CALIFORNIA SUNSHINE RCFE

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 by having unlocked knives, cleaning supplies, and unlocked gardening which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 05/21/2025 Plan of Correction Manager locked up the items during inspection. Deficiency cleared. Civil penalty of $250 is being assessed for a repeat violation.

Official classification

Type B

Official code

87411(f)

Regulation authority

CCR

What the official deficiency says

(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure. A report shall be made of each screening, signed by the examining physician. The report shall indicate whether the person is physically qualified to perform the duties to be assigned, and whether he/she has any health condition that would create a hazard to him/herself, other staff members or residents. A signed statement shall be obtained from each volunteer affirming that he/she is in good health.Personnel with evidence of physical illness or emotional instability that poses a significant threat to the well-being of residents shall be relieved of their duties. 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 health screening and TB test which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 06/13/2025 Plan of Correction Facility agreed to obtain health screening for S2 and S3, and TB test for S2. Facility will submit documents to CCLD by POC date.

Official classification

Type B

Official code

1569.618(c)(3)

Regulation authority

HSC

What the official deficiency says

(c)The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staff to provide CPR. 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 current CPR and First Aid training for staff which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 06/13/2025 Plan of Correction Facility has agreed to obtain current CPR and First Aid training for S2 and S3. Facility will submit documents to CCLD by POC date.

Official classification

Type B

Official code

87458(a)

Regulation authority

CCR

What the official deficiency says

(a) Prior to a person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment, signed by a licensed medical professional acting within the scope of their practice and made within the last year, to be kept in the resident's record. 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 medical assessment and TB test for R2 which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 06/13/2025 Plan of Correction Facility has agreed to obtain medical assessment and TB test for R2. Facility will submit documents to CCLD by POC date.

Official classification

Type B

Official code

87467(a)(3)

Regulation authority

CCR

What the official deficiency says

(a) Prior to, or within two weeks of the resident's admission, the licensee shall arrange a meeting with the resident, the resident's representative, if any, appropriate facility staff, and a representative of the resident's home health agency, if any, and any other appropriate parties, to prepare a written record of the care the resident will receive in the facility, and the resident's preferences regarding the services provided at the facility. (3) The licensee shall arrange a meeting with the resident and appropriate individuals identified in Section 87467(a)(1) to review and revise the written record as specified, when there is a significant change in the resident's condition, or once every 12 months, whichever occurs first. Significant changes shall include, but not be limited to occurrences specified in Section 87463, Reappraisals. 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 current reappraisal needs and service plans for residents which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 06/13/2025 Plan of Correction Facility has agreed to obtain current needs and service plans for R1 and R2. Facility will submit the documents to CCLD by POC date.

Official classification

Type B

Official code

87507(d)

Regulation authority

CCR

What the official deficiency says

(d) The licensee shall retain in the resident's file the original signed and dated admission agreement and all subsequent signed and dated modifications. This does not apply to rate increases which have specific notification requirements as specified in Health and Safety Code section 1569.655. 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 admission agreement for R1 which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 06/13/2025 Plan of Correction Facility agreed to obtain R1's admission agreement and submit a copy to CCLD by POC date.

Official classification

Type B

Official code

87458(b)

Regulation authority

CCR

What the official deficiency says

(b) The licensee shall obtain an updated medical assessment when required by the Department. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview and record review, the licensee did not comply with the section cited above by not having an updated medical assessment for R1 with current ambulatory status which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 06/13/2025 Plan of Correction Facility agreed to obtain an updated medical assessment for R1 with current ambulatory status and submit a copy to CCLD by POC date.

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 having cleaning solutions such as windex and pine sol in an unlocked cabinet in common bathroom and fabuloso antibacterial multi purpose cleaner on counter near sink which poses an immediate health, in a safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/13/2024 Plan of Correction Administrator removed the cleaning solutions and placed in a locked cabinet during visit. Deficiency cleared

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

87465 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 in having medications in an unlocked cabinet located in the kitchen which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/13/2024 Plan of Correction Staff immediately locked cabinet with medication during visit. Deficiency cleared.

