ELIM PLACE

Official classification

Type A

Official code

87465(a)(4)

Regulation authority

CCR

What the official deficiency says

(4) The licensee shall assist residents with self-administered medications as needed. 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 2 out of 4 residents medication count was incorrect which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/11/2026 Plan of Correction Administrator agrees to submit statement of intent by due date and to provide in- service training to staff and conduct a Medication audit of all medication and submit training records and audit results when completed to CCLD

Official classification

Type B

Official code

1569.625(b)(1)

Regulation authority

HSC

What the official deficiency says

(1) The department shall adopt regulations to require staff members of residential care facilities for the elderly who assist residents with personal activities of daily living to receive appropriate training. This training shall consist of 40 hours of training. A staff member shall complete 20 hours, including six hours specific to dementia care, as required by subdivision (a) of Section 1569.626 and four hours specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696, before working independently with residents. The remaining 20 hours shall include six hours specific to dementia care and shall be completed within the first four weeks of employment. The training coursework may utilize various methods of instruction, including, but not limited to, lectures, instructional videos, and interactive online courses. The additional 16 hours shall be hands-on training. 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 2 out of 4 staff were without the required training which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/19/2026 Plan of Correction Administrator agrees to submit Initial and annual training records of all staff to CCLD by due date.

Official classification

Type B

Official code

87465(c)(3)

Regulation authority

CCR

What the official deficiency says

(c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication, but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: (3) A record of each dose is maintained in the resident's record. The record shall include the date and time the PRN medication was taken, the dosage taken, and the resident's response. 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 2 out of 4 residents response was not documented which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/19/2026 Plan of Correction Administrator agrees to provide staff in- service training regrading PRN Medication documentation and follow up with EMAR system to allow entry of required documentation and submit records to CCLD by due date.

Official classification

Type A

Official code

87464(f)(1)

Regulation authority

CCR

What the official deficiency says

87464(f)(1) Basic Services (f)Basic services shall at a minimum include: (1)Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement was not met as evidenced by: Based on record review and interviews due to lack of supervision facility failed to prevent resident being hit by another resident

Official plan of correction

Administrator agrees to develop a plan for preventative measures and complete staff training and submit records when completed.

Deadline recorded: Apr 7, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(a)(4)

Regulation authority

CCR

What the official deficiency says

87465(a)(4) (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following:(4) The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by: Based on records reviewed and interviews conducted, R1 was given multiple doses of the same medication, which poses an immediate Health & Safety risk to the residents.

Official plan of correction

Administrator conducted medication training on 2/9/26 and provided documentation during visit.

Deadline recorded: Feb 13, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(c)(2)

Regulation authority

CCR

What the official deficiency says

(c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: (2) Once ordered by the physician the medication is given according to the physician's directions. Based on records reviewed and interviews conducted, R1 was given the wrong dose of morphine, which poses an immediate Health & Safety risk to the residents.

Official plan of correction

On 10/17/25 Staff completed medication training and submitted completion documents to CCLD by POC due date.

Deadline recorded: Nov 5, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87217(a)

Regulation authority

CCR

What the official deficiency says

87217 (a) Safeguards for Resident Cash, Personal Property, and Valuables : A licensee shall not be required to handle residents' cash resources. However, if a resident incapable of handling his own cash resources, as documented by the initial or subsequent appraisal, is accepted for care, his cash resource shall be safeguarded in accordance with the regulations in this section.

Official plan of correction

Per Administrator, facility will reimburse the $200 that is missing by the POC date.

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