SILVERADO SENIOR LIVING - THE HUNTINGTON

Official classification

Type B

Official code

87211(a)(1)(D)

Regulation authority

CCR

What the official deficiency says

87211(a)(1)(D) Reporting Requirements: (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (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. (D) Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident. This requirement is not met evidenced by: R1 showed inappropriate sexual behaviors on 01/28/2024, 03/08/2024, 03/09/2024, 04/27/2024, 05/01/2024, 05/06/2024, 05/09/2024, 06/26/2024, 08/10/2024. and 07/14/2024. Facility did not report these incidents to the department as required.

Official plan of correction

Administrator will read section 87211 and send a signed letter via fax or mail stating that Administrator has read and understands section 87211. Also, Administrator will create and send incident reports when resident had inappropriate sexual behaviors for the dates of 01/28/2024, 03/08/2024, 03/09/2024, 04/27/2024, 05/01/2024, 05/06/2024, 05/09/2024, 06/26/2024, 08/10/2024, and 07/14/2024 and fax or mail to the department by plan of correction date which is 11/04/2025

Deadline recorded: Nov 4, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

(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) (interview) (record review)], the licensee did not comply with the section cited above. The south side fire door was tested and did not operate properly; it did not open after 30 seconds. One door in the lobby is not working and does not open after 30 seconds. Staff provided work order for Wandering Gate Upgrade proposal from West Mills Communications Corporation which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/04/2025 Plan of Correction Administrator will make sure that fire doors are repaired and contact the fire department to notify them of the doors. And send proof of correction to LPA by 11/04/2025

Official classification

Type B

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

(e) Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degrees C) and not more than 120 degree F (49 degrees C). This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above the water measured between 102.3 - 120.0 which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/28/2025 Plan of Correction Administrator will adjust water temperature and keep log for 3 days and send to LPA by POC date.

Official classification

Type A

Official code

87468.2

Regulation authority

CCR

What the official deficiency says

(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: (4) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement is not met as evidence by: Based on documents reviewed and interviews, licensee did not ensure R1’s inappropriate sexual behavior disturbed other residents in care which poses an immediate risk to the personal rights, health, or safety of the persons in care.

Official plan of correction

Licensee will create a plan to deal with inappropriate behaviors showing steps, documentation, and considerations of privacy, will train facility staff on the plan and provide a copy to the department by POC date 08/24/2025

Deadline recorded: Aug 24, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87405(h)(3)

Regulation authority

CCR

What the official deficiency says

87405(h)(3) Administrator - Qualifications and Duties (h) The administrator shall have the responsibility to: (3) Develop an administrative plan and procedures to ensure clear definition of lines of responsibility, equitable workloads, and adequate supervision. This requirement is not met as evidenced by: Based on interviews and documents reviewed, licensee did not ensure the administrator seek appropriate intervention for R1 in the course of (eight) 8 months which poses an immediate risk to the personal rights, safety, and health of the persons in care.

Official plan of correction

Licensee will ensure Administrator is aware and/or takes the necessary continue education to address inappropriate behaviors in a timely manner to be able to plan and train staff to address the behaviors and will submit a copy of education obtained by POC due date 8/24/2025

Deadline recorded: Aug 24, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(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 deficiency is evidenced by: Based on observation by LPAs and Director of Health Services during tour of facility licensee did not ensure staff locked up 3 pairs of scissors left unattended in the unlocked wellness room at 9:50AM on the second floor of dementia care facility which poses a potential risk to the health, safety, or personal rights of the persons in care.

Official plan of correction

Citation previously cleared at the time of the visit on 2/25/25. ***no further action necessary***

Deadline recorded: Feb 26, 2025. 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

(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 deficiency is evidenced by: Based on observation by LPAs and Director of Health Services during tour of facility licensee did not ensure staff locked up 3 pairs of scissors left unattended in the unlocked wellness room at 9:50AM on the second floor of dementia care facility which poses a immediate risk to the health, safety, or personal rights of the persons in care.

Official plan of correction

Staff removed the scissors and made them inaccessible to residents in care. ***No further action required***

Deadline recorded: Feb 26, 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

87468.1 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 requirement has not been met as evidenced by: S3 and S5 stated that resident's correspondence is opened and screened before giving it to resident which poses an immediate risk to the health, safety, or personal rights to the persons in care.

Official plan of correction

Administrator will read section 87468.1 and send a written statement to LPA stating she has read and understands the section. Also, facility staff will not open any correspondence belonging to residents and will provide it to residents promptly and unopened.

Deadline recorded: Jan 31, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

(e) Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degrees C) and not more than 120 degree F (49 degrees C). This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. the water at the facility measured 93.7 to 122.0 in random rooms which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/17/2024 Plan of Correction Administrator will adjust water and keep a log for seven (7) days and send to LPA as proof of correction. Civil penalties issued for repeat violation.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

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, the licensee did not comply with the section cited above. Facility front side fire door is not operating as it should, it will not open. Call cord in room 157 needs repair, and there is a leak in the food storage room which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/20/2024 Plan of Correction Administrator will repair the fire door, the call cord in room 157 and the water leak in the food storage room. Facility will send proof of repairs to LPA. Facility reported the fire door to fire department today. per Administrator. Facility repaired fire door and call cord during visit. Only thing pending is the leak in food storage room.

