HM LOVE & CARE HOME

Official classification

Type A

Official code

87465(h)(1)(C)

Regulation authority

CCR

What the official deficiency says

87465 Incidental Medical and Dental Care: (h) ...: (1) Medications shall be centrally stored under the following circumstances: (C) Because of potential dangers related to the medication itself, or due to physical arrangements in the facility and the condition or the habits of other persons in the...... ..facility, the medications are determined by either a physician, the administrator, or Department to be a safety hazard to others. -This requirement is not met as evidenced by: -Based on observation, the licensee did not comply with the section above in R1's medications in the dining table which pose an immediate risks to persons in care.

Official plan of correction

Staff removed the medications. In addition, licensee-administrator stated she'll buy and provide a lock box to R1. Proof to be submitted by 5/06/26.

Deadline recorded: May 6, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87303(f)(2)

Regulation authority

CCR

What the official deficiency says

87303 Maintenance and Operation (f) All waste shall be located, stored, and disposed of in a manner that will not transmit communicable diseases...... (2) Syringes and needles are disposed of in accordance with the California Code of Regulations, Title 8, Section 5193...... -This requirement is not met as evidenced by: -Based on observation, the licensee did not comply with the section above in used lancets in the dining table and used syringes and other lancets in unlocked cabinet which pose an immediate risks to persons in care.

Official plan of correction

Licensee-administrator took all the items and stated she will properly disposed them. In addition, licensee-administrator to in-service the staff and submit copy of training topic with attendees signatures by 5/06/26.

Deadline recorded: May 6, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87307(a)

Regulation authority

CCR

What the official deficiency says

87307 Personal Accommodations and Services (a) Living accommodations and grounds shall be related to the facility's function. ........ -This requirement is not met as evidenced by: -Based on observation and interview, the licensee did not comply with the section above in having R1's personal and confidential documents and medications stacked in the dining table which pose a potential personal rights risks to persons in care.

Official plan of correction

Staff removed the medications. In addition, licensee-administrator will put cabinet/drawer in the resident's room and have all the items in the dining table transfered. Pictures to be submitted by 5/20/26.

Deadline recorded: May 20, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.618(c)

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: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview and record review, the licensee did not comply with the section cited above by not employing an administrator to carry out their responsibilities of which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/23/2025 Plan of Correction Licensee to provide the required documents to change administrator on record by POC date.

Official classification

Type B

Official code

87412(a)

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: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview and record review, the licensee did not comply with the section cited above by not ensuring that all personnel records maintained proof of a Health Screening, TB testing, and Training which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/23/2025 Plan of Correction Licensee to provide proof of the required documents and review the regulation by the POC date.

Official classification

Type B

Official code

1569.625(b)(2)

Regulation authority

HSC

What the official deficiency says

(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview and record review, the licensee did not comply with the section cited above by not providing required training to all staff which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/23/2025 Plan of Correction Licensee to provide the required documents to change administrator on record by POC date.

Official classification

Type B

Official code

87468(c)(2)(A)

Regulation authority

CCR

What the official deficiency says

(c) Licensees shall prominently post personal rights, nondiscrimination notice, and complaint information in areas accessible to residents, representatives, and the public. (2) Information on the appropriate reporting agency in case of a complaint or emergency, including procedures for filing confidential complaints, shall be posted as follows: (A) Licensees may use the Residential Care Facility for the Elderly (RCFE) Complaint Poster (PUB 475) or may develop their own poster as provided in this section. A poster developed by the licensee shall contain the same content as the PUB 475. The poster that is posted shall be 20” x 26” in size and be posted in the main entryway of the facility. PUB 475 may be accessed, downloaded, and printed from the www.ccld.ca.gov website. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview and record review, the licensee did not comply with the section cited above by not posting the required poster which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/23/2025 Plan of Correction Licensee to post the required poster by the POC date.

Official classification

Type B

Official code

87463(h)(1)

Regulation authority

CCR

What the official deficiency says

(h) The licensee shall request that all residents receive an annual routine visit with a licensed medical professional once every twelve months, either in person or by video appointment. (1) Documentation of the annual routine visit, such as a visit summary, shall be added to the resident's record. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview and record review, the licensee did not comply with the section cited above by not conducting an annual reappraisal for all residents which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/23/2025 Plan of Correction Licensee to conduct an annual reappraisal for all residents by the POC date.

Official classification

Type A

Official code

87405(a)

Regulation authority

CCR

What the official deficiency says

(a) All facilities shall have a qualified and currently certified administrator. The administrator shall have sufficient freedom from other responsibilities and shall be on the premises a sufficient number of hours... When the administrator is not in the facility, there shall be coverage by a designated substitute... This requirement was not met as evidence by: Based on observation the Licensee did not comply with the section cited above in having a qualified and certified administrator, which poses a potential health and safety risk to persons in care.

Official plan of correction

Licensee agreed to implement a plan to hire a new administrator and submit plan to CCLD by POC date.

Deadline recorded: Nov 2, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87307(a)(3)

Regulation authority

CCR

What the official deficiency says

(a) Living accommodations... shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents... who may reside in the facility. (3) Equipment and supplies necessary for personal care... shall be readily available to each resident. ...the licensee shall assure provision of: (B) Bedroom furniture... a chair, night stand, a lamp, or lights sufficient for reading, and a chest of drawers. This requirement was not met as evidence by: Based on observation the Licensee did not comply with the section cited above in having a chest of drawers for R1, which poses a potential health and safety risk to persons in care.

