BERMUDA RESIDENTIAL CARE HOME

Official classification

Type B

Official code

87468.1(a)(8)

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: To have their representatives regularly informed by the licensee of activities related to care or services, including ongoing evaluations, as appropriate to their needs. This requirement was not met as evidenced by: Based on interviews and observations the facility did not communicate R1's change of condition with family

Official plan of correction

The facility agrees to review the regulation and create a plan of communication for informing families of residents change of condition and submit it to CCLD by POC date.

Deadline recorded: Sep 11, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. 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 a fence that has fallen over between the driveway and the backyard which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/07/2025 Plan of Correction By POC date the Licensee agrees to submit a timeline of when the fence will be replaced. Additionally the Licensee agrees to send a photo of the repaired fence to CCLD.

Official classification

Type A

Official code

87506(b)(15)

Regulation authority

CCR

What the official deficiency says

(b) Each resident's record shall contain at least the following information: (15) The admission agreement and pre-admission appraisal, specified in Sections 87507, Admission Agreements and 87457, Pre-admission Appraisal. 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 an admissions agrement in 4 out of 6 resident files which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/07/2025 Plan of Correction The Licensee agrees put in signed resident agreements in to all resident files. Proof of Correction will be sent to CCLD by POC date.

Official classification

Type B

Official code

87412(a)(11)

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: (11) A health screening as specified in Section 87411, Personnel Requirements - General. 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 a health screening for 2 of 2 staff records that were reviewed which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/18/2025 Plan of Correction The licensee agrees to get a completed LIC 503 for any staff member that does not have one. Proof of Correction will be sent to CCLD by POC date.

Official classification

Type B

Official code

87555(b)(26)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements 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 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 by not having a one week supplies of nonperishable foods which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/18/2025 Plan of Correction Licensee agrees to purchase a one week supply of nonperishable foods. Proof of correction will be sent to CCLD by POC date.

Official classification

Type B

Official code

87506(b)(16)

Regulation authority

CCR

What the official deficiency says

(b) Each resident's record shall contain at least the following information: (16) Records of resident's cash resources as specified in Section 87217, Safeguards for Resident Cash, Personal Property, and Valuables. 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 a Personal Property, and Valuables list in 3 out of 6 resident files which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/18/2025 Plan of Correction The Licensee agrees put in signed Personal Property, and Valuables list in to all resident files. Proof of Correction will be sent to CCLD by POC date.

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 by not having an updated appraisal in 6 out of 6 resident files which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/18/2025 Plan of Correction The Licensee agrees put in an updated apprasial needs and servies plan in to all resident files. Proof of Correction will be sent to CCLD by POC date.

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 record review, the licensee did not comply with the section cited above by not having R2's hospice care plan at the facility which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/11/2025 Plan of Correction The Licensee agrees have a completed hospice care plan in R2's file. Proof of Correction will be sent to CCLD by POC date.

Official classification

Type B

Official code

87211(a)(1)

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: (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. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview, the licensee did not comply with the section cited above by not submittig incident reports for residents which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/18/2025 Plan of Correction The Licensee agrees to review the regulation and submitt a self certified letter of understanding. Proof of Correction will be sent to CCLD by POC date

Official classification

Type A

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 hot water temperature which measured at 131.5 deg F which posed an immediate Health & Safety risk to residents in care.

Official plan of correction

POC Due Date: 06/27/2022 Plan of Correction The facility will adjust the water heater and photo will be sent to CCLD by POC date.

Official classification

Type B

Official code

87202(a)

Regulation authority

CCR

What the official deficiency says

(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: 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 a fire extinguisher service tags dated 10/28/2019, which poses a potential health & safety risk to residents in care.

Official plan of correction

POC Due Date: 06/27/2022 Plan of Correction Administrator will either have fire extinguisher serviced or purchase a new fire extinguisher and tape receipt to fire extinguisher. A photo will be sent to CCLD by POC date.