NEW ALAMO RESIDENCE 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 having dangerous items accesable which poses an immediate safety risk to persons in care.

Official plan of correction

POC Due Date: 02/04/2026 Plan of Correction Items removed POC clear

Official classification

Type A

Official code

87465(h)(1)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (1) Medications shall be centrally stored under the following circumstances: 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 not securiing medications which poses an immediate safety risk to persons in care.

Official plan of correction

POC Due Date: 02/04/2026 Plan of Correction Staff secured medications POC clear

Official classification

Type B

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

(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 in hot water being over 120 degrees F in 1 out of 2 bathrooms which poses a potential safety risk to persons in care.

Official plan of correction

POC Due Date: 03/01/2026 Plan of Correction By POC facility will adjust water and notify CCLD

Official classification

Type B

Official code

87303(e)(5)

Regulation authority

CCR

What the official deficiency says

(5) Slip-resistant mats, strips, or flooring shall be used in all bathtub and shower floors. 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 not having any slip resistant mats in the showers which poses a potential safetyrisk to persons in care.

Official plan of correction

POC Due Date: 03/01/2026 Plan of Correction By POC facility will obtain and install mats and notify CCLD

Official classification

Type B

Official code

87307(e)(1)

Regulation authority

CCR

What the official deficiency says

(e) The licensee shall supervise residents as needed and as determined by the resident's appraisal pursuant to Section 87457, Pre-Admission Appraisal or Section 87463, Reappraisals, when residents are in proximity to or when there is use of the following items: (1) Ranges, ovens, heaters, fireplaces, wood stoves, inserts, and other heating devices. 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 having a lit candle in R6's room unsupervised which poses a potential safety risk to persons in care.

Official plan of correction

POC Due Date: 02/04/2026 Plan of Correction Candles removed POC clear

Official classification

Type B

Official code

87308(c)

Regulation authority

CCR

What the official deficiency says

(c) General storage space shall be maintained for equipment and supplies as necessary to ensure that space used to meet other requirements of these regulations is not also used for 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 not having the storage area maintained and PPE/Supplies covered in rat droppings which poses a potential health and personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/01/2026 Plan of Correction By POC facility will reorganize and have pest control come and notify 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 2 out of 3 staff not having met training requirements which poses a potential personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/01/2026 Plan of Correction By POC facility agrees to have staff trained by a CCLD approved vendor and notify CCLD

Official classification

Type B

Official code

87219(a)

Regulation authority

CCR

What the official deficiency says

(a) Residents shall be encouraged to maintain and develop their quality of life through participation in a variety of planned activities. The activities made available shall include: 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 not conducting activities or having an activities schedule being followed which poses a potential personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/01/2026 Plan of Correction By POC facility will develop and implement an daily activities schedule and document activies and notify CCLD

Official classification

Type B

Official code

87555(a)

Regulation authority

CCR

What the official deficiency says

(a) The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents an shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. All food shall be selected, stored, prepared and served in a safe and healthful manner. 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 not having food stocked/ served to meet the nutrition requriements which poses a potential health and personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/01/2026 Plan of Correction By POC facility agrees to review the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council and purchace food accordingly and notify CCLD. Facility also agrees to develop a poster on nutritional expectations for meals and have available in kitchen for staff and notify CCLD.

Official classification

Type B

Official code

87555(b)(26)

Regulation authority

CCR

What the official deficiency says

(26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises. 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 not having a one week supply of non-erishable foods which poses a potential health and personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/01/2026 Plan of Correction By POC facility agrees to purchase an additional emergency supply food bucket and notify CCLD

Official classification

Type B

Official code

87463(a)

Regulation authority

CCR

What the official deficiency says

(a) The pre-admission appraisal, as specified in Section 87457, Pre-Admission Appraisal, shall be updated, in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition, as defined in Section 87101, Definitions, and to keep the appraisal accurate. For the purposes of this section, the updated pre-admission appraisal shall be referred to as the reappraisal. 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 3 out of 6 residents not having up to date appraisals which poses a potential personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/01/2026 Plan of Correction By POC facility agrees to have appraisals updated and notify CCLD

Official classification

Type B

Official code

87608(a)(5)(B)

Regulation authority

CCR

What the official deficiency says

(B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails. 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 in R6 having full bed rails without the required conditions being met which poses a potential personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/01/2026 Plan of Correction By POC facility agrees to take the neccasary steps to see if they can get an exception for R6's bed rails and notify CCLD.

Official classification

Type A

Official code

87203

Regulation authority

CCR

What the official deficiency says

All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. 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 living room fire exit blocked with a stick preventing it from opening on the inside which poses an immediate safety risk to persons in care.

Official plan of correction

POC Due Date: 02/04/2026 Plan of Correction Stik removed POC clear

Official classification

Type B

Official code

87303(b)(1)

Regulation authority

CCR

What the official deficiency says

(b) A comfortable temperature maintained at all times.(1)The facility shall...minimum of 68 degree F, (20 degrees C). This requirement is not met as evidence by: Based on observation, the licensee did not comply with the section cited above. On 2/21/25 LPA observed the facility temprature at 64 degrees F which posed a potential personal rights risk to persons in care.

