COUNTRY HOUSE

Official classification

Type A

Official code

87411(g)(1)

Regulation authority

CCR

What the official deficiency says

87411 Personnel Requirements - General (g) Prior to employment or initial presence in the facility, all employees and volunteers subject to a criminal record review shall: (1) Obtain a California clearance or a criminal record exemption as required by law or Department regulations. This is evidenced by: Based on interviews conducted, observation, and documentation reviewed, the Licensee did not ensure that S1 had a valid criminal record clearance before working in the facility, which posed an immediate health and safety risk to residents in care.

Official plan of correction

Administrator agrees to fill out a LIC 9098 Proof of Correction Form indicating the regulation is understood for the future. Further, civil penalties have been assesed. Adminsistrator shall provide LIC 9098 to LPA by end of business on December 12, 2025.

Deadline recorded: Dec 12, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87303(e)(3)

Regulation authority

CCR

What the official deficiency says

(e) Water supplies and plumbing fixtures shall be maintained as follows: (3) Taps delivering water at 125 degree F (52 degrees C) or above shall be prominently identified by warning signs. 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 that the water is not consistently measuring within range throughout the facility which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/24/2024 Plan of Correction Administrator will ensure that caregivers are check the water temp before resident showers. The administrator will enusre that the water temp remains in range. Admin will provide a training to the caregivers, and provide documentation to the department. Administrator will monitor the temps to determin if the facility needs new water heater.

Official classification

Type B

Official code

87705(c)(5)

Regulation authority

CCR

What the official deficiency says

(c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (5) Each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, both of which shall include a reassessment of the resident's dementia care needs. 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 two out of five resident files did not have an updated medical assessment which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/24/2024 Plan of Correction The Admin and RCC will work together to create and implement a tracking system for residents with dementia to ensure that residents with dementia recieve a medical assessment annually.