ALAMO CARE HOME

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 in the knife drawer in the kitchen not being locked and under the kitchen sink being unlocked with cleaning supplies (ie. Fabuloso, Windex, metal cleaner, ect) which poses an immediate safety risk to persons in care.

Official plan of correction

POC Due Date: 05/27/2026 Plan of Correction Cabinent and drawer Locked, and additional training given POC clear.

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 licensee did not comply with the section cited above in the medicine drawer containing centerally stored perscription medications in the kitchen being unlocked which poses an immediate safety risk to persons in care.

Official plan of correction

POC Due Date: 05/27/2026 Plan of Correction Drawer Locked, and additional training given POC clear.

Official classification

Type B

Official code

87412(f)

Regulation authority

CCR

What the official deficiency says

(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 observation and attempted record review, the licensee did not comply with the section cited above in 0 out of 3 staff having personell records available for review which poses a potential personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/03/2026 Plan of Correction By POC Facility agrees to have hard copy files available at the facility for review and notify CCLD

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 record review, the licensee did not comply with the section cited above in not having any documented quarterly drills on file which poses a potential safety and personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/03/2026 Plan of Correction By POC facility agrees to conduct and document an emergency disaster drill and notify CCLD.

Official classification

Type B

Official code

87465(h)(5)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. This requirement was not met as evidence by: Based on observations the facility did not comply with the section cited above by batching R1's medication for the week in a pill organizer which poses a potential health risk to resident in care.

Official plan of correction

By POC facility agrees to review the regulation and retrain all the staff on medication procedures and notify CCLD

Deadline recorded: Jul 17, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87307(a)

Regulation authority

CCR

What the official deficiency says

(a)Living accommodations and grounds shall be related to the facility's function....The following provisions shall apply: This requirement was not met as evidence by: Based on observations and interview the facility did not comply with the section cited above by by staff living in an office space and running an unapproved business not related to the facilities function which poses a potential personal rights violation to resident in care.

Official plan of correction

By POC facility agrees to start the process of obtaining a new fire clearence for the office space and submit a plan for the unapproved business and notify CCLD

Deadline recorded: Jul 17, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)(1)(A)

Regulation authority

CCR

What the official deficiency says

(a)Each licensee shall furnish...(1)A written report ... within seven days... (A)Death of any resident...from the facility. This requirement was not met as evidence by: Based on record review and interview the facility did not comply with the section cited above by not reporting the death of R2 which poses a potential personal rights violation to residents in care.

Official plan of correction

By POC facility agrees to review the regulation and submit any and all death reports not previously submitted and notify CCLD

Deadline recorded: Jul 17, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87506(d)

Regulation authority

CCR

What the official deficiency says

(d)All resident records shall be available...upon demand... following requirements: This requirement was not met as evidence by: Based on record review and interview the facility did not comply with the section cited above by not having residents records upon demand which poses a potential personal rights violation to residents in care.

Official plan of correction

By POC facility agrees to update records and files and notify CCLD

Deadline recorded: Jul 17, 2025. A deadline is not proof that correction was completed.

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 ...State Fire Marshal. This requirement is not met as evidence by: Based on record review and interview the facility did not comply with the section cited above by being over their fire clearence capacity which posed an immediate safety risk to resident in care.

Official plan of correction

Facility is no longer over capacity POC clear.

Deadline recorded: Jul 8, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87405(a)

Regulation authority

CCR

What the official deficiency says

(a)All facilities shall have a qualified and currently certified administrator...to fulfill his/her responsibilities... This requirement is not met as evidence by: Based on observations and interview the facility did not comply with the section cited above by Administrator lacking the knowledge to adequetly fo their duties which poses a potential personal rights risk to residents in care.

Official plan of correction

By POC administrator agrees to sign up for refresher courses taught by an approved CCLD vendor and notify CCLD

Deadline recorded: Jul 17, 2025. A deadline is not proof that correction was completed.

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 ... This requirement is not met as evidence by: Based on record review and interview the facility did not comply with the section cited above by not having all staff files which poses a potential personal rights violation to residents in care.

Official plan of correction

By POC administrator agrees to update all files and notify CCLD

Deadline recorded: Jul 17, 2025. 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) Except as specified.. the licensee shall ensure... knives...are in locked storage and are not left unattended... This requirement is not met as evidence by: Based on observation the Licensee did not comply with the above regulation by having an accessible knife which poses an immediate safety risk to persons in care.

