PRECIOUS LIFE RESIDENCES, LLC

Official classification

Type B

Official code

87506(a)

Regulation authority

CCR

What the official deficiency says

87506 (a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. This requirement is not met as evidenced by: Based on records review, R1 do not have all required records maintained on file.

Official plan of correction

Licensee shall ensure that residents have all the required records on file. Licensee will submit R1’s Lic 602A, Lic 603A, Lic 625, Lic 622, Lic 627C, Lic 613C, TB results, and Lic 601 to the Fresno CCL office by POC due date 06/10/26.

Deadline recorded: Jun 10, 2026. 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

no deficiency

Official plan of correction

no deficiency

Deadline recorded: Nov 26, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87355(e)(2)

Regulation authority

CCR

What the official deficiency says

87355(e)(2) 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: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c)… This requirement is not met as evidenced by: Deficient Practice Statement Based on records reviewed, S1 is not fingerprinted cleared and not associated to facility was providing resident care and supervision, which poses an immediate risk to the health and safety of the residents.

Official plan of correction

POC Due Date: 11/19/2025 Plan of Correction S1 left the facility during visit. S1 is not permitted back until fingerprinted cleared and associated to the facility.

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, the licensee did not comply with the section cited above when LPA and Licensee observed residents’ medications stored and unlock in the medication cabinet, medication on nightstand in room 4, and medications for former residents under dining room counter, which poses an immediate health, safety or personal rights risk to person in care.

Official plan of correction

POC Due Date: 11/19/2025 Plan of Correction Licensee shall ensure all medications are locked and inaccessible to residents by POC due date 11/19/25.

Official classification

Type A

Official code

87465(d)(3)

Regulation authority

CCR

What the official deficiency says

87465(d)(3) The date and time …medication was taken, the dosage taken, and the resident’s response shall be documented and maintained in the resident’s facility record. This requirement was not met as evidenced by: Deficient Practice Statement Based on observations, records reviewed, and interviews conducted, L1 administered R1’s Stimulant laxative medication on 11/18/25 in the morning, and R1’s Fentanyl patch was applied on 11/09/25 and did not record in the resident’s MARs, which poses/posed a potential health and safety risk for the person in care.

Official plan of correction

POC Due Date: 11/19/2025 Plan of Correction L1 will be retrained in-service training on proper administering medication and documentation. Licensee will submit proof of retraining in-service training to CCL by POC due date 11/19/25.

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

87309(a)…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 and L1 observed knives stored in kitchen drawer, chemicals and cleaning solution unlock throughout the facility and tools were unlock in the garage cabinet, accessible to residents which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/19/2025 Plan of Correction Licensee immediately locked knives, chemicals and cleaning solution. POC cleared during visit.

Official classification

Type A

Official code

87405(d)(2)

Regulation authority

CCR

What the official deficiency says

87405(d)(2) Administrator-Qualifications and Duties. The administrator shall have the knowledge of and ability to conform to applicable laws, rules and regulations. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, Fire Extinguisher has a service date of 08/09/24, which poses an immediate health and safety risk to the residents.

Official plan of correction

POC Due Date: 11/19/2025 Plan of Correction Fire extinguisher shall be replaced or serviced with a current date. Proof of correction will be submitted to the CCL office by POC due date 11/19/25.

Official classification

Type A

Official code

1569.618(c)(3)

Regulation authority

HSC

What the official deficiency says

1569.618 (c)(3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staff to provide CPR. This requirement is not met as evidenced by: Deficient Practice Statement S2 do have current First Aid/ CPR certification, this poses an immediately health and safety risk for the residents in care.

Official plan of correction

POC Due Date: 11/19/2025 Plan of Correction Licensee shall ensure that staff have current First Aid/ CPR certification. Proof of S2 First Aid/ CPR certification is to be submitted to the Fresno CCL by 11/19/25.

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… 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 when LPA reviewed R1’s file, whose currently receiving hospice care with no hospice care plan on file, which poses a potential health or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/24/2025 Plan of Correction Licensee will obtain R1’s current hospice care plan and submit it to Fresno CCL by POC due date 11/24/25.

