BELLA CARE HOME LLC

Official classification

Type A

Official code

87411(f)

Regulation authority

CCR

What the official deficiency says

(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure. A report shall be made of each screening, signed by the examining physician. The report shall indicate whether the person is physically qualified to perform the duties to be assigned, and whether he/she has any health condition that would create a hazard to him/herself, other staff members or residents. A signed statement shall be obtained from each volunteer affirming that he/she is in good health.Personnel with evidence of physical illness or emotional instability that poses a significant threat to the well-being of residents shall be relieved of their duties. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review for staff, the licensee did not comply with the section cited above in one of four files reviewed which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/03/2026 Plan of Correction Facility will let Licensing know of the progress of the TB test for the staff.

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. 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 that the medications for today, were found in an unlocked cabinet which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/30/2026 Plan of Correction Facility will provide a medication training to all staff by 3/30 and provide proof of training to CCL.

Official classification

Type A

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 that the pills for today were found unlocked in a pill box in a cabinet in the kitchen which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/30/2026 Plan of Correction Facility will provide a medication training to all staff by 3/30 and provide proof of training to CCL.

Official classification

Type B

Official code

87211(a)(1)

Regulation authority

CCR

What the official deficiency says

(1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. 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 that a review revealed that incidents that occured in the home were not reported to Licensing which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/03/2026 Plan of Correction Facility shall provide incident reports to Licensing that are required and Licensee and Administrator shall review CCL 87211 Reporting Requirements. Administrator shall provide a statement to Licensing that Reporting Requirements have beed reviewed.

Official classification

Type B

Official code

1569.695(a)(2)

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: (2) Plans for the facility to be self-reliant for a period of not less than 72 hours immediately following any emergency or disaster, including, but not limited to, a short-term or long-term power failure. If the facility plans to shelter in place and one or more utilities, including water, sewer, gas, or electricity, is not available, the facility shall have a plan and supplies available to provide alternative resources during an outage. 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 that there is no 72 hour supply of food and water for the staff and residents at the facility should an emergency occur which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/10/2026 Plan of Correction Facility shall purchase a 3 day (72 hour) supply of food and water for the residents and staff and provide pictures to Licensing by 4/10/26.

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 interview and record review, the licensee did not comply with the section cited above in Licensee did not have complete training for staff, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/24/2024 Plan of Correction Licensee agrees to complete staff training for all staff and will submit where the staff obtained the training, hours of training to meet regulation and certificates of staff that completed the training by POC due date 5/24/24.

Official classification

Type A

Official code

87203

Regulation authority

CCR

What the official deficiency says

87203 Fire Safety -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 was not met as evidence by: LPA observation of front door being secured with a pin at the bottom of the door. This poses an immediate health and safety or personal rights risk to residents in care.

Official plan of correction

Staff immediately removed pin. Licensee to dispose of pin. Hole in door will be patched up by POC date.

Deadline recorded: Aug 11, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87707(a)(2)

Regulation authority

CCR

What the official deficiency says

87707 Training Requirements If Advertising Dementia Special Care, Programming And/Or Environments (2) Direct care staff shall complete at least eight hours of in-service training on the subject of serving residents with dementia within 12 months of working in the facility and in each succeeding 12-month period... This requirement was not met as evidence by: LPA's observation of 4 of 4 personnel files having incomplete training records. This posess a potential health and safety or personal rights risk to residents in care.

Official plan of correction

Licensee stated training will be completed and record documentation will be updated and maintained accordingly. Licensee to provide updated records by POC date.

Deadline recorded: Aug 19, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87411(d)(3)

Regulation authority

CCR

What the official deficiency says

87411 Personnel Requirements - General (d) All personnel shall be given on the job training or have related experience in the job assigned to them...as evidenced by safe and effective job performance:(3) Skill and knowledge required to provide necessary resident care and supervision, including the ability to communicate with residents. This requirement was not met as evidence by: LPA's observation of a picture provided during investigation. The picture showing R3 in a wheelchair leaning back with the wheels of the wheelchair in the air. This poses a potential health and safety or personal rights risk to residents in care.

Official plan of correction

Licensee to provide training to all staff on regulations. A sign in sheet and training material to be provided to CCL by POC date.

Deadline recorded: Aug 19, 2022. A deadline is not proof that correction was completed.