HELPING HANDS SENIOR CARE

Official classification

Type A

Official code

87631(a)(1)

Regulation authority

CCR

What the official deficiency says

87631 Healing Wounds (a) Except as specified in Section 87611(a), the licensee shall be permitted to accept or retain a resident who has a healing wound under the following circumstances: (1) When care is performed by or under the supervision of an appropriately skilled professional. This requirement was not met as evidenced by LPAs request for Home Health records and interviews with staff, there is no plan of care.

Official plan of correction

Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation

Deadline recorded: Nov 6, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87466

Regulation authority

CCR

What the official deficiency says

87466 Observation of the Resident The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs. When changes such as unusual weight gains or losses or deterioration of mental ability or physical health condition are observed, the licensee shall ensure that such changes are documented and brought to the attention of the resident's physician and the resident's responsible person, if any. **This requirement is not met as evidenced by LPAs review of R2 hospital records stating R2 was sent to the ER via ambulance by the wound specialist clinic due to worsening of the right leg wound. R2 was hospitalized for 3 days to receive antibiotics for a serious infection on their leg. An immediate civil penalty in the amount of $500 is hereby assessed. If not corrected, the violation will have a direct and immediate risk to the health, safety, or personal rights of clients in care.

Official plan of correction

Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation An immediate Civil penalty in the amount of $500 is hereby assessed.

Deadline recorded: Nov 6, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

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. (A) The bag may be emptied by facility staff who receive instruction from an appropriately skilled professional. **This requirement was not met as evidenced by LPAs interview with R7 and records review of R7s file.

Official plan of correction

Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation

Deadline recorded: Nov 6, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87628(a)

Regulation authority

CCR

What the official deficiency says

87628 Diabetes (a) The licensee shall be permitted to accept or retain a resident who has diabetes if the resident is able to perform his/her own glucose testing with blood or urine specimens, and is able to administer his/her own medication including medication administered orally or through injection, or has it administered by an appropriately skilled professional. **This requirement was not met as evidenced by LPAs observation and interviews with R7 and S3 stating S3 performs the glucose testing for R7 and prepares the dose of insulin. LPA observed S3 conducting glucose testing, insulin dial and R7 injecting themselves with insulin pen.

Official plan of correction

Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation

Deadline recorded: Nov 6, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87609(b)(4)(A)

Regulation authority

CCR

What the official deficiency says

87609 Allowable Health Conditions and the Use of Home Health Agencies (b) Incidental medical care may be provided to residents through a licensed home health agency provided the following conditions are met: (4) The licensee and home health agency agree in writing on the responsibilities of the home health agency, and those of the licensee in caring for the resident’s medical condition(s). (A) The written agreement shall reflect the services, frequency and duration of care. **This requirement was not met as evidenced by LPAs interviews with R7 and S3, stating Home Health changed R7’s catheter wrong. Facility was unable to provide proof of home health care plan.

Official plan of correction

Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation

Deadline recorded: Nov 6, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87613(a)(2)

Regulation authority

CCR

What the official deficiency says

87613 General Requirements for Restricted Health Conditions (a) Prior to admission of a resident with a restricted health condition, the licensee shall: (2) Ensure that facility staff who will participate in meeting the resident’s specialized care needs complete training provided by a licensed professional sufficient to meet those needs. **This requirement was not met as evidenced by LPAs request of training records for 5 out of 10 restricted health conditions observed involving R2 for oxygen and wound care, R4 for managed incontinence and R7 for catheter and diabetic care.

Official plan of correction

Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation

Deadline recorded: Nov 6, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87463(e)

Regulation authority

CCR

What the official deficiency says

87463 Reappraisals (e) The licensee shall immediately, or as soon as reasonably possible, bring any significant change in condition, as defined in Section 87101, Definitions, to the attention of the appropriate licensed medical professional and if applicable, other specialized care provider. Documentation of such communication shall be added to the resident's record and shall include: **This requirement was not met as evidenced by LPA review of R2's records. There was no reappraisal observed in R2s file.

Official plan of correction

Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation

Deadline recorded: Nov 6, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87633(b)(4)

Regulation authority

CCR

What the official deficiency says

87633 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:(4) A description of the area of licensee’s responsibility for implementing the plan including, but not limited to, facility staff duties; record keeping; and communication with the hospice agency, resident’s physician, and the resident’s responsible person(s), if any. This description shall include the type and frequency of the tasks to be performed by the facility. **This requirement was not met as evidenced by LPAs records review and interviews conducted, there is was no hospice care plan or descrption of resposibilty for R4's care.

