BAY CARE ASSISTED LIVING LLC

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 observation, the licensee did not comply with the section cited above by not having which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 11/21/2025 Plan of Correction Administrator agreed to provide a copy of staff CPR/First Aid certificate to the Department by the POC date.

Official classification

Type B

Official code

1569.695(a)

Regulation authority

HSC

What the official deficiency says

(a)In addition to any other requirement of this chapter, a residential care facility for the elderly shall have an emergency and disaster plan that shall include, but not be limited to, all of the following: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and interview, the licensee did not comply with the section cited above by not having a copy of the emergency and disaster plan which poses a potential health and safety or risk to persons in care.

Official plan of correction

POC Due Date: 11/20/2025 Plan of Correction Administrator agreed to complete the emergency and disaster plan and email a copy to the Department by the POC date.

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 interview, the licensee did not comply with the section cited above by not able to provide proof of drills conducted which poses a potential health and safety or risk to persons in care.

Official plan of correction

POC Due Date: 11/20/2025 Plan of Correction Administrator agreed to conduct a drill with staff and residents, create a log and provided a copy to the Department by the POC date.

Official classification

Type B

Official code

87411(c)(1)

Regulation authority

CCR

What the official deficiency says

(1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross. 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 staff first aid certified which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/11/2023 Plan of Correction Administrator agreed to have all staff first aid certified and submit a copy of each staff certification to CCLD by POC date.

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 having any of the staff trained within first two weeks of employment which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/16/2023 Plan of Correction Administrator agreed to have all staff trained and submit self-certification that the training have been completed to CCLD by POC date.

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 observation and record review, the licensee did not comply with the section cited above in the resident records completed which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/13/2023 Plan of Correction The administrator agreed to complete the resident records and submit self-certification that the records are completed to CCLD by POC date.

Official classification

Type B

Official code

87608(a)(3)

Regulation authority

CCR

What the official deficiency says

(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 the bedrails for R1 which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/13/2023 Plan of Correction Administrator agreed to obtain a doctor's order for the bedrails and submit a copy to CCLD by the POC date.

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: 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 having S2 fingerprinted and associated to the facility which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/05/2023 Plan of Correction Administrator agreed to have S2 fingerprinted and submit document to CCLD 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 and record review, the licensee did not comply with the section cited above in having the personnel records complete which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/13/2023 Plan of Correction Administrator agreed to have all staff records completed and submit self-certification to CCLD by POC date.

Official classification

Type B

Official code

87555(b)(26)

Regulation authority

CCR

What the official deficiency says

87555 General Food Service Requirements (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 in having 7-day of non perishable and 2-day perishable foods for residents which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/11/2023 Plan of Correction Administrator agreed to purchase food and submit pictures of food and reciepts to CCLD by POC date.

Official classification

Type B

Official code

87307(6)

Regulation authority

CCR

What the official deficiency says

87705 Care of Persons with Dementia (6) All outdoor and indoor passageways and stairways shall be kept free of obstruction. 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 walker, 2 wheelchair, a chest of drawers and other items in back yard which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/16/2023 Plan of Correction Administrator agreed to remove all items and submit a photo of back yard to CCLD by POC date.

Official classification

Type A

Official code

87705(f)(1)

Regulation authority

CCR

What the official deficiency says

(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 was not met as evidence by: Based on LPA observation licensee did not comply with the section cited above by having the sharps cabinet unlocked located in the kitchen which poses an immediate health and safety risk to residents in care.

Official plan of correction

Administrator will conduct training with staff on working with residents with demintia including the importance of keeping sharp objects locked and inaccessible to residents in care. Administrator will provide a signed attendance sheet to CCLD no later then the POC date.

Deadline recorded: Sep 16, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87506(a)(e)

Regulation authority

CCR

What the official deficiency says

(a) The licensee shall ensure that a separate, complete, and current record is maintained...facility or in a central ... (e)Original records ...shall be retained for a minimum of three (3) years following termination of service to the resident. This requirement was not met as evidenced by: Based on LPAs observation licensee did not comply with the section cited above by not maintaining residents records a minimum of 3 years following termination (death) of service of the resident in care. Facility was not able to provide documents to CCLD staff, which poses a potential health and safety risk to residents.

Official plan of correction

Facility will submit a written addendum describing in detail how resident records will be kept intact and readily available up to 3 years after termination of services. Facility will submit a copy of the addendum no later then the POC date.

Deadline recorded: Sep 15, 2022. A deadline is not proof that correction was completed.