LERWICK HOME CARE

Official classification

Type A

Official code

87202(a)

Regulation authority

CCR

What the official deficiency says

87202 (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: Based on records, the licensee did not comply with the section cited above when the California Department of Health Care Services (DHCS) conducted facility visit on 03/24/26, two emergency fire exits were found obstructed, which an immediate health and safety risk which poses an immediate health, safety or personal rights risk to persons in care..

Official plan of correction

Licensee will submit written statements detailing how the facility will ensure that all fire exits are free of obstruction to the department by POC due date 03/27/26.

Deadline recorded: Mar 27, 2026. 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

87309(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: Based on observation, the Licensee did not comply with the section cited above when LPA observed cleaning chemicals unlock under kitchen sink, chemicals unlock in laundry room and in garage cabinet accessible to the residents in care, this poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee immediately locked chemicals during visit. POC cleared during visit.

Deadline recorded: Mar 27, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87202(a)

Regulation authority

CCR

What the official deficiency says

87202 (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: Based on observation, the licensee did not comply with the section cited above when LPA observed the front door locked and secured with a metal padlock, which an immediate health and safety risk which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee immediately unlocked and removed lock. POC cleared during visit.

Deadline recorded: Feb 27, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

87465(h)(2) Centrally stored medicines shall be kept in a safe and locked place... not accessible to persons other than employees... This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, R1’s medication was stored in the refrigerator on the side door unlock, which poses an immediate health, safety or personal rights risk to person in care.

Official plan of correction

POC Due Date: 12/24/2025 Plan of Correction Staff immediately removed and lock medications in small refrigerator in the staff room. POC cleared during visit.

Official classification

Type B

Official code

87612(a)(2)

Regulation authority

CCR

What the official deficiency says

87612 (a)(2) The licensee may provide care for residents who have any of the following restricted health conditions,(2) Catheter care as specified in Section 87623. This requirement is not met as evidenced by Deficient Practice Statement Based on interview conducted, observation, and records reviewed, R1 has a restricted health conditions with no restricted health condition care plan on file or in placed, poses/posed a potential health and safety and personal rights risk to the resident in care.

Official plan of correction

POC Due Date: 01/05/2026 Plan of Correction Licensee will submit a Restricted Health Condition care plan for R1 to the Fresno CCL by POC due date 01/05/26.

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

87309(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 when LPA observed a tool ranch in kitchen drawer, bug spray with car oil stored in the back of the garage, a shovel stored next to chemical cabinet, and chemical cabinet in the garage lock was loose and unlock, this poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/22/2025 Plan of Correction Licensee immediately removed shovel off the premises and lock the tool ranch. Staff removed the bug spray and car oil stored into the garage cabinet. Staff immediately tighten lock on garge cabinet. POC cleared during visit.

Official classification

Type A

Official code

87555(b)(8)

Regulation authority

CCR

What the official deficiency says

87555(b)(8) All food shall be of good quality. Commercial foods shall be approved by appropriate federal, state, and local authorities. Good in damaged containers shall not be accepted, used, or retained. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, multiple expired nonperishable food and snacks was observed in pantry, poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/22/2025 Plan of Correction Licensee immediately disregarded expired food. POC cleared during visit.

Official classification

Type A

Official code

87465(c)(2)

Regulation authority

CCR

What the official deficiency says

87465 (c)(2) Once ordered by the physician the medication is given according to the physician's directions. This requirement was not met as evidenced by: Deficient Practice Statement Based on records review and observation, staff did not administer R1’s medication Furosemide 20 mg and medication Cephalexin 500 mg as directed by physician. Staff did not administer R2’s medication Atorvastatin 40 mg and medication Amlodipine 10 mg as directed by physician, which poses an immediate health and safety risk for the person in care.

Official plan of correction

POC Due Date: 01/22/2025 Plan of Correction Licensee agree to write statement of steps facility will take to ensure regulations is met. Statement will be submitted to Fresno CCL by POC due date 01/22/25.

Official classification

Type A

Official code

87465(d)(3)

Regulation authority

CCR

What the official deficiency says

87465(d)(3) The date and time the PRN medication was taken, the dosage taken, and the resident's response shall be documented and maintained in the resident's facility record. This requirement is not met as evidenced by: Deficient Practice Statement Based on records review and interviews, staff have administered medications and not documented in the MARs for R1’s medication Furosemide 20 mg, Cephalexin 500 mg, R4 medication Tylenol 325 mg, and R2’s medication Tylenol 650mg in the MARs. Staff confirmed and stated all the residents’ medications were administered on 01/21/25 at 08:00AM and was not record, which poses an immediate health and safety risk for the person in care.

