AG HEALTH CARE, INC.

Official classification

Type A

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

(2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. 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 degrees C) and not more than 120 degree F (49 degrees C). This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. The hot water was 132.6 degrees Fahrenheit, which poses an immediate safety risk to persons in care.

Official plan of correction

POC Due Date: 05/29/2026 Plan of Correction On or before the due date, the Licensee shall reduce the hot water temperature to the safe range between 105 and 120 and send proof to LPA Sampair.

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, and other similar items 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: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. The locks are not functional on drawer and cabinets where knives and cleaning solutions are stored in kitchen, which poses an immediate safety risk to persons in care.

Official plan of correction

POC Due Date: 05/29/2026 Plan of Correction On or before the due date, the Licensee shall get the locks professionally repaired and send proof to LPA Sampair.

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. The shared bathroom storage cabinet under the sink are so dirty that one of the doors will not slide in the grooves because the dirt and dust obstruct its movement. The carpet in the dining room has black spots on it, because the material has been worn away and only the black backing shows. The kitchen cabinet doors have thick deposits of grease and dirt on them, all of which pose a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 06/04/2026 Plan of Correction On or before the due date, the Licensee and staff will do a deep cleaning of the entire facility and remove the dining room carpet. Photo proof will be sent to LPA Sampair on or before the due 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 record review, the licensee did not comply with the section cited above in 1 out of 1 Quarterly Emergency/Disaster Drill records, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/14/2024 Plan of Correction On or before the due date, the Licensee shall ensure that at least 1 emergency / disaster drill has been conducted for every shift. Further, drills shall be scheduled for at least the next 12 months for the facility and the emergency / distaster drill shall be posted.

Official classification

Type A

Official code

87309(a)

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. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. Windex was stored in bathroom and dishwashing soap stored in kitchen where accessible to clients, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/20/2023 Plan of Correction Licensee cleared during visit.

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. Gates into the back yard are falling apart, and in that state of disrepair they are very difficult open and for a resident in an emergency potentially impossible to open which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/31/2022 Plan of Correction Licensee shall have the gates repaired by the POC due date along with pictures, video, receipts, and/or licensee attestation sent to the LPA to verify that correction.

Official classification

Type B

Official code

87555(b)(9)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (9) Procedures which protect the safety, acceptability and nutritive values of food shall be observed in food storage, preparation and service. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above with opened food stored in the refrigerator and freezer without a date on them, as well as kitchen counters and refrigerator/freezer in need of a deep clean to remove caked on dirt and grime. in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/24/2022 Plan of Correction Licensee shall have all of the opened food dated and the deep clean of the kitchen counters and refrigerator/freezer by the POC due date along with pictures, video, receipts, and/or licensee attestation sent to the LPA to verify that correction.

Official classification

Type B

Official code

87468.1(a)(2)

Regulation authority

CCR

What the official deficiency says

Tit. 22, § 87468.1 - Personal Rights of Residents In all Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above because the facility does not have a 30-day supply of PPE (e.g., facemasks, respirators, gowns, gloves, and eye protection such as face shield or goggles) and a list including items on hand or indicating where such items will be acquired (such as CCL Regional Office) and when posing a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/24/2022 Plan of Correction Licensee shall acquire and store at the facility a 30-day supply of PPE (e.g., facemasks, respirators, gowns, gloves, and eye protection such as face shield or goggles). Licensee shall provide proof to the LPA by the POC due date.

Official classification

Type B

Official code

87468.1(a)(2)

Regulation authority

CCR

What the official deficiency says

(a) Residents in all ... facilities ... shall have all of the following personal rights: ... (2) To be accorded safe, healthful and comfortable accommodations. This requirement is not met as evidenced by: Based on an interview and review of the records, the licensee did not comply with the section cited above when ADM Anthony Oshinowo entered the facility within 10 days of his international travel, which posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

ADM Anthony Oshinowo has already completed the correction by completing the Covid-19 testing.

Deadline recorded: Dec 14, 2021. A deadline is not proof that correction was completed.