DYSICO CARE HOME, RCFE

Official classification

Type B

Official code

87463(a)

Regulation authority

CCR

What the official deficiency says

87463(a) Reappraisals (a) The pre-admission appraisal, as specified in Section 87457...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...keep the appraisal accurate.... Based on records review, the licensee did not comply with the section cited above in by not having an Appraisl Needs and Services on file for R1 which pose a potential health, safety and/or personal rights risks to persons in care.

Official plan of correction

Administrator agreed to complete an Appraisal Needs and Services and submit to CCLD by POC due date.

Deadline recorded: Jul 27, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87633(b)

Regulation authority

CCR

What the official deficiency says

87633 (b) Hospice Care of Terminally Ill Residents (b) A current and complete hospice care plan shall be maintained in the facility for each hospice resident and include the following: Based on records review, the licensee did not comply with the section cited above in by not having an hospice care plan on file for R1 which pose a potential health, safety and/or personal rights risks to persons in care.

Official plan of correction

Administrator agreed to submit an hospice care plan to CCLD by POC due date.

Deadline recorded: Jul 27, 2026. A deadline is not proof that correction was completed.

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 interview and record review, the licensee did not comply with the section cited above in by not having CPR training for S1-S3 which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 10/25/2024 Plan of Correction Administrator agreed to submit CPR training for S1-S3 to CCLD by POC due 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 record review, the licensee did not comply with the section cited above in by not having 20hrs annual training for S2 and S3 which poses a potential health, and safety risk to persons in care.

Official plan of correction

POC Due Date: 11/01/2024 Plan of Correction Administrator agreed to submit completed training certificates for S2 and S3 to CCLD by POC due 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 and record review, the licensee did not comply with the section cited above in by not having a doctor's order on file for R5 half-rail hospital bed which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/01/2024 Plan of Correction Administrator agreed to submit a doctor's order for R5's 1/2 rail hospital bed for mobility, postural support and submit to CCLD by POC due date.

Official classification

Type B

Official code

87618(b)(3)(A)

Regulation authority

CCR

What the official deficiency says

(3) Ensuring that the use of oxygen equipment meets the following requirements: (A) A report shall be made in writing to the local fire jurisdiction that oxygen is in use at the facility. 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 in by not notifying local fire dept in writing that oxygen is in use in bedroom #3/R4 which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 10/25/2024 Plan of Correction Administrator agreed to submit a copy of letter sent to local fire department and to place a copy of letter in R4's file to CCLD by POC due date.

Official classification

Type B

Official code

87623(b)(2)

Regulation authority

CCR

What the official deficiency says

87623 Indwelling Urinary Catheter (b) In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for the following: (2) Ensuring that the bag and tubing are changed by an appropriately skilled professional should the resident require assistance. 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 in by having documentation on file for R1's foley catheter which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 11/01/2024 Plan of Correction Administrator agree to submit an exception request letter with supporting documents: Physician's Report, Doctor's Order, Appraisal Needs and Services that outlines in detail who is caring for the catheter and what care is the staff provided with the catheter. In addition, what training has the staff had and who was the licensed health professional that conducted the training. All documents should be submitted to CCLD by POC due date.

Official classification

Type A

Official code

87705(f)(1)

Regulation authority

CCR

What the official deficiency says

87705 Care of Persons with Dementia (f) The following shall be stored inaccessible to residents with dementia: (1) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s). 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 knife inaccessible to residents which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/22/2022 Plan of Correction Administrator immediatley removed knife from dish rack and locked it in a locked kitchen drawer. Deficiency cleared during visit.

Official classification

Type B

Official code

87608(a)(3)

Regulation authority

CCR

What the official deficiency says

87608 Postural Supports (a) Based on the individual's preadmission appraisal, and subsequent changes to that appraisal, the facility shall provide assistance and care for the resident in those activities of daily living which the resident is unable to do for himself/herself. Postural supports may be used under the following conditions. (3) A written order from a physician indicating the need for the postural support shall be maintained in the resident’s record. The licensing agency shall be authorized to require other additional documentation if needed to verify the order. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and record review) the licensee did not comply with the section cited above in having a doctor's order for a hospital bed for R2, R3, and R6 which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/28/2022 Plan of Correction Administrator agreed to get a doctor's order for the hospital beds and submit a copy to CCLD by POC date.