DESIRED PEACE HOME CARE 2

Official classification

Type B

Official code

87211(a)

Regulation authority

CCR

What the official deficiency says

(a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: This requirement is not met as evidence by: Based on interviews and record review, licensee did not comply with section cited above by not submitting incident reports and hospice notification to CCLD which poses a potential health and safety risk to the persons in care.

Official plan of correction

Administrator agreed to read 87211(a) and send a self certifying email to CCLD by POC date.

Deadline recorded: Aug 28, 2025. A deadline is not proof that correction was completed.

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: Based on observation, the licensee did not comply with the section cited above by having full bed rails for residents who are not on hospice care which poses an immediate health and safety risk to persons in care.

Official plan of correction

Administrator has agreed to remove full bed rails for the two residents and submit picture proof to CCLD by POC date. During LPA's visit R4's bed rail was changed to half rail.

Deadline recorded: May 12, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

Not listed

Regulation authority

Not listed

What the official deficiency says

Care of Persons with Dementia (f) The following shall be stored inaccessible to residents with dementia: (2) Over-the-counter medication, nutritional supplements or vitamins, alcohol, cigarettes, and toxic substances such as certain plants, gardening supplies, cleaning supplies and disinfectants. This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above in staff failed to ensure all poisonous products like garden fertilizer are inaccessible to residents in care, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator agreed to conduct in-service for all staff regarding the regulation cited. Admiinistrator will send copy of training topics, names and signature of staff by 9/26/2022.

Deadline recorded: Sep 21, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87465(d)(3)

Regulation authority

CCR

What the official deficiency says

Incidental Medical and Dental Care (d) If the resident is unable to determine his/her own need for a prescription or nonprescription PRN medication, and is unable to 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: (3) The date and time the PRN medication was taken, the dosage taken, and the resident's response shall be documented and maintained in the resident's facility record. This requirement was not met as evidenced by: Based on observation and records review licensee failed to maintain medication administration record form for all residents in care which poses/posed a potential health, safety risk to persons in care.

Official plan of correction

Administrator/licensee agreed to start using Medication administration form for all residents in care, LPA requested not to back date the records (administrator agreed), a copy of medication adminstration record (MAR) is needed to be submitted on POC date.

Deadline recorded: Aug 15, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87411(d)(5)

Regulation authority

CCR

What the official deficiency says

(d) All personnel shall be given on the job training or have related experience in the job assigned to them. This training and/or related experience shall provide knowledge of and skill in the following, as appropriate for the job assigned and as evidenced by safe and effective job performance: (5) Knowledge necessary in order to recognize early signs of illness and the need for professional help. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview , the licensee did not comply with the facility has NOT conducted staff training on infection prevention, symptoms, transmission and PPE use in which poses/posed a potential health, safety risk to persons in care.

Official plan of correction

POC Due Date: 10/08/2021 Plan of Correction Administrator will train all staff on infection prevention, symptoms, transmission and PPE use, proof of training is needs to be submitted to LPA via email on POC date.