Official classification

Type B

Official code

87506(b)(17)

Regulation authority

CCR

What the official deficiency says

87506 (b)(17) Documents and information required… This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, all residents’ files were reviewed. A complete appraisal (Lic 603) and was not observed in R1 and R5 files. A complete Needs and Services plan (Lic 625) was not observed in R3, R4and R5’s files. Medical Consent form (Lic 627C) was not observed in R2, R3, and R5’s files. R5’s file was observed with no current physician report (Lic 602A), which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/01/2025 Plan of Correction Licensee shall ensure that all residents have the required records on file. Completed Lic 603 for R1 and R5, completed Lic 625 for R2, R3, R4 and R5, Lic 625C for R2, R3, and R5, and Lic 602A for R5 will be completed and submitted the Fresno CCL office by POC due date 12/01/25.

Official classification

Type B

Official code

87608(a)(3)

Regulation authority

CCR

What the official deficiency says

87608 (a)(3) A written order from a physician indicating the need for the postural support shall be maintained in the resident’s record. The licensing agency shall be authorized to require other additional documentation if needed to verify the order. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview conducted, observation and records reviewed, R4 uses a half rail bed. There is no doctor’s order for ½ rail bed for R4, which poses/posed a potential health and safety and personal rights risk to the resident in care.

Official plan of correction

POC Due Date: 11/24/2025 Plan of Correction Licensee state will obtain doctor’s order for ½ rail bed. Doctor’s order will be submitted to the Fresno CCL by POC due date 11/24/25.

Official classification

Type B

Official code

87608(a)(5)(B)

Regulation authority

CCR

What the official deficiency says

87608(a)(5)(B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and records reviewed, R1 whose receiving hospice care and R2 whose not receiving hospice care were observed with full rail bed, which poses/posed a potential health and safety and personal rights risk to the resident in care.

Official plan of correction

POC Due Date: 11/24/2025 Plan of Correction Full bed rails are prohibited. If doctor indicates the need for R1 to have full rails bed, order will be obtain and submitted to Fresno CCL by POC due date. R1 and R2 full rails shall be removed by POC due date 11/24/25.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

87303 (a)The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, LPA and L1 toured the facility and observed side backyard fence boards broken, spider webs were observed around the outside of the facility patio and walls, live cockroach was observed in kitchen drawer, which poses/posed a potential health and safety and personal rights risk to the resident in care.

Official plan of correction

POC Due Date: 11/24/2025 Plan of Correction The facility shall be in good repair, clean, and sanitary by POC due date. Proof of repair of the backyard fence board, proof of spider webs cleaned, and pest control services schedule for cockroach will be submitted to the Fresno CCL by POC due date 11/24/25.

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: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above when LPA and L1 observed wood stick on the bottom of the exit sliding door blocking and preventing sliding door to open. LPA was informed by L1 and S2 that the wood stick is to prevent anyone from coming inside at night, 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

POC Due Date: 11/19/2025 Plan of Correction Administrator immediately removed metal lever rod. POC cleared during visit.

Official classification

Type B

Official code

1569.655(a)

Regulation authority

HSC

What the official deficiency says

HSC 1569.655 (a) If a licensee of a residential care facility for the elderly increases the rates of fees for residents or makes increases in any of its rate structures for services, the licensee shall provide no less than 60 days' prior written notice to the residents or the residents' representatives setting forth the amount of the increase, the reason for the increase, and a general description of the additional costs, except for an increase in the rate due to a change in the level of care of the resident… This requirement is not met as evidenced by: Based on records reviewed and interview conducted, the licensee did not comply with the section cited above. Licensee informed R1 rent adjust applied starting the same month, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee shall submit a plan of steps that will be taken to ensure the regulation is met which will include when and how Licensee will notify residents or the resident’s representative of any rate increases by the POC due date 02/14/25.

Deadline recorded: Feb 14, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87507(g)(5)(A)

Regulation authority

CCR

What the official deficiency says

87507(g)(5)(A) Refund conditions. (A)Facility policy concerning refunds, including the conditions under which a refund for advanced monthly fees will be returned in the event of a resident’s death… This requirement is not met as evidenced by: Based on records reviewed and interview conducted, the licensee did not comply with the section cited above when R2 made payments for September 2024 in August 2024 and deceased on 09/27/24. R1 made payments for October 2024 in September 2024 and R1 moved out of the facility on 10/27/24. L1 did not refund full refund amount after R2 deceased, which poses/posed a potential health, safety or personal rights risk to persons in care

Official plan of correction

Licensee agrees to submit proof of refund to Fresno CCL office by POC due date 02/26/25.