Official classification

Type B

Official code

80072(a)(b)(1)

Regulation authority

CCR

What the official deficiency says

80072(a)(b)(1) (a) In addition to Section 80072, the following shall apply. (b) The licensee shall insure that each client is accorded the following personal rights. (1) To visit the facility with his/her relatives or authorized representative prior to admission. Facility failed to insure that resident/family or authorized representative visit facility prior to admission.

Official plan of correction

Administrator will send written plan on how they will avoid this in the future and train admitting staff to insure that residents are accorded all personal rights and send sign roster of staff who attended the training by POC date.

Deadline recorded: Jan 18, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87458(a)

Regulation authority

CCR

What the official deficiency says

(a) Prior to a person's acceptance as a resident, the licensee shall obtain and keep on file, documentation of a medical assessment, signed by a physician, made within the last year. The licensee shall be permitted to use the form LIC 602 (Rev. 9/89), Physician's Report, to obtain the medical assessment. This requirement is not met as evidenced by: Resident#1 did not have a current physician report on file. Based on file review, Administrator did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator would obtain an updated phyisican report LIC 602 and provide a copy of the physician report to Licensing by POC due date.

Deadline recorded: Nov 14, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87705(c)(5)

Regulation authority

CCR

What the official deficiency says

This requirement is not met as evidenced by: Deficient Practice Statement 87705(c)(5) Each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, Based on record review, the licensee did not comply with the section cited above in which 3 out of 5 residents' physician's report are past a year of its last exam which poses a potential health and safety risk to residents in care.

Official plan of correction

POC Due Date: 11/21/2023 Plan of Correction The administrator shall ensure all residents with dementia have current medical assessments. The physician's report for Residents #1, #2, and #4 shall be submitted to LPA by POC due date 11/21/23.

Official classification

Type B

Official code

87411(f)

Regulation authority

CCR

What the official deficiency says

This requirement is not met as evidenced by: Deficient Practice Statement 87411(f) All personnel shall be in good health...Good physical health shall be verified by a health screening, including a chest x-ray....not more than six (6) months prior to or seven (7) days after employment or licensure. Based on record review, the licensee did not comply with the section cited above in which 2 of the 4 staff did not have health screening forms filled out which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 11/21/2023 Plan of Correction The administrator shall ensure all staff have health screening completed in their files. The health screening form for Staff #2 and #3 shall be submitted to LPA by 11/21/23.

Official classification

Type A

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

87303 Maintenance and Operation (e) Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C). This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in which 4 out of the 8 rooms' hot water temperature were over 120 degrees F which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/27/2023 Plan of Correction The administrator shall ensure the hot water temperature is within the range of 105-120 degrees F. A log of the hot water temperature shall be submitted to LPA by 10/27/23.

Official classification

Type A

Official code

87411(a)

Regulation authority

CCR

What the official deficiency says

87411 Personnel Requirements – General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs.... This requirement is not met as evidenced by: Based on interviews and records review, the facility failed to ensure that R1 was wearing a hip protector garment and resulted in a hip fracture which poses an immediate health and safety risk to residents in care.

Official plan of correction

The Administrator shall develop a plan to ensure that all residents who signs up for the Impactactive waiver are provided with the hip protection garment. This plan shall be submitted to LPA by the POC due date 2/2/23. In addition, an in-service training shall be provided to all care staff to ensure hip protectors are worn. This training log shall be submitted to LPA by POC date 2/9/23. **A civil penalty of $500 is being issued.**

Deadline recorded: Feb 3, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87468.2(a)(4)

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...(4) To care, supervision, and services that meet their individual needs and are delivered by staff... This requirement is not met as evidenced by: Based on interviews, staff did not ensure that R1, who was supposed to be provided a hip protector, was wearing one which poses an immediate health and safety risk to residents in care.

Official plan of correction

The Administrator shall provide a plan to ensure all residents who requested for a hip protector garment are wearing one by POC due date 2/2/23.

Deadline recorded: Feb 3, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87625(b)(1)

Regulation authority

CCR

What the official deficiency says

87625 Managed Incontinence (b) In addition to Section 87611,... the licensee shall be responsible for the following: (1) Ensuring that residents who can benefit from scheduled toileting are assisted...rather than being diapered. This requirement is not met as evidenced by: Based on staff interview, the Administrator did not ensure that resident is being transferred to the toilet upon request which poses a potential health, safety, and personal rights risk to residents in care.

Official plan of correction

The Administrator shall conduct an in-service training to care staff in regards to managing residents who are incontinence and who can benefit from a scheduled toileting as opposed to being diapered. The training log shall be submitted to LPA by POC due date 9/27/22.

Deadline recorded: Sep 27, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.1(a)(1)

Regulation authority

CCR

What the official deficiency says

87468.1 Personal Rights of Residents in All Facities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement is not met as evidenced by: Based on interviews, S-1 admitted to not taking R-1 to sit on the toilet when requested on 6/4/21 which poses a potential personal rights risk to residents in care.

Official plan of correction

Administrator shall conduct an in-service training as a reminder to all staff regarding personal rights. The POC shall be submitted to LPA by POC due date 7/14/22. **POC has been cleared as of 7/7/22***

Deadline recorded: Jul 14, 2022. A deadline is not proof that correction was completed.