QCARE RESIDENTIAL FACILITY II

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...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: Based on observations, the licensee did not comply with the section cited above by having scissors, mallet, and multi-tool keychain unlocked which poses an immediate safety risk to persons in care.

Official plan of correction

Deficiency cleared during the visit.

Deadline recorded: Jan 23, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87705(f)(2)

Regulation authority

CCR

What the official deficiency says

(f) ... (2) The licensee shall ensure that the fire clearance includes approval of locked exterior doors or perimeter fence gates and that facility staff on all shifts have access to, and know how to use, equipment needed to unlock exterior doors or perimeter fence gates. This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above in having a bolt locking the side gate latch in the backyard which poses an immediate health and safety to persons in care.

Official plan of correction

Staff removed the bolt from the side gate. Staff will have an in-service training and send proof to CCLD by POC date.

Deadline recorded: Jan 23, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

(2)...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 degree C) and not more than 120 degree F (49 degree C). This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above by having the hot water temperature measured at 127.6 degrees Fahrenehit which poses an immediate safety risk to persons in care.

Official plan of correction

Staff agrees to have the water measured within range and send proof to CCLD by POC date.

Deadline recorded: Jan 23, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

(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 due to having medications not stored in a locked container in the fridge of the kitchen, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/12/2025 Plan of Correction Administrator will add a locked storage container in the fridge and submit proof to the LPA on or before POC date.

Official classification

Type B

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, including nails protruding from the backyard shed, ladders strewn in the backyard, screen doors having patches that need to be repaired, and one of the gate doors in the backyard not opening all the way which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/18/2025 Plan of Correction Administrator will send pictures to LPA to prove these issues were corrected and fixed on or before the POC date.

Official classification

Type A

Official code

87705(f)(2)

Regulation authority

CCR

What the official deficiency says

(f) Licensees that lock exterior doors or perimeter fence gates shall meet the following initial and continuing requirements: (2) The licensee shall ensure that the fire clearance includes approval of locked exterior doors or perimeter fence gates and that facility staff on all shifts have access to, and know how to use, equipment needed to unlock exterior doors or perimeter fence gates. 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 child locks on the backyard gates along with a locking latch on the top of the front door, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/12/2025 Plan of Correction Administrator will submit photo proof to LPA on or before POC date that these locks were removed. In addition, an immiedate civil penalty of $500 was issued.

Official classification

Type B

Official code

1569.695(c)

Regulation authority

HSC

What the official deficiency says

(c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of residents is not required during a drill. While a facility may provide an opportunity for residents to participate in a drill, it shall not require any resident participation. Documentation of the drills shall include the date, the type of emergency covered by the drill, and the names of staff participating in the drill. 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 in that the administrator stated that fire drills have not been conducted in the last two years which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/18/2025 Plan of Correction On or before POC date, administrator will run an emergency drill for this quarter and submit documentation to LPA.

Official classification

Type A

Official code

87465(h)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: 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 medication left inside residents’ rooms unlock which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/11/2024 Plan of Correction Administrator agree to remove and lock up all medication. Administrator will submit photo to CCLD by CLD date.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

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 due to resident shared bathroom drawer is broken which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/30/2024 Plan of Correction Administrator agree to fix the broken drawer in the residents share bathroom. Administrator will send photo to CCLD by POC date.

Official classification

Type B

Official code

87412(a)(6)(A)

Regulation authority

CCR

What the official deficiency says

(A) For administrators this shall include verification that he/she meets the educational requirements in Section 87405(d) through (g). 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 conducted staff files reviewed training is incomplete which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/30/2024 Plan of Correction Administrator agree to provide a plan on staff training, and provide proof of completion to CCLD by POC date.

Official classification

Type B

Official code

87465(e)

Regulation authority

CCR

What the official deficiency says

(e) For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician on a prescription blank, maintained in the resident's file, and a label on the medication. Both the physician's order and the label shall contain at least all of 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 residents central medication list/PRN medication do not have a label on the medication which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/20/2024 Plan of Correction Administrator agree to get all the PRN medication lable and match with central medication order. Adminstrator will submit photo of each PRN with a label to CCLD by POC date.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

Maintenance and Operation 87303(a) (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 chairs, wood, cabinets, toilet top, CD holder, ladder, table leaf, shovel, rake, oxygen tank, bed frames, washer and dryer and night stand which poses a potential health, safety risk to persons in care.

Official plan of correction

POC Due Date: 09/28/2022 Plan of Correction Administrator will remove building materials, chairs, wood, cabinets, toilet top, CD holder, ladder, table leaf, shovel, rake, oxygen tank, bed frames, washer and dryer and night stand from the backyard into storage and/or dumpster and will provide pictures to CCL no later than the POC date.

Official classification

Type B

Official code

87305(a)

Regulation authority

CCR

What the official deficiency says

Alterations to Existing Building or New Facilities (a) Prior to construction or alterations, all facilities shall obtain a building permit. 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 alliterating an existing building which poses a potential health and safety or personal risk to persons in care.

Official plan of correction

POC Due Date: 09/28/2022 Plan of Correction Administrator will submit approved permit from the local county department along with a new facility sketch to CCL no later than the POC date.

Official classification

Type B

Official code

87468.1(1)

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: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement was not met as evidenced by the unauthorized recorded video of R1 which posed a potential health & safety risk to residents in care.

Official plan of correction

By POC due date, Administrator agreed to complete and submit to CCLD a copy of staff retraining certification by an approved CCLD vendor on residents’ personal rights.

Deadline recorded: Aug 26, 2022. A deadline is not proof that correction was completed.