Deadline recorded: Feb 26, 2025. 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, the licensee did not comply with the section cited above when LPA and Licensee observed residents’ medications stored and unlock in the medication cabinet. Over the counter medications were observed stored in First Aid box unlock on the wall. LPA observed R1 and R2 refrigeration medication was observed stored in the refrigerator unlock which poses an immediate health, safety or personal rights risk to person in care.

Official plan of correction

POC Due Date: 12/10/2024 Plan of Correction Licensee immediately locked medication cabinet. Licensee shall ensure to have resident’s medication that requires refrigeration lock and inaccessible to residents. Proof of R1 and R2’s refrigeration medication lock shall be submitted to the department by POC due date 12/10/24.

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 Cardizem 120 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: 12/10/2024 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 12/10/24. Licensee shall have all staff retrained on administering medications. Licensee will submit documentation of training topics with staff attendance rooster to the Fresno CCL office by 12/23/24.

Official classification

Type A

Official code

87465(h)(5)

Regulation authority

CCR

What the official deficiency says

87465(h)(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 when LPA checked R1’s medication and observed a different color tablet stored with R1’s Losartan 50mg medication in the medication bottle which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/10/2024 Plan of Correction Licensee shall submit documents of steps the facility will take to ensure facility meets the regulation to Fresno CCL office by POC due date 12/10/24.

Official classification

Type A

Official code

87705(f)(1)

Regulation authority

CCR

What the official deficiency says

87705 (f)(1) Care of Persons with Dementia (f) 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 knives stored unlock under medication shelf and in in garage cabinet accessible to residents which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/10/2024 Plan of Correction Staff immediately removed knives into lock shelf. POC cleared during visit.

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 cleaning supplies unlock under the kitchen sink and under bathroom sink. At approximately 12:42PM, LPA and L1 observed chemicals stored in garage cabinet unlock. Alcohol bottle was observed on resident television stand unlock in the R3 and R5’s shared room. Cleaning chemicals stored under bathroom sink unlock. A bleach bottle was observed outside next the BBQ grill unlock 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: 12/10/2024 Plan of Correction L1 immediately removed chemicals and cleaning solution to lock laundry shelf. POC cleared during visit.

Official classification

Type B

Official code

87412(a)

Regulation authority

CCR

What the official deficiency says

87412(a)The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. This requirement is not met as evidenced by: Deficient Practice Statement Based on records review, S1 and S2 do not have all the required personnel records maintained on file.

Official plan of correction

POC Due Date: 12/27/2024 Plan of Correction Licensee shall ensure all staff have all the required records on file. Licensee will submit Lic 503, Lic 508, and Lic 9052 for S1 and S2 to the Fresno CCL office by POC due date 12/27/24.

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

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, the licensee did not comply with the section cited above when LPA and Administrator observed at approximately 11:18 AM in bedroom 1, Resident 1 (R1)’s whose able to store own medication, all R1's medications stored on top and in a rolling night stand unlock. At approximately 11:22 AM, LPA and Administrator observed in bedroom 4 bathroom, Risamine ointment, Dayquil 12 oz, and Hydrocortisone cream 1% stored under bathroom sink unlock. LPA and Administrator was informed by staff that Resident 3 (R3)’s Triamclinolone 1% cream was stored under bathroom sink unlock. Medications were observed 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: 01/18/2024 Plan of Correction Administrator and caregiver removed immediately the medications from R2’s bathroom and R3’s medication into lock cabinet. Licensee shall submit POC of how and where R1’s medication shall be locked and inaccessible to other residents in the facility but accessible to R1 by due date or 1/18/24. R1’s medication shall be locked and inaccessible to residents in care shall be submitted to CCL by POC due date of 1/018/24.

Official classification

Type B

Official code

87465(c)(3)

Regulation authority

CCR

What the official deficiency says

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 and records reviewed, LPA and Administrator reviewed residents’ MARs and observed five out of six residents’ medications that were dispense were not documented for three occasions. Resident 4 (R4)’s PRN medication Miralax documented administered by staff for three days after medications had ran out and last dispensed on 01/14/24. MAR not documented correctly by staff possess a potential health and safety risk for the person in care.

Official plan of correction

POC Due Date: 01/26/2024 Plan of Correction Licensee shall submit a written Plan of Correction (POC) Licensee agrees to retrained staff on proper administering medication and documentation. Licensee will submit documentation of training topics and staff attendance roster to CCL by POC due date 1/26/24.