CARE 4 ONE II

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 record review, the licensee did not comply with the section cited above as multiple documents are missing from resident files, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/13/2026 Plan of Correction On or before plan of correction due date, Licensee will email CCLD copies of the missing documents from resident files which includes but is not limited to: updated Appraisal Needs And Services Plans (LIC625), signed Consent For Emergency Medical Treatment (LIC627C), signed Personal Rights (LIC613C), signed Inventory List.

Official classification

Type B

Official code

1531.2(7)

Regulation authority

HSC

What the official deficiency says

1531.2(7) Emergency fire and earthquake drills shall be conducted at least once every three months, or more frequently as required by a county or city fire department or local fire prevention district. The drills shall include all facility staff and volunteers providing client care and supervision. This requirement is not met as evidenced by: Based on interviews and file review, the licensee did not comply with the section cited above by not having emergency fire and earthquake drills at least once every three months for the residents in care which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator agreed to read health and safety code1531.2(7), conduct training at least once every three months and email CCLD names of staff participants with signatures by POC date.

Deadline recorded: Oct 15, 2025. A deadline is not proof that correction was completed.

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: Based on interviews and record review, the licensee did not comply with the section cited above by not having planned activities that maintain and develop quality of life for the residents in care which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator agreed to create a planned activity calendar with activities that will develop quality of life for residents in care and email photos of monthly activities to CCLD by POC date.

Deadline recorded: Oct 15, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87618(b)(3)(B)

Regulation authority

CCR

What the official deficiency says

(3) Ensuring that the use of oxygen equipment meets the following requirements: (B) “No Smoking-Oxygen in Use” signs shall be posted in the appropriate areas. 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 Oxygen in Use signs posted which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/22/2024 Plan of Correction The facility agrees to post signs stating “No Smoking-Oxygen in Use” on residents door and on the facility front door. Proof of correction will be sent to CCLD by POC date.

Official classification

Type B

Official code

87309(a)(1)

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. (1) Storage areas for poisons, and firearms and other dangerous weapons shall be locked. 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 container of break fluid out in the yard which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/19/2024 Plan of Correction Cleared during visit.

Official classification

Type B

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 the admissions agreement for all of the residents which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/26/2024 Plan of Correction The facility will get signed admissions agreements for each resident. Proof of correction will be sent to CCLD by POC date.