Official plan of correction

Licensee agreed to purchase a chest of drawers for R1 and submit a photo to CCLD by POC date.

Deadline recorded: Nov 8, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87307(a)(3)(C)

Regulation authority

CCR

What the official deficiency says

(a) Living accommodations... should be related to the facility's function... (3) ...supplies necessary for personal care and maintenance of adequate hygiene... the licensee shall assure provision of: (C) Clean linen... top bed sheets, bottom bed sheets, pillow cases, mattress pads, bath towels... The quantity shall be sufficient to permit changing at least once per week... The linen shall be in good repair. This requirement was not met as evidence by: Based on observation the Licensee did not comply with the section cited above in having sufficient quantity of linen, which poses a potential health and safety risk for persons in care.

Official plan of correction

Licensee agreed to purchase linen and submit photos and receipts to CCLD by POC date.

Deadline recorded: Nov 8, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87464(f)(4)

Regulation authority

CCR

What the official deficiency says

(f) Basic services shall at a minimum include: (4) Personal assistance and care as needed by the resident and as indicated in the pre-admission appraisal, with those activities of daily living such as dressing, eating, bathing and assistance with taking prescribed medications, as specified in Section 87608, Postural Supports Based on interviews and observation the Licensee did not comply with the section cited above in assisting resident with personal grooming, which poses a potential health and safety risk to persons in care.

Official plan of correction

Licensee agreed to keep a log or notes of bathing and grooming schedule and submit a 2-week copy to CCLD.

Deadline recorded: Nov 15, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87412(a)

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: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview and record review, the licensee did not comply with the section cited above in 3 out of 3 staff files not being completed and updated with training, health screenings and personal rights forms which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/03/2024 Plan of Correction Licensee to review and update all staff files with CCLD forms and self certify by POC date of 09/03/24.

Official classification

Type B

Official code

87412(d)

Regulation authority

CCR

What the official deficiency says

(d) The licensee shall maintain documentation that an administrator has met the certification requirements specified in Section 87406, Administrator Certification Requirements or the recertification requirements in Section 87407, Administrator Recertification Requirements. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview and record review, the licensee did not comply with the section cited above by administrator not completing off of the certification requirements as an Administrator which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/03/2024 Plan of Correction Licensee to review regulations for all Administrator recertification requirements, apply and pay for the application, and submit proof to CCLD by the POC date of 09/03/24.

Official classification

Type B

Official code

1569.69(a)(2)

Regulation authority

HSC

What the official deficiency says

(a) Each residential care facility for the elderly licensed under this chapter shall ensure that each employee of the facility who assists residents with the self-administration of medications meets all of the following training requirements: (2) In facilities licensed to provide care for 15 or fewer persons, the employee shall complete 10 hours of initial training. This training shall consist of 6 hours of hands-on shadowing training, which shall be completed prior to assisting with the self-administration of medications, and 4 hours of other training or instruction, as described in subdivision (f), which shall be completed within the first two weeks of employment. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview and record review, the licensee did not comply with the section cited above in 1 out of 3 reviewed staff files not possessing proof of required training which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/03/2024 Plan of Correction Licensee to review and update all staff files for required training and send a copy to CCLD by the POC date of 09/03/24.

Official classification

Type A

Official code

87411(a)

Regulation authority

CCR

What the official deficiency says

(a) Facility personnel shall at all times be sufficient in numbers... to provide the services necessary to meet resident needs... The licensing agency may require any facility to provide additional staff whenever it determines... This requirement was not met as evidence by: Based on observation and interview the Licensee did not comply with the section cited above in having staff present at the facility, which poses a potential health and safety risk to persons in care.

Official plan of correction

Licensee arrived at 2:55pm, 10 minutes after LPAs arrived. Deficiency cleared during visit.

Deadline recorded: Apr 13, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87506(d)

Regulation authority

CCR

What the official deficiency says

87506 Resident Records (d) All resident records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours... This requirement was not met as evidence by: Based on observation the Licensee did not comply with the section cited above in having R1's file available for review on premises, which poses a potential health and safety risk to persons in care.

Official plan of correction

Licensee agreed to review regulation 87506 and submit self-certification that the regulation has been reviewed and will be abided by going forward to CCLD by POC date.

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

Official classification

Type A

Official code

87355(d)(3)

Regulation authority

CCR

What the official deficiency says

(3) The licensee shall submit these fingerprints to the California Department of Justice, along with a second set of fingerprints for the purpose of searching the records of the Federal Bureau of Investigation, or comply with Section 87355(c), prior to the individual's employment, residence, or initial presence in the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interviews and record review, the licensee did not comply with the section cited above in 1 out of 3 persons, the Care Staff was not associated to the facility and did not have criminal record clearance which posed an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/02/2023 Plan of Correction Care staff was escorted out of the facility by Co-Administrator on 08/02/23 around 10:30 AM.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

The facility shall be...safe...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 in 1 out of 12 lower kitchen drawers did not have a panle and was in direpair which poses a safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/16/2023 Plan of Correction Licensee to review regulation, inform staff, self-certify, and provide a photo to CCLD on or before 08/16/23.