AAA RESIDENTIAL ELDERLY RETREAT

Official classification

Type A

Official code

87202(a)

Regulation authority

CCR

What the official deficiency says

87202 Fire Clearance (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 was not met as evidenced by: During the investigation of complaint #24-AS-20260504163930, LPA observed that there was a latch at the top of the front door of the facility. LPA conducted a file review for the facility and the facility has a waiver for locked perimeter gates; however, LPA observed the interior front door of the facility had a latch to secure the door closed, which poses an Immediate Health and Safety Risk to persons in care.

Official plan of correction

On today's vist, LPA observed the latch was removed from the front door. Staff stated that on 05/11/2026, the same day LPA went to the facility, the front door and back door latches were removed. POC CLEARED

Deadline recorded: Aug 15, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87465(a)

Regulation authority

CCR

What the official deficiency says

87465 Incidental Medical and Dental Care (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: This requirement was not met as evidenced by: LPA observed a resident with a restricted health condition. LPA requested to review the restricted health care plan. Licensee stated that the resident has a restricted health care plan, home health goes to facility, and staff have been trained. However, licensee stated that documentation is locked and licensee is not available to come to the facility. LPA was not provided with a health care plan for review, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee will provide restricted health care plan and documentation of staff that have been trained on the resident's restricted health condition by POC due date of 08/17/2026.

Deadline recorded: Aug 17, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(a)(5)

Regulation authority

CCR

What the official deficiency says

87465(a)(5) 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 and record review, the licensee did not comply with the section cited above in 1 out of 1 medications that were reviewed had missing pills and interview with the administrator could not proof and or did not have information for the missing medication which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/27/2022 Plan of Correction The Licensee agrees to maintain a centrally stored log with start dates on log and on medications to ensure all clients are receiving their medications. The Licensee will assign designated individuals to administrator medication instead of all staff. The Licensee agrees to review all medication given and logged after administrating to confirm accuracy and provide documents as proof of correction.

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

87309(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 when LPA observed chemicals unlocked with all 6 residents present during observation, 4 of the 6 residents are ambulatory. Bleach bottle unlocked in the facility office and cleaning chemicals stored in unlocked laundry room accessible to residents in care this poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/23/2021 Plan of Correction Administrator immediately locked the facility office and the laundry room where the bottle of bleach and cleaning chemical was stored. POC cleared during visit