deficiency says

87303 Maintenance and Operation (g) Facilities which have machines and do their own laundry shall: (1) Have ... equipment maintained in good repair. This requirement was not met as evidenced by: LPAs observed that mold was growing on the drum and on the rubber gasket of the upright clothes washer, which poses an immediate health risk to persons in care.

Official plan of correction

The administrator agreed to replace the clothes washer on or before the due date.

Deadline recorded: Apr 23, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

80019(e)(3)

Regulation authority

CCR

What the official deficiency says

80019 Criminal Record Clearance: (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall prior to working, residing or volunteering in a licensed facility:(3) Request a transfer of a criminal record clearance as specified in Section 80019(f) -This requirement is not met as evidenced by: -Based on interview and record review, the licensee did not comply with the section above in administrator not associated to this facility which poses a potential safety and/or personal rights risks to persons in care.

Official plan of correction

Area Director stated she'll have the ADM associated. Proof to be submitted by 1/03/25.

Deadline recorded: Jan 3, 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 as water temperature observed at 127.7 degrees Fahrenheit which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/08/2024 Plan of Correction Bring water temperature to between 105 and 120 degrees Fahrenheit and submit proof to LPA D. Doidge

Official classification

Type B

Official code

87705(h)

Regulation authority

CCR

What the official deficiency says

(h) Outdoor facility space used for resident recreation and leisure shall be completely enclosed by a fence with self-closing latches and gates, or walls, to protect the safety of residents. 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 gate does not self close, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/14/2024 Plan of Correction Install self closing mechanism for exterior gate and submit proof to LPA D. Doidge

Official classification

Type B

Official code

87468.1(a)(1)

Regulation authority

CCR

What the official deficiency says

87468.1(a)(1) Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights:(1)To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement is not met as evidence by: Based on records review, licensee failed to protect residents personal rights where R1, was emotionaly threatens by former staff (S1), poses a potentia health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator agreed to train all staff regarding the citations. Copy fo training need to send to CCL by POC due date.

Deadline recorded: Apr 24, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87468.1(a)(2)

Regulation authority

CCR

What the official deficiency says

87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2) To be accorded safe, healthful... This requirement was not met as evidenced by: Based on observation, licensee did not comply with the section cited above. LPAs observed medicine was not reflled timely that resulted resident missed two doses of medicine which poses an immediate health, safety risk to persons in care.

Official plan of correction

Administrator and LVN will retrain staff for seven rights medication, and submit proof of training to CCL by the POC due day.

Deadline recorded: Apr 21, 2022. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87411(c)(3)(D)

Regulation authority

CCR

What the official deficiency says

87411 Personnel Requirements - General (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 (3) The training shall include, but not be limited to, the following: (D) Policies and procedures regarding medications, including the knowledge in Section 87411(d)(4). Any on-the-job training provided for the requirements in Section 87411(d)(4) may also count towards the requirement in this subsection. This requirement was not met as evidenced by: Based on observation, interview and record review, licensee did not comply with the section cited above. LPAs observed no training has been provided to staff after incident occurred which poses an immediate health, safety risk to persons in care.

Official plan of correction

Administrator and LVN will retrain staff for all required sessions on the regulation, and submit training agenda and staff sign-in sheet to CCL by the POC due day.

Deadline recorded: Apr 21, 2022. A deadline is not proof that correction was completed.