Hazardous items and storage
Cited in 3 reports, with 3 deficiencies in total.
34819 CLOVER STREET, Union City CA 94587
6 bedsLatest official report Jan 29, 2026Licensed
The available records show 8 Type A and 10 Type B deficiencies for this facility.
No later report is available, so the records do not show what happened afterward.
Both classifications are published by California CDSS and are shown as published. SeniorLivingFacts does not rename them or add a severity level of its own.
Counts cover the five-year public record. Typical figures are the median for the 152 Alameda County facilities licensed for 6 or fewer beds.
In the available public five-year record, CCLD published 5 reports for this facility: 5 inspections, 0 complaint investigations, and 0 licensing or administrative records.
Those records contain 8 Type A and 10 Type B deficiencies.
0 deficiencies have explicit official correction or clearance evidence in the loaded records.
More than the typical 4
1 in the last 12 months
Well above the typical 4
3 in the last 12 months
Well above the typical 1
2 in the last 12 months
Well above the typical 2
1 in the last 12 months
Most this size also have none
0 in the last 12 months
Last 36 months
Topics cited in more than one report during the last 36 months. A repeat may show a pattern worth asking about. Each date opens its report below.
Cited in 3 reports, with 3 deficiencies in total.
Cited in 2 reports, with 3 deficiencies in total.
All preserved reports from the most recent to the oldest, sortable by report type.
(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 temperature in both bathrooms measured to 126.5 and 138.1 degrees Fahrenheit, which poses an immediate health, safety, or personal rights risk to persons in care.
POC Due Date: 01/30/2026 Plan of Correction On or before plan of correction due date, licensee will send picture or video proof of a lowered max hot water temperature in both bathrooms.
(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. (1) Disinfectants, cleaning solutions, and poisonous substances shall be stored in areas separate from food supplies as specified in Section 87555, General Food Service Requirements. 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 cleaning substances were found in unlocked cabinets, which poses an immediate health, safety, or personal rights risk to persons in care.
POC Due Date: 01/30/2026 Plan of Correction Fixed on site. Cabinets were locked and cleaning supplies were removed from unlocked cabinets.
(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 no residents had an updated Appraisal Needs And Services form, which poses/posed a potential health, safety, or personal rights risk to persons in care.
POC Due Date: 02/06/2026 Plan of Correction On or before plan of correction due date, licensee will send PDF copies of updated Appraisal Needs And Service forms for all four residents.
(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 in knife in a cabinet unlocked, razor and chemical left in the resident bathroom, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 01/07/2025 Plan of Correction Staff locked knive, razor, and lock chemical during inspection. Defiency Clear.
(h) The following requirements shall apply to medications which are centrally stored: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation central storage for medications unlocked, residents' medications in unlocked kitchen cabinet, and unlocked refrigerator with residents' medications the licensee did not comply with the section cited above, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 01/07/2025 Plan of Correction Staff locked medication cabinet, and lock medication in the refrigerator during inspection. Defiency Clear.
(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 for peritoneal cleanser in one of the resident's bedrooms and razor and ointment in the common bathroom, and staff bedroom with vitamins/sipplements unlocked which pose an immediate health, safety and/or personal rights risk to persons in care.
POC Due Date: 01/28/2024 Plan of Correction Staff locked the items. In addition, administrator to in-service the staff and submit copy of training topic with attendees signatures by 1/28/24.
(h) The following requirements shall apply to medications which are centrally stored: (1) Medications shall be centrally stored under the following circumstances: (C) Because of potential dangers related to the medication itself, or due to physical arrangements in the facility and the condition or the habits of other persons in the facility, the medications are determined by either a physician, the administrator, or Department to be a safety hazard to others. 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 the following which pose immediate health and/or personal rights risks to persons in care: refrigeratorr in staff room where resident's medication are kept was unlocked; unlocked kitchen cabinet where other residents medication are kept
POC Due Date: 01/29/2024 Plan of Correction Staff locked the room and cabinet. In addition, administrator to in-service the staff and submit copy of training topic with attendees signatures by 1/28/24.
(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 for unlocked central storage for medications which pose an immediate health, safety and/or personal rights risk to persons in care.
POC Due Date: 01/28/2024 Plan of Correction Staff locked the storage. In addition, administrator to in-service the staff and submit copy of training topic with attendees signatures by 1/28/24.