Official plan of correction

Caregiver locked away dangerous items.

Deadline recorded: Jun 19, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87464(f)(1)

Regulation authority

CCR

What the official deficiency says

(f) Basic services shall at a minimum include:(1) Care and supervision... Based on observation and interview the Licensee did not comply with the above regulation by not providing adequate supervision which poses an immediate safety risk to persons in care.

Official plan of correction

By POC Facility agrees to implement a sign in and sign out sheet for all staff and notify CCLD

Deadline recorded: Jun 26, 2025. 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

(a) Facility personnel shall at all times be sufficient...for the provision of adequate services. This requirement is not met as evidence by: Based on observation the Licensee did not comply with the above regulation by not having adequete and competent staff which poses a potential safety risk to persons in care.

Official plan of correction

By POC Facility agrees to hire additional staff and notify CCLD

Deadline recorded: Jun 26, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87755(c)

Regulation authority

CCR

What the official deficiency says

(c) The licensing agency shall have the authority to inspect... records upon demand... This requirement is not met as evidence by: Based on interview the Licensee did not comply with the above regulation by not having records available upon demand which poses a potential personal rights risk to persons in care.

Official plan of correction

By POC facility agrees to create a designated spot for all files that can be accessed by staff and notify CCLD

Deadline recorded: Jun 26, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87405(a)

Regulation authority

CCR

What the official deficiency says

(a) All facilities shall have a ... designated substitute who shall have qualifications adequate to be responsible and accountable for management and administration of the facility ... This requirement is not met as evidence by: Based on interview the Licensee did not comply with the above regulation by not having a substitute administrator in their absence which poses a potential personal rights risk to persons in care.

Official plan of correction

By POC Facility agrees to hire a backup administrator and notify CCLD

Deadline recorded: Jun 26, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87411(4)

Regulation authority

CCR

What the official deficiency says

(4) All training shall be conducted by a person...who satisfies at least one of the following criteria related to education and experience: This requirement is not met as evidence by: Based on interview the Licensee did not comply with the above regulation by S3 and S4 not have been trained according to regulation which poses a potential personal rights risk to persons in care.

Official plan of correction

By POC Facility agrees to retrain all staff utilizing a CCL approved vendor and submit the name of vendors and scheduled trainings to CCLD

Deadline recorded: Jun 26, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87311

Regulation authority

CCR

What the official deficiency says

All facilities shall have telephone service on the premises... This requirement is not met as evidence by: Based on interview the Licensee did not comply with the above regulation by not having a designated facility phone which poses a potential personal rights risk to persons in care.

Official plan of correction

By POC facility agrees to obtain phone service that stays on the premises for resident use and notify CCLD

Deadline recorded: Jun 26, 2025. A deadline is not proof that correction was completed.

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 record review, the licensee did not comply with the section cited above by not having their file available which poses a potential personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/23/2025 Plan of Correction By POC Licensee agrees to make their file available at the facility and notify CCL

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 by S1 and Licensee not having first aid training which poses a potential safety risk to persons in care.

Official plan of correction

POC Due Date: 04/23/2025 Plan of Correction By POC Licensee agrees to have staff complete first aid training and notify CCL

Official classification

Type B

Official code

87506(b)

Regulation authority

CCR

What the official deficiency says

(b) Each resident's record shall contain at least 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 R1 not having a file which poses a potential health and personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/23/2025 Plan of Correction By POC Licencee agrees to complete a file for R1 and notify CCL.

Official classification

Type A

Official code

87202(a)

Regulation authority

CCR

What the official deficiency says

(a)All facilities shall maintain a fire clearance ...State Fire Marshal. This requirement is not met as evidence by: Based on observation and interview the facility did not comply with the above regulation by having 7 residents when they are cleared for 6 which poses an immediate safety risk to persons in care.

Official plan of correction

By POC Facility agrees to contact other facilities to begin the process of relocating resident and update CCLD of their progress.

Deadline recorded: Jan 31, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87705(f)(1)

Regulation authority

CCR

What the official deficiency says

(f) The following shall be stored inaccessible to residents with dementia:(1) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s). This requirement is not met as evidence by: Based on observation the Licensee did not comply with the above regulation by having accessible scissors, and knife which poses an immediate health and safety risk to persons in care.

Official plan of correction

Caregiver locked away dangerous items.

Deadline recorded: Jul 5, 2024. A deadline is not proof that correction was completed.