Official classification

Type B

Official code

87307(e)

Regulation authority

CCR

What the official deficiency says

(e) Facilities providing services to residents who have physical or mental disabilities shall assure the inaccessibility of fishponds, wading pools, hot tubs, swimming pools or similar bodies of water, when not in active use by residents, through fencing, covering or other means. 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 an unsecured lock around the fence of the pool which poses a potential health, safety risk to persons in care.

Official plan of correction

POC Due Date: 06/19/2024 Plan of Correction Administrator agreed to purchase a secure lock and provide photos to CCLD by POC date.

Official classification

Type B

Official code

87608(a)(5)(A)

Regulation authority

CCR

What the official deficiency says

(A) A bed rail that extends from the head half the length of the bed and used only for assistance with mobility shall be allowed. 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 medical bed in Resident's room#2 that extends from the head half the length of the bed without a medical order or order summary which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/19/2024 Plan of Correction Administrator agreed to provide an email of the order summary and or Physician orders for medical bed for resident in room#2 to CLLD by POC date

Official classification

Type B

Official code

87506(a)

Regulation authority

CCR

What the official deficiency says

87506(a) 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 have completed resident files for R1, R2, R3 and R4 which poses/posed a potential health, safety or personal rights risk to persons in care. R1, R2 and R3 files are missing LIC 601, and LIC 603A. R4 file was observed to be empty and did not obtain the required forms.

Official plan of correction

POC Due Date: 05/01/2023 Plan of Correction Administrator will complete the required LIC forms, place them in the resident files and provide a photographic proof to CCL by POC date.

Official classification

Type B

Official code

87468.2(a)(4)

Regulation authority

CCR

What the official deficiency says

Residents in all residential care facilities for the elderly shall have all of the following personal rights: (4) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement was not met as evidenced by resident sustaining unexplained injury which posed a potential health & safety risk to residents in care.

Official plan of correction

By POC due date, Administrator agrees to submit to CCLD completed in-service staff retraining on residents’ personal rights as specified under Title 22 regulation Section 87468.2. Administrator will submit to CCLD copy of completed staff retraining.

Deadline recorded: May 20, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87705(b)(1)

Regulation authority

CCR

What the official deficiency says

The plan of operation shall address the needs of residents with dementia, including: (1) Procedures for notifying the resident’s physician, family members and responsible persons who have requested notification, and conservator, if any, when a resident’s behavior or condition changes This requirement was not met as evidenced by staff failing to seek medical attention for resident's fall which posed a potential health & safety risk to residents in care.

Official plan of correction

By POC due date, administrator agrees to conduct in-service staff retraining on timely addressing residents’ medical needs. Administrator agrees to submit completed staff retraining certifications to CCLD

Deadline recorded: May 20, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87705(b)(2)

Regulation authority

CCR

What the official deficiency says

The plan of operation shall address the needs of residents with dementia, including: (2) Safety measures to address behaviors such as wandering, aggressive behavior and ingestion of toxic materials. This requirement was not met as evidenced by resident sustaining several falls which posed a potential health & safety risk to residents in care.

Official plan of correction

By POC due date, Administrator agrees to submit to CCLD completed in-service staff retraining on proper supervision and care of residents. Administrator will submit to CCLD copy of completed staff retraining.

Deadline recorded: May 20, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)(1)

Regulation authority

CCR

What the official deficiency says

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 requirement was not met as evidenced by staff not reporting incidents to the licensing office which posed a potential health & safety risk to residents in care.

Official plan of correction

By POC due date, Administrator agrees to submit to CCLD completed in-service staff retraining on reporting requirements as specified under Title 22 regulation Section 87211. Administrator will submit to CCLD copy of completed staff retraining.

Deadline recorded: May 20, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.1(a)(2)

Regulation authority

CCR

What the official deficiency says

Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement was not met as evidenced by fecal smears on resident's wall which posed a potential health & safety risk to residents in care.

Official plan of correction

By POC due date, Administrator agrees to submit to CCLD completed in-service staff retraining on residents’ personal rights as specified under Title 22 regulation Section 87468.1. Administrator will submit to CCLD copy of completed staff retraining .

Deadline recorded: May 20, 2022. A deadline is not proof that correction was completed.