Official plan of correction

Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation

Deadline recorded: Nov 6, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

1569.2(c)

Regulation authority

HSC

What the official deficiency says

(c) “Care and supervision” means the facility assumes responsibility for, or provides or promises to provide in the future, ongoing assistance with activities of daily living without which the resident’s physical health, mental health, safety, or welfare would be endangered. Assistance includes assistance with taking medications, money management, or personal care. **This was not met as evidenced by interview with residents and administrator there was an incident involving law enforcement on site searching for a suspect, the suspect had entered and was hiding in R6's home.

Official plan of correction

Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation

Deadline recorded: Nov 6, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87405(a)

Regulation authority

CCR

What the official deficiency says

Administrator Qualifications: a)All facilities shall have a qualified and currently certified administrator. The licensee and the administrator may be one and the same person. The administrator shall have sufficient freedom from other responsibilities and shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility as specified in this section. When the administrator is not in the facility, there shall be coverage by a designated substitute who shall have qualifications adequate to be responsible and accountable for management and administration of the facility as specified in this section. The Department may require that the administrator devote additional hours in the facility to fulfill his/her responsibilities when the need for such additional hours is substantiated by written documentation.**This was not met as evidenced by Adminstrator has not been available in person with LPAs for 3 visits on 10/14/25, 10/30/25 & 11/0525. Interviews with residents state they may see Administrator once per month, Administrator is not present.

Official plan of correction

Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation

Deadline recorded: Nov 19, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

8411(c)

Regulation authority

CCR

What the official deficiency says

Personnel Requirements - General: All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69 **This was not met as evidenced by, based on record review and interview with Administrator Assistant, direct care staff have no documented training on file.

Official plan of correction

Administrator to submit training records for all staff to Fresno Regional office by plan of correction due date

Deadline recorded: Nov 21, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87411(d)

Regulation authority

CCR

What the official deficiency says

Personnel Requirements - General: All personnel shall be given on the job training or have related experience in the job assigned to them. This training and/or related experience shall provide knowledge of and skill in the following, as appropriate for the job assigned and as evidenced by safe and effective job performance: **This was not met as evidenced by, based on record rerview and interview with Administrator Assistant, direct care staff have no documented training on file.

Official plan of correction

Administrator to submit training records for all staff to Fresno Regional office by plan of correction due date

Deadline recorded: Nov 21, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87209(a)(2)

Regulation authority

CCR

What the official deficiency says

Program Flexibility: a)The use of alternate concepts, programs, services, procedures, techniques, equipment, space, personnel qualifications or staffing ratios, or the conduct of experimental or demonstration projects shall not be prohibited by these regulations provided that: (2) A written request for a waiver or exception and substantiating evidence supporting the request shall be submitted in advance to the licensing agency by the applicant or licensee. **This was not met as evidenced by, R2 has a medical assessment signed by a nurse practioner, not a physician,

Official plan of correction

Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation

Deadline recorded: Nov 21, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.1(a)(15)

Regulation authority

CCR

What the official deficiency says

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: (15) To send and receive unopened correspondence in a prompt manner. **This was not met as evidenced by, interviews conducted with R2 & R3 who stated that they are not receiving mail. During records review of resident files LPAs observed unopened mail for R5 in their file.

Official plan of correction

Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation

Deadline recorded: Nov 19, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.2(a)(9)

Regulation authority

CCR

What the official deficiency says

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (9) To present grievances and recommend changes in policies, procedures, and services to the facility staff, management, and governing authority, and to any other person without restraint, coercion, discrimination, reprisal, or other retaliatory actions..**Thiis requirement was not as evidenced by LPAs interviews, licensee stated R4 brought problems to the facility and needs to find another place to live.

Official plan of correction

Administrator will provide training to staff and submit agenda and sign in sheets to Fresno Regional Office by plan of correction due date.

Deadline recorded: Nov 21, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87221

Regulation authority

CCR

What the official deficiency says

87221 Resident Councils The facility shall permit the formation of a resident council by interested residents, provide space and post notice for meetings, and provide assistance in attending meetings for those residents who request it. In order to permit a free exchange of ideas, at least part of each meeting shall be allowed to be conducted without the presence of any facility personnel. Residents shall be encouraged, but shall not be compelled to attend. The purpose of such an organization shall be to work with the administration in improving the quality of life for all residents by enriching the activity program and to discuss the services offered by the facility and make recommendations regarding identified problems. This requirement was not met as evidenced by LPAs interviews with residents and records review. There has been no notice or resident council formed.

Official plan of correction

Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation

Deadline recorded: Nov 21, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87208(a)(11)

Regulation authority

CCR

What the official deficiency says

(a) The licensee shall have and maintain a current, written definitive plan of operation for the facility. The licensee shall operate the facility in accordance with the terms specified in the plan of operation and may be cited for not doing so pursuant to Health and Safety Code section 1569.49. The plan and related materials shall be on file in the facility and shall be submitted to the licensing agency with the license application. 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: (11) A description of the ways in which the licensee will address resident behavioral expression as defined in Section 87101, Definitions, including resident assessments, care practices, and safety measures. 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 which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/14/2025 Plan of Correction Plan of operation to be updated to include behavioral expression, a copy to be sent to Fresno Regional Office by plan of correction due date.

