A FAITHFUL HOME OF CERRITOS

Official classification

Type B

Official code

87412(f)

Regulation authority

CCR

What the official deficiency says

(f) All personnel records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the following requirements: This requirement is not met as evidenced by: Deficient Practice Statement Based on interview, the licensee did not comply with the section cited above in 2 out of 2 staff files was not available for review, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/07/2026 Plan of Correction The facility will ensure all files are available at the facility for review, A copy of the staff files will be sent to LPA by POC due date.

Official classification

Type B

Official code

87458(c)(1)

Regulation authority

CCR

What the official deficiency says

(c) 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: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, and record review, the licensee did not comply with the section cited above in 2 out of 6 residents did not have a TB test o file, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/28/2026 Plan of Correction The facility will ensure all residents have a TB test on file. A copy of the test is due to LPA by POC due date.

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 documentation of a medical assessment, signed by a licensed medical professional acting within the scope of their practice and made within the last year, to be kept in the resident's record. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, LPA observed Resident #6 (R6’s) file did not have an updated medical assessment which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/26/2025 Plan of Correction Administrator will send Resident #6 (R6's) updated medical assessment to the LPA by the POC due date.

Official classification

Type B

Official code

87705(c)(5)

Regulation authority

CCR

What the official deficiency says

(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, both of which shall include a reassessment of the resident’s dementia care needs. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, Resident #2 (R2) and Resident #3 (R3’s) file physician’s report has a Dementia diagnosis that are over a year old which poses a potential health, safety, or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/26/2025 Plan of Correction The facility will ensure the Resident #2 (R2) and Resident #3 (R3’s) physician’s report is updated and send the updated copy to LPA by POC due date.

Official classification

Type B

Official code

87411(f)

Regulation authority

CCR

What the official deficiency says

(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 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. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, Staff #2 (S2’s) file did not have a health screening which poses a potential health, safety, or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/26/2025 Plan of Correction The administrator will send Staff #2 (S2’s) health screening to the LPA by the POC due date.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

87303 Maintenance and Operation (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 was not met as evidence by: LPA observed a large bubble on the ceiling of R1’s room, interviews with 2 out of 3 residents, 2 out of 3 staff and 1 family memeber confirmed that they have observed the leaks in R1’s room during the rainy season.

Official plan of correction

Administrator to submit a written plan to LPA via email explaining how facility will ensure that no water will enter residents room during rainy seasons.

Deadline recorded: May 27, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

80087(a)

Regulation authority

CCR

What the official deficiency says

80087 Buildings and Grounds (a) The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. This requirement was not met as evidence by: During visit on 11/12/24 LPA toured R1's room and observed a large bubble in the ceiling of R1's room. 2 staff confirmed there had been a leak in room during rainy season, 2 residents also confirmed leak, R4's family member also confirmed leak. Although Administrator provided a roofing inspection that was conducted 11/14/24, this roof inspection did not disclose inspection of the noticeable bubble in ceiling of R1's bedroom. During visit on 11/22/24 LPA observed bubble on ceiling of R1's room still present, and new damage to R1's recess lighting.

Official plan of correction

Administrator/Licensee to have a repair person who is knowledgeable in water damage and mold to inspect ceiling in R1's room. Copy of the inspection and any needed repairs to be provided and completed by POC due date.

Deadline recorded: Dec 9, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.2(a)(6)

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: (6) To make choices concerning their daily lives in the facility. This requirement was not met as evidenced by: Based on interviews R1 was unable to make the decison concerning how long they can use the bathroom. The bathroom time for R1 include showers, washing their face and having a bowel movement , which is potentially a health safety, or personal rights risk to persons in care.

Official plan of correction

The licensee will ensure the resident can make their own choices. Staff training will be conducted regarding residents personal rights. A copy of the traing is due to LPA by POC due date.

Deadline recorded: Oct 24, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.2(a)(6)

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: (6) To make choices concerning their daily lives in the facility. This requirement was not met as evidenced by: Based on interviews R1 was unable to make the decison concerning their daily lives, which is potentially a health,which poses an immediate health, safety, or personal rights risk to persons in care.

Official plan of correction

The licensee will ensure the resident can make their own choices. Staff training will be conducted regarding residents personal rights. A copy of the traing is due to LPA by POC due date.

Deadline recorded: Oct 24, 2024. 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: Based on observation and interview, the licensee did not comply with the section cited above in which the Licensee did not ensure R1's dresser is in good repair, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

The facility shall ensure R1's dresser is in good repair at all times. Photo proof of the correction is due to the LPA by the POC due date.

Deadline recorded: Sep 9, 2024. 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

(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, both of which shall include a reassessment of the resident’s dementia care needs. 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 5 out of 6 residents has dementia but the physcians report is over a year old or do not have a date, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/17/2024 Plan of Correction The facility will ensure the resident physcians report is update and send the updated copy to LPA by POC due date.