Official plan of correction

Facility has removed the automatic temprature adjustment and now the facility is the correct temprature POC clear

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

Official classification

Type B

Official code

87555(b)(26)

Regulation authority

CCR

What the official deficiency says

(b) The following...shall apply:(26)Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained... This requirement is not met as evidence by: Based on observation, the licensee did not comply with the section cited above. LPA observed that the facility did not have the required 2 days of perishables and 7 days of non- perishable foods. which posed a potential personal rights risk to persons in care.

Official plan of correction

The facility has purchased additional food. POC clear

Deadline recorded: Aug 8, 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) 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. LPAs observed unlocked clorox, drain cleaner and oxy cleaner stored underneath bathroom sink cabinet which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 03/16/2023 Plan of Correction DEFICIENCY CLEARED DURING VISIT. LPAs observed Administrator removed items and locked it away.

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

87465(h)(2) INCIDENTAL MEDICAL AND DENTAL CARE (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 by having unlocked tylenol stored inside medication cabinet in R2's bathroom which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 03/16/2023 Plan of Correction DEFICIENCY CLEARED DURING VISIT. LPAs observed Administrator removed tylenol and locked it away.

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 by not completing quarterly drills for each shift which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/20/2023 Plan of Correction By POC date, Administrator agrees to conduct a drill with staff for each shift and submit a copy of drill with staff signatures to CCLD.

Official classification

Type B

Official code

87203

Regulation authority

CCR

What the official deficiency says

87203 FIRE SAFETY All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. 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 fire extinguisher was last serviced on 1/9/22 which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/31/2023 Plan of Correction By POC date, Administrator agrees to submit photo to CCLD

Official classification

Type B

Official code

87411(c)(1)

Regulation authority

CCR

What the official deficiency says

87411(c)(1) 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 (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 and interview, the licensee did not comply with the section cited above. LPAs observed S1's first aid expired in December of 2020 and S1 stated S1 provides care which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/31/2023 Plan of Correction By POC date, Administrator agrees to send a copy of S1's first aid certificate.

Official classification

Type B

Official code

87506(a)

Regulation authority

CCR

What the official deficiency says

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 by not having all residents records maintained and available to LPAs which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/24/2023 Plan of Correction By POC date, Administrator agrees to maintain residents record at facility and submit self certification letter to CCLD

Official classification

Type A

Official code

87355(e)(1)

Regulation authority

CCR

What the official deficiency says

CRIMINAL RECORD CLEARANCE (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing.. (1) Obtain a California clearance or a criminal record exemption as required by the Department or This requirement is not met as evidenced by: Based on the Deparments record review and observation, Licensee did not comply with the regulation above. S1 has been employed at the facility without fingerprint clearance since November 2021. S1 was observed by the Department on 12/21/2021 which poses an immediate health and safety risk to persons in care.

Official plan of correction

Deficiency cleared. S1 was removed from facility on 12/22/2021. On 12/27/2021, LPA confirmed S1 is no longer at the facility. A $500 Civil Penalty is assessed.

Deadline recorded: Jun 25, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87405(d)(2)

Regulation authority

CCR

What the official deficiency says

87405(d)(2) Administrator - Qualifications and Duties (d) The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7). If the licensee is also the administrator, all requirements for an administrator shall apply. (2) Knowledge of and ability to conform to the applicable laws, rules and regulations. 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. S1 does not have an exemption for COVID-19 on file and weekly COVID-19 testing is not being conducted in accordance to Public Health Order and PIN 22-05.1-ASC which poses a potential health and safety risk to persons in care..

Official plan of correction

POC Due Date: 07/08/2022 Plan of Correction By POC, Administrator will submit a plan to CCLD indicating whether S1 will have an exemption on file or obtain COVID-19 vaccination and a self-certification letter that a weekly COVID-19 testing will be completed for S1 in according to Public Health Order and PIN 22-05.1-ASC and PIN 21-32.1-ASC

Official classification

Type B

Official code

87355(c)(1)

Regulation authority

CCR

What the official deficiency says

87355(c)(1)CRIMINAL RECORD CLEARANCE (c) A licensee or applicant for a license may request a transfer of a criminal record clearance from one state licensed facility to another,..providing the following documents to the Department: (1) A signed Criminal Background Clearance Transfer Request, LIC 9182 (Rev. 4/02). This requirement is not met as evidenced by: Based on record review, Licensee did not comply with the regulation cited above. LPA observed S1 is fingerprint cleared. However, not associated to the facility which poses a potential health and safety risk to resdients in care.

Official plan of correction

POC cleared during visit. Administrator faxed LIC 9182 and a copy of identifcation and provided LPA a copy. DEFICIENCY CLEARED DURING VISIT.

Deadline recorded: Dec 29, 2021. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

1569.17(c)(3)

Regulation authority

HSC

What the official deficiency says

1569.17(c)(3) Fingerprints and criminal records.. (3)…If the State Department of Social Services determines, on the basis of the fingerprint images submitted to the Department of Justice, that the person has been convicted of a sex offense against a minor…. the receipt of the notification from the Department of Justice to act immediately to terminate the person’s employment, remove the person from the residential care facility for the elderly….” This requirement is not met as evidenced by: Based on evidence obtained during the course of this investigation, Licensee did not comply with the regulation cited above. The Department observed RSO present at the facility on 12/21/2021 which poses an immediate health and safety risk to persons in care.

Official plan of correction

Administrator will review regulation and submit a self certification letter of understanding to CCL by POC date. AN IMMEDIATE $500 CIVIL PENALTY IS BEING ASSESSED.

Deadline recorded: Dec 28, 2021. A deadline is not proof that correction was completed.