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

Official plan of correction

POC Due Date: 11/14/2025 Plan of Correction Licensee/Administrator to report all incidents immediately to Department by telephone call and a written report with 7 calendar days, as well as notify family members. A written statement to be submitted to Department acknowledging and compliance of regulation to be submitted to Department by plan of correction due date.

Official classification

Type B

Official code

1569.267(d)

Regulation authority

HSC

What the official deficiency says

(d) The licensee shall provide initial and ongoing training for all members of its staff to ensure that residents’ rights are fully respected and implemented. This requirement is not met as evidenced by: Deficient Practice Statement Based on record reviews, the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/14/2025 Plan of Correction All staff must receive required training under Title 22 regulations prior to providing care to residents. Plan of correction and traiing records to be submitted to Fresno Regional Office by due date.

Official classification

Type B

Official code

1569.319(a)

Regulation authority

HSC

What the official deficiency says

(a) A licensee of a facility that has internet service shall provide at least one internet access device, such as a computer, smart phone, tablet, or other device, that can support real-time interactive applications, is equipped with videoconferencing technology, including microphone and camera functions, and is dedicated for resident use. 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 in 4 out of 4 occupied buildings on site which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/14/2025 Plan of Correction Licensee/Administrator to purchase electronic device for each building and submit proof of purchase receipt to Fresno Regional Office by plan of correction due date.

Official classification

Type B

Official code

87555(b)(8)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (8) All food shall be of good quality. Commercial foods shall be approved by appropriate federal, state and local authorities. Food in damaged containers shall not be accepted, used or retained. 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 which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/14/2025 Plan of Correction Facility to provide food of good quality and provide receipts to Fresno Regional Office by plan of correction due date.

Official classification

Type B

Official code

87555(b)(7)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (7) Modified diets prescribed by a resident's physician as a medical necessity shall be provided. 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 3 out of 3 persons which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/14/2025 Plan of Correction Licensee/Administrator to hire designated cook to meet dietary needs of residents. Plan of correction to be submitted by due date.

Official classification

Type A

Official code

87202(a)

Regulation authority

CCR

What the official deficiency says

(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: 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 1 out of 9 out of persons which poses an immediate health, safety or personal rights risk to persons in care. Resident 1 is bedridden and facility is not cleared for bedridden.

Official plan of correction

POC Due Date: 10/15/2025 Plan of Correction Facility to submit an LIC 200, LIC 9054, LIC 9099 to Fresno CCL office no later than plan of correction due date.

Official classification

Type A

Official code

1569.17(c)(1)(A)

Regulation authority

HSC

What the official deficiency says

(c)(1)(A) Subsequent to initial licensure, a person specified in subdivision (b) who is not exempted from fingerprinting shall obtain either a criminal record clearance or an exemption, pursuant to subdivision (f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in a facility. 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 which poses an immediate health, safety or personal rights risk to persons in care. Staff 1 is not fingerprinted and cleared and has worked 5 days or more from 9/29/25 through 10/12/25.

Official plan of correction

POC Due Date: 10/15/2025 Plan of Correction Staff 1 was removed from schedule and told they would not be able to return to work until fingerprinted and cleared. DEFICIENCY CLEARED AT TIME OF INSPECTION

Official classification

Type A

Official code

87355(e)(4)

Regulation authority

CCR

What the official deficiency says

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (4) Request and be approved for a transfer of a criminal record exemption, as specified in Section 87356(r), unless, upon request for a transfer, the Department permits the individual to be employed, reside or be present at the facility. 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 which poses an immediate health, safety or personal rights risk to persons in care. Staff 2 has a fingerprint exemption that has not be transfered to facility. Staff 2 has worked 5 days or more between 9/29/25 - 10/12/25.

Official plan of correction

POC Due Date: 10/15/2025 Plan of Correction Administrator to submit LIC 9188 Fingerprint Transfer Exemption to Department for Staff 2. Staff 2 may return to work when exemption is transfered and Staff 2 is associated to facility.

Official classification

Type B

Official code

80075(k)(1)

Regulation authority

CCR

What the official deficiency says

80075(k)(1) - Medication 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 was not met as evidenced by Medication is currently stored in locked cabinet in each kitchen area however the lock is not serving its intended purpose and medication is accessible.

Official plan of correction

Facility will store medication centrally in the office until appropriate locks can be purchased and installed. Proof by picture will be send to CCL by the due date of June 25, 2025.

Deadline recorded: Jun 25, 2025. A deadline is not proof that correction was completed.