Admission, assessment, and evictionType B
- Official classification
- Type B
- Official code
- 87458(c)(1)(A)
- Regulation authority
- CCR
What the official deficiency says
The medical assessment shall include, but not be limited to: 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: Communicable tuberculosis. Deficient Practice Statement Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as resident #1 (R1) is missing a health screening with proof of negative TB test which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 03/25/2026 Plan of Correction Licensee to submit health screening (LIC 503) with negative TB test results by POC due date. Lizeth.villegas@dss.ca.gov
Admission, assessment, and evictionType B
- Official classification
- Type B
- Official code
- 87457(c)(1)(A)
- Regulation authority
- CCR
What the official deficiency says
87457 Pre-Admission Appraisal Prior to admission a determination of the prospective resident's suitability for admission shall be completed and shall include an appraisal of their individual service needs in comparison with the admission criteria specified in Section 87455, Acceptance and Retention Limitations. The appraisal shall document, at a minimum: An evaluation of the prospective resident's functional capabilities, mental condition, and social factors as specified in Sections 87459, Functional Capabilities and 87462, Social Factor. Deficient Practice Statement Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as residents #1-5 (R1-R5) do not have a needs and service plan in their file for LPA to review which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 03/25/2026 Plan of Correction Licensee to complete a needs and service plan for all residents and submit a copy to LPA by POC due date.
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 87411(f)
- Regulation authority
- CCR
What the official deficiency says
87411 Personnel Requirements - General 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 report shall 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. Deficient Practice Statement Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as Staff #1 (S1) did not have a health screening with proof of negative TB test for LPA to review which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 03/25/2026 Plan of Correction Licensee to provide LPA with proof of health screening with a negative TB test completd and signed by a physician by POC due date.
Records and plan of operationType B
- Official classification
- Type B
- Official code
- 87208(a)(1)
- Regulation authority
- CCR
What the official deficiency says
87208 Plan of Operation The licensee shall have and maintain a current, written definitive plan of operation for the facility. The licensee shall operate the facility in accordance with the terms specified in the plan of operation and may be cited for not doing so pursuant to Health and Safety Code section 1569.49. The plan and related materials shall be on file in the facility and shall be submitted to the licensing agency with the license application. Any significant changes in the plan of operation which would affect the services to residents shall be submitted to the licensing agency for approval. The plan and related materials shall contain the following: Statement of purposes and program goals. Deficient Practice Statement Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as facility currently has dog(s) in the backyard which is not part of their approved paln of operation. This poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 03/25/2026 Plan of Correction Licensee to submit an updated plan of operation detailing what is the purpose and program goals of having the Dog(s) at the facility. If the licensee does not wish to update the plan of operation, licensee shall provide proof to LPA by POC due date that the dog(s) have been relocated.