(e) For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician on a prescription blank, maintained in the resident's file, and a label on the medication. Both the physician's order and the label shall contain at least all of the following information. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in resident (R2) has 8 medications with no doctor's order on file.which poses an immediate health and/or personal rights risk to persons in care.
POC Due Date: 01/28/2024 Plan of Correction Administrator stated she'll obtain doctor's order. Copy to be submitted by 1/28/24.
(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) or This requirement is not met as evidenced by: Deficient Practice Statement Based on interview and record review, the licensee did not comply with the section cited above for S3 not associated to the facility which poses a potential safety and/or personal rights risk to persons in care.
POC Due Date: 02/10/2024 Plan of Correction Administrator to have the staff associated and submit proof by 2/10/24.
(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 interview and record review)], the licensee did not comply with the section cited above for staff (S2) not having the required 20 hours annual training on file which poses a potential health, safety and/or personal rights risk to persons in care.
POC Due Date: 02/10/2024 Plan of Correction Administrator to have the staff complete the required training and submit proof by 2/10//24.
(a) A licensee of a facility that has internet service shall provide at least one internet access device, such as a computer, smart phone, tablet, or other device, that can support real-time interactive applications, is equipped with videoconferencing technology, including microphone and camera functions, and is dedicated for resident use. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview, the licensee did not comply with the section cited above for not having internet service poses a potential personal rights risk to persons in care.
POC Due Date: 02/10/2024 Plan of Correction Administrator stated she'll have internet service. Proof to be submitted by 2/10/24.
(c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of residents is not required during a drill. While a facility may provide an opportunity for residents to participate in a drill, it shall not require any resident participation. Documentation of the drills shall include the date, the type of emergency covered by the drill, and the names of staff participating in the drill. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview and reord review, the licensee did not comply with the section cited above for not conducting disaster drills as required which poses/posed a potential safety risk to persons in care.
POC Due Date: 02/10/2024 Plan of Correction Administrator stated she'll have drills conducted. Proof to be submitted by 2/10/24.
(c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (6) Appraisals are conducted on an ongoing basis pursuant to Section 87463, Reappraisals. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview and recorda review, the licensee did not comply with the section cited above in residents' (R1, R2 & R3) LIC625 over a year old. which pose a potential health and/or personal rights risk to persons in care.
POC Due Date: 02/10/2024 Plan of Correction Administrator stated she'll complete the appraisal. Self-certification to be submitted by 2/10/24.
This requirement is not met as evidenced by: Deficient Practice Statement Based on interview and record review, the licensee did not comply with the section cited above in residents (R1,R2, & R3) LIC602A over a year old .which pose a potential health and/or personal rights risk to persons in care
POC Due Date: 02/10/2024 Plan of Correction Administrator to have doctor's appointment scheduled and update the LIC602As. Self-certification to be submitted by 2/10/24.
87411 Personnel Requirements - General (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 .. This requirement is not met as evidenced by: Deficient Practice Statement Based on records review, the licensee did not comply with the section cited above in S2 and S3 not having LIC503 Health Screening on file which poses a potential health risk to persons in care.
POC Due Date: 02/10/2024 Plan of Correction Administrator to have the staff health screened and submiit copies of LIC503s by 2/10/24.
§1569.625 Staff training; legislative findings; contents (b) (1) The department shall adopt regulations to require staff members of residential care facilities for the elderly who assist residents with personal activities of daily living to receive appropriate training. This training shall consist of 40 hours of training. A staff member shall complete 20 hours, including six hours specific to dementia care, as required by subdivision (a) of Section 1569.626 and four hours specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696, before working independently with residents....... This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above for S3 not having the required hours of training completed which poses a potential health, safety and/or personal rights risk to persons in care.
POC Due Date: 02/10/2024 Plan of Correction Admimistrstor stated she'll have the training completed. Self-certification to be submitted by 2/10/24.
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 for R2's medications not properly records on LIC622 which poses a potentiial personal rights risk to persons in care
POC Due Date: 02/10/2024 Plan of Correction Administrator to have the LIC622 corrected and submit self-certification by 2/10/24.
California Department of Social Services, Community Care Licensing Division. Public facility history is described by the source as a five-year window. Older records and previous-licensee history may require a regional-office request. Type 741 RCFE-CCRCs, nursing homes, and other care settings are excluded from this page.
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