REYES GUEST HOMES-BELFORD

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times... This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above with a broken front door latch, 2 of 3 sink handles not operating correctly, and the rear sliding glass door not easily sliding, which pose a potential safety risk to persons in care.

Official plan of correction

The Licensee has agreed to make the repairs to the front door, sinks, and sliding glass door.

Deadline recorded: Aug 10, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87113

Regulation authority

CCR

What the official deficiency says

87113 Posting of License: The license shall be posted in a prominent location in the licensed facility accessible to public view. This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above with no license posted, which pose a potential safety risk to persons in care.

Official plan of correction

The Licensee has agreed to post the license.

Deadline recorded: Aug 10, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87355(e)(2)

Regulation authority

CCR

What the official deficiency says

87355 Criminal Record Clearance (e) All individuals subject to a criminal record review . . . shall prior to working . . . in a licensed facility: (2) Obtain a California clearance or a criminal record exemption as required by the Department. This requirement is not met as evidenced by: Based on record review, licensee did not comply with the section cited above. Staff S1 was not fingerprint cleared, which poses an immediate health and safety risk to the persons in care.

Official plan of correction

Cleared during inspection Civil penalty of $500 is being assessed.

Deadline recorded: Oct 14, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87355(e)(3)

Regulation authority

CCR

What the official deficiency says

87355 Criminal Record Clearance (e) All individuals subject to a criminal record review . . . shall prior to working . . . in a licensed facility: (3) Request a transfer of a criminal record clearance . . . This requirement is not met as evidenced by: Based on record review, licensee did not comply with the section cited above. Staff S2 and S3's fingerprint clearance had not been transferred to this facility, which poses an immediate health and safety risk to the persons in care.

Official plan of correction

On or before the due date, the Licensee has agreed to not allow S3 to return to the facility until they have their background clearance transferred to this facility. S3's fingerprint clearance was transfered during the inspection. Civil penalty of $1,000 is being assessed.

Deadline recorded: Oct 14, 2025. A deadline is not proof that correction was completed.

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 as there were multiple unlocked cabinets with cleaning chemicals and screws/nails, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/14/2025 Plan of Correction Administrator will send photo proof to the LPAs that the dangerous items are removed from the areas on or before the plan of correction due date.

Official classification

Type B

Official code

87203

Regulation authority

CCR

What the official deficiency says

All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic 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 an expired fire extinguisher, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/20/2025 Plan of Correction On or before plan of correction due date, administrator will procure a brand new fire extinguisher or have professional maintenance done, and submit photo proof to LPAs.

Official classification

Type A

Official code

87468.1(a)(6)

Regulation authority

CCR

What the official deficiency says

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: (6) To leave or depart the facility at any time and to not be locked into any room, building, or on facility premises by day or night... 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 of 2 gates that was locked, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/09/2024 Plan of Correction Staff unlocked and removed the lock from the gate.

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 is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in the kitchen by storing knives and scissors in an unlocked drawer, which posed an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/09/2024 Plan of Correction Staff removed knives and scissors from unlocked drawer.

Official classification

Type B

Official code

87208(a)(7)(A)

Regulation authority

CCR

What the official deficiency says

87208 Plan of Operation (a) Each facility shall have and maintain a current, written definitive plan of operation... Any significant changes in the plan of operation which would affect the services to residents shall be submitted to the licensing agency for approval. The plan and related materials shall contain the following: (7) Sketches, showing dimensions, of the following: (A) Building(s) to be occupied, including a floor plan that describes the capacities of the buildings for the uses intended and a designation of the rooms to be used for nonambulatory residents and for bedridden residents... 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 6 non-ambulatory rooms, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/15/2024 Plan of Correction Licensee shall submit an LIC 200 with an updated facility sketch (LIC 999) to the Oakland Regional Office.

Official classification

Type A

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

(e) Water supplies and plumbing fixtures shall be maintained as follows: (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 temperature was 123.1 degrees Fahrenheit, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/09/2024 Plan of Correction On or before the due date, the Licensee shall send proof to LPA Sampair that the hot water temperature has been reduced to the safe range of 105 to 120 degrees Fahrenheit.

Official classification

Type B

Official code

87303(e)(5)

Regulation authority

CCR

What the official deficiency says

(e) Water supplies and plumbing fixtures shall be maintained as follows: (5) Non-skid mats or strips shall be used in all bathtubs and showers. 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 2 out of 3 showers that had no non-skid mats or strips, which posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/15/2024 Plan of Correction Staff cleared citation during inspection by obtaining non-skid mats for the showers and adding them to the showers.

Official classification

Type B

Official code

87305(a)

Regulation authority

CCR

What the official deficiency says

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 in 1 out of 6 non-ambulatory rooms by providing no proof of a building permit for construction that added an exterior door and a ramp to a non-ambulatory room, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/15/2024 Plan of Correction On or before the due date, the Licensee shall send a copy of the building permit for the construction to LPA Sampair.

Official classification

Type A

Official code

87618(b)(3)

Regulation authority

CCR

What the official deficiency says

(3) Ensuring that the use of oxygen equipment meets the following requirements: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above for 1 of 1 residents using oxygen because (1) no report to fire dept in writing, (2) insecure non-portable oxygen tank, and (3) no " No Smoking Oxygen in Use " sign posted on the front door which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/17/2023 Plan of Correction Licensee must: (1) report to fire dept in writing, (2) must secure non-portable oxygen tank to the wall, and (3) must post " No Smoking Oxygen in Use " sign on the front door.

Official classification

Type B

Official code

87305(a)

Regulation authority

CCR

What the official deficiency says

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 because they have allowed a shed to be converted into a bedroom where a staff member has been living part-time, 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 Licensee must convert shed back to being a shed and not a bedroom for use by anyone.

Official classification

Type B

Official code

87465(h)(5)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. 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 6 of the 6 resident's medications with the use of transfer containers to dispense them to the residents on a daily basis, 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 Licensee must remove the transfer containers, update the plan of operation, and retrain staff to dispense the medications to residents directly from the originally received containers at time of dispensing.

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 since the last emergency drill that was conducted in September of 2021, 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 Licensee shall conduct an emergency drill on or before the due date and attest to LPA that the drill has been conducted via email or text.

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 an unsafe use of the HVAC closet for storage, which posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/26/2021 Plan of Correction Violation cleared during inspection.

Official classification

Type A

Official code

87608(a)(5)(B)

Regulation authority

CCR

What the official deficiency says

87608 Postural Supports (a) .... Postural supports may be used under the following conditions. (5)(B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails. -This requirement is not met as evidenced by: -Based on interviews and records review, the licensee did not comply with the section above by having a full bed rails in R1’s bed. R1 climbed up the bedrail resulting to a fall and R1 sustained fracture at the hip which posed immediate health and safety risks to person in care.

Official plan of correction

License, administrator and staff to undergo a refresher training conducted by an authorized vendor and submit the following: 1. Proof of registration for training to be submitted by 10/07/2021. 2. Copies of training certificates to be submitted by 10/16/2021. A $500.00 civil penalty is assessed,

Deadline recorded: Oct 7, 2021. A deadline is not proof that correction was completed.