Official plan of correction

POC Due Date: 01/22/2025 Plan of Correction Licensee immediately documented and record R1’s medication Furosemide, Cephalexin, Tylenol and R2’s medication Tylenol in the MARs. Licensee shall have S1 retrained on medication training which include administering medications, reviewing medications and MAR. Licensee will submit documentation of training materials with staff attendance rooster to the Fresno CCL office by POC due date 01/22/25.

Official classification

Type A

Official code

87455(b)(9)

Regulation authority

CCR

What the official deficiency says

87455 (b)(9) The following persons may be accepted or retained by the licensee: (9)Persons who have been diagnosed as terminally ill and who have obtained the services of hospice, certified in accordance with federal medicare conditions of participation and licensure, provided the licensee has obtained a facility hospice care waiver in accordance with the provisions of Section 87632, Hospice Care Waiver, and hospice care is being provided in accordance with the provisions of Section 87633, Hospice Care for Terminally Ill Residents. This requirement is not met as evidenced by: Deficient Practice Statement Based on records reviewed and observation, the facility has hospice waiver for 2 residents and had obtain 3 residents on hospice care, which poses/posed an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/22/2025 Plan of Correction Licensee shall not obtain more than hospice waiver granted. Licensee will request for hospice waiver increase and submitted to the Fresno CCL by POC due date 01/22/25. Licensee states agree to relocate 1 of the 3 resident receiving hospice care if hospice waiver increase is denied.

Official classification

Type B

Official code

87633(b)

Regulation authority

CCR

What the official deficiency says

87633(b) A current and complete hospice care plan shall be maintained in the facility for each hospice resident and include the following: 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 when 1 out of 3 residents whose receiving Hospice care did not have a hospice care plan on file. R3 files were reviewed and confirmed by Licensee that the files did not contain Hospice Plan of care, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/31/2025 Plan of Correction Hospice care plan for R3 shall be obtained by POC due date 01/31/25.

Official classification

Type B

Official code

87458(c)(1)(A)

Regulation authority

CCR

What the official deficiency says

87458(c)(1)(A) The medical assessment shall include, but not be limited to: (1) A physical examination of the resident indicating the licensed medical professional's diagnosis or diagnoses and results of an examination for all of the following: (A)Communicable tuberculosis. This requirement is not met as evidenced by: Deficient Practice Statement Based on records reviewed, residents’ files were reviewed, 1 out of 6 residents do not have TB result on file. Licensee confirmed R1 do not have TB results on file, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/07/2025 Plan of Correction Licensee will submit proof of TB result for R1 to Fresno CCL by POC due date 02/07/25.

Official classification

Type B

Official code

87411(f)

Regulation authority

CCR

What the official deficiency says

87411(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 reports hall 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 records review, S1 did not have a good health screening and TB result on file and was confirmed by Licensee, which poses a potential risk to the health and safety of the residents.

Official plan of correction

POC Due Date: 02/07/2025 Plan of Correction S1 good health screening and TB result shall be submitted to the Fresno CCL office by POC due date 02/07/25.

Official classification

Type A

Official code

87705(f)(1)

Regulation authority

CCR

What the official deficiency says

87705 (f)(1) 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 when LPA observed at approximately 12:05 PM, multiple kitchen knives in kitchen drawer unlock and accessible to residents poses an immediate health, safety or personal rights risk to person in care.

Official plan of correction

POC Due Date: 02/01/2024 Plan of Correction Administrator immediately removed all the knives and locked under kitchen sink. POC cleared during visit.

Official classification

Type B

Official code

87465(d)(3)

Regulation authority

CCR

What the official deficiency says

87465(d)(3) The date and time the PRN medication was taken, the dosage taken, and the resident's response shall be documented and maintained in the resident's facility record. 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 reviewed R1’s MARs and medications and observed that R1’s medication Senna Plus Tab 50-8.6 was administered up to current date however there were no documentation of the medication being administered to the residents which poses a potential health, safety or personal rights risk to person in care.

Official plan of correction

POC Due Date: 02/06/2024 Plan of Correction Administrator shall have staff retrained on administering medication to ensure that all medication being administered to the resident is being logged. A copy of the training shall be submitted to the Fresno CCL office by POC due date 02/06/24.