DEER RIDGE COUNTRY VILLA

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 cleaners and disinfectants inaccessible to residents which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/26/2026 Plan of Correction Caregiver locked kitchen cabinet with cleaners and disinfectants immediately. Deficiency cleared during visit.

Official classification

Type B

Official code

87633(b)

Regulation authority

CCR

What the official deficiency says

(b) A current and complete hospice care plan shall be maintained in the facility for each hospice resident and include 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 in having a hospice care plan on file for three residents which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/04/2026 Plan of Correction Administrator agreed to obtain hospice care plan for R6 and submit to CCLD by POC date. House Manager obtained hospice plans for R1 and R4 during visit.

Official classification

Type A

Official code

87465(c)(2)

Regulation authority

CCR

What the official deficiency says

c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: (2) Once ordered by the physician the medication is given according to the physician's directions. This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above by not having R1's prescribed medications administered as directed by physician which poses an immediate health and safety risk to persons in care.

Official plan of correction

Administrator will send CCLD an email of a plan to implement ongoing staff training regarding administering medication by POC date.

Deadline recorded: Aug 13, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.2(a)

Regulation authority

CCR

What the official deficiency says

87468.2 (a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all the following personal rights: This requirement was not met as evidence by: Based on observation, the licensee did not comply with the section cited above by having a camera with audio and recording capabilities in R1's room which poses a potential personal rights risk to persons in care.

Official plan of correction

Staff immediately removed the camera with audio and recording capabilities during visit. Deficiency cleared.

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

Official classification

Type B

Official code

87211(a)(1)(B)

Regulation authority

CCR

What the official deficiency says

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. (B) Any serious injury as determined by the attending physician and occurring while the resident is under facility supervision. This requirement is not met as evidenced by:

Official plan of correction

Administrator agreed to send Incident Reports to CCLD . Adminstrator aslo agreed to send a self certifying email to advise have read the regulation to CCLD by POC date

Deadline recorded: Sep 10, 2024. A deadline is not proof that correction was completed.

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 observation, the licensee did not comply with the section cited above in not having the follwing documents in residents records appraisal needs and service plans(ANS),Physician Reports (MA), Consent Forms(CF),Emergency Identification(ID)and Personal Rights.which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 04/08/2024 Plan of Correction

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 in staff failed to lock disinfectant and sharp objects such as knives and scissors, which were accessible to residents in care, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/21/2023 Plan of Correction Staff locked the disinfectant , knives and scissors. Cleared and corrected during the visit.

Official classification

Type B

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

(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 in licensee failed to regulate hot water at the two bathroom sink, LPA observed 138F temperature, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/21/2023 Plan of Correction Corrected during visit. Administrator adjusted the hot water temperature. LPA measured the water, reading was 122F.

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 licensee failed to regulate tap water at maximum 125F, LPA observed tap water ranging 135-138F which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/21/2023 Plan of Correction Corrected during visit. Administrator adjusted the hot water temperature, LPA measured the water, reading was 122F.