ARGONAUT CARE HOME 3

Official classification

Type A

Official code

87411(a)

Regulation authority

CCR

What the official deficiency says

This is an amended report. Licensing Program Analyst, Arvin Villanueva (LPA) AMENDED this report which was previously entered on this facility in error on 8/19/2025.

Official plan of correction

The exact report in its original form can be located on facility number 32701223. No citations and a copy of this report was provided.

Deadline recorded: Aug 20, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87309(a)(1)

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. (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. LPA observed the storage shed to be unlocked and observed chemicals and sharp gardening tools; LPA observed two scrissors in a kitchen drawer accessible to residents; LPA observed cleaning chemicals in a kitchen cabinet; 3 medication pills inside a medication cup inside one of the ktichen cabinet were accesible to residents; and LPA observed injectable medication inside the kitchen refrigerator that was accessible to residents. These pose an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/25/2025 Plan of Correction Per discussion, administrator will submit a plan to conduct staff training; submit plan to the Department by POC due date. Per discussion with the facility representative, S2 agreed to conduct staff training related to the deficiencies that were observed. Submit training to the Department once completed.

Official classification

Type B

Official code

87211(a)(1)(A)

Regulation authority

CCR

What the official deficiency says

(a) (1) A written report shall be submitted to the licensing agency...within seven days of the occurrence of any of the events...(A)Death of any resident from any cause regardless of where the death occurred... This requirement is not met as evidenced by: Based on record review and interview, a death report was submitted to the Department past the seven days requirement, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Per discussion with the Designated Staff (S1), licensee to submit a written plan of correction detailing the steps the facility will take to ensure all reportable incidents are reported to the Department in a timely manner. Plan to be submitted by POC due date.

Deadline recorded: Oct 2, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87412(f)

Regulation authority

CCR

What the official deficiency says

Personnel Records: (f) All personnel 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: Deficient Practice Statement Based on record review and interview, the licensee did not comply with the section cited above. 4 of 4 staff files were reviewed and found files to be incomplete and 1 of 4 files was not available for review during the visit which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/20/2024 Plan of Correction Licensee to enusre to keep staff files at the facility available for review at all times. LIcensee agreed to create checklist of what to keep in the staff files according to the regulation and submit the checklist to the Department by POC due date.

Official classification

Type B

Official code

1569.625(b)(1)

Regulation authority

HSC

What the official deficiency says

Other Provisions: (1)...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 and interview, the licensee did not comply with the section cited above. 4 of 4 staff files reviewed were missing this requirement and at least 2 staff files were not available for review during this visit which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/20/2024 Plan of Correction Licensee to ensure the required intial trainings are provided to staff within the first four weeks of employment. Licensee agreed to create a checklist of initial trainings to provide to staff and submit the checklist to the Department by the POC due date.

Official classification

Type B

Official code

1569.69(a)(2)

Regulation authority

HSC

What the official deficiency says

Other Provisions: (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 and interview, the licensee did not comply with the section cited above. 4 of 4 staff files reviewed, there was no evidence of medication training, including hands-on shadowing, was provided to staff prior to staff assisting residents in care with their medication which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/20/2024 Plan of Correction Licensee to ensure staff assisting residents in care with their medications recieve necessary trainings per regulation prior to staff assisting with medication administration. Licensee to submit a declaration of understanding of the regulatory requirments for assisting with resident's medication. Submission to the Department is by the POC due date. Licensee to provide staff training on medication assistance as required by regulations. Submit proof of training by POC due date.

Official classification

Type B

Official code

1569.695(c)

Regulation authority

HSC

What the official deficiency says

Other Provisions: (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 record review, the licensee did not comply with the section cited above. Documentation of quarterly emergency/fire drills was not available for review during this visit which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/20/2024 Plan of Correction Licensee to ensure to conduct emergency/fire drills on a quarterly basis and document each drill per regulation. Licensee agreed to submit to the Department proof of emergency/fire drills by POC due date.

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

Incidental Medical and Dental Care Services: (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 and interview, the licensee did not comply with the section cited above where during facility observation, LPA observed an insulin injection pen stored inside the kitchen refridgerator which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/08/2024 Plan of Correction Licensee to schedule additional medication training with all staff who handle medications covering the regulation cited above. Licensee to submit training date to the Department by the POC due date and once training complete, Administrator to submit signed staff training.

Official classification

Type A

Official code

87465(c)(2)

Regulation authority

CCR

What the official deficiency says

Incidental Medical and Dental Care Services: (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, interview and record review, the licensee did not comply with the section cited above where during medication review, 2 of R1's medications were found to not have physician's order available for review during this visit which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/08/2024 Plan of Correction A statement of correction will be completed and submitted to the Department by the POC due date. Licensee to obtain physician's orders of all residents' medications and submit physician's order to the Department once obtained.

Official classification

Type A

Official code

87465(a)(4)

Regulation authority

CCR

What the official deficiency says

Incidental Medical and Dental Care Services: (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 and record review, the licensee did not comply with the section cited above where during medication review of resident_1 (R1), LPA observed 5 medications to be missing which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/08/2024 Plan of Correction Licensee to obtain all missing medications for R1. Licensee to send in a copy of the centrally stored medication record, indicating missing medications are available for R1. POC due date.

Official classification

Type A

Official code

87465(a)(5)

Regulation authority

CCR

What the official deficiency says

Incidental Medical and Dental Care Services: (5)... staff designated by the licensee may assist persons with self-administration as needed. Assistance with self-administered medications shall be limited to the following: 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 where during a review of the medication administration record (MAR) for Febuary 2024, LPA observed 4 of R1's medications to have missing staff initials since 2/1/2024, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/08/2024 Plan of Correction Licensee to schedule additional medication training with all staff who handle medications covering following MD orders, refills and documentation. Licensee to submit the date of the training to the Department by POC due date; and once training is completed, licensee to submit the signed training to the Department.

Official classification

Type B

Official code

87465(b)

Regulation authority

CCR

What the official deficiency says

Incidental Medical and Dental Care Services: (b) If the resident's physician has stated in writing that the resident is able to determine and communicate his/her need for a prescription or nonprescription PRN medication, facility staff shall be permitted to assist the resident with self-administration of his/her PRN medication. 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 where during resident file review, 2 of 2 resident files did not contain PRN authorization signed by physician which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/14/2024 Plan of Correction Licensee to obtain PRN authorization letter from residents' physician and submit the signed PRN authorization to the Department by the POC due date.

Official classification

Type A

Official code

87465(i)

Regulation authority

CCR

What the official deficiency says

(i) Prescription medications which are not taken with the resident upon termination of services, not returned to the issuing pharmacy, nor retained in the facility as ordered by the resident’s physician and documented in the resident’s record nor disposed of according to the hospice’s established procedures or which are otherwise to be disposed of shall be destroyed in the facility by the facility administrator and one other adult who is not a resident. Both shall sign a record, to be retained for at least three years, which lists the following: 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 where during a medication review, LPA observed 2 of R1's medications to be expired which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/08/2024 Plan of Correction Licensee tol conduct a medication audit on medications. Licensee to ensure that all staff responsible for administration of medication are re-trained on facility protocol/procedure as it relates to destruction of expired/discontinued medications a timely manner. Licensee to submit the staff training date by POC due date and once training is complete, licensee to submit the proof of training to the Department.