TWIN PALMS

Official classification

Type A

Official code

87355(e)(3)

Regulation authority

CCR

What the official deficiency says

(e) 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: (3) Request a transfer of a criminal record clearance as specified in Section 87355(c) or 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 1 out of 4 staff members (S3) is not associated to the facility which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/15/2026 Plan of Correction The Administrator will review the regulation and email LPA Segovia a statement of understanding and will confirm they will not employee staff members without proper clearance/transfer by POC due date.

Official classification

Type B

Official code

1569.618(c)(3)

Regulation authority

HSC

What the official deficiency says

(c)The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (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 Based on observation, interview and record review, the licensee did not comply with the section cited above in 2 out of 3 current staff members did not have current CPR/First-Aid which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/23/2026 Plan of Correction The Administartor will email LPA Segovia the renewed CPR for S1 and S2 by POC due date.

Official classification

Type A

Official code

87465(a)(1)

Regulation authority

CCR

What the official deficiency says

Incidental Medical and Dental Care: (a) A plan for incidental medical and dental care shall be developed by each facility... (1) The licensee shall arrange... for medical and dental care appropriate to the conditions and needs of residents. This requirement is not met as evidenced by: Based on interview and record reviews, licensee did not comply with the section cited above by providing care to R1 without hiring a Wound Specialist and or a medical professional from 12/26/23 to 01/09/24, which poses/posed an immediate health and safety risk to resident in care.

Official plan of correction

The Administrator has agreed to do the following: Submit a Statement of Understanding, and the steps the facility will take to avoid similar issues from happening again and to ensure compliance to the cited regulation This is a zero tolarance and an immediate civil penalty of $500.00 will be assessed

Deadline recorded: Feb 3, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87463(a)

Regulation authority

CCR

What the official deficiency says

Reappraisals: (a) The pre-admission appraisal shall be updated, in writing as frequently as necessary to note significant changes and to keep the appraisal accurate. The reappraisals shall document changes in the resident's physical, medical... This requirement is not met as evidenced by: Based on interview and record reviews, licensee did not comply with the section cited above. Adminsitrator confirmed that upon R1's discharge from the hospital on 12/26/23, R1's reappraisal was not updated, which poses/posed a potential health and safety risk to resident in care.

Official plan of correction

Administrator agreed to submit a statement of understanding on how all residents will have a proper reappraisal when changes occur and coming out of the hospital to ensure their needs are met. Proof of statement shall be submitted to LPA by POC date.

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

Official classification

Type A

Official code

87465(g)

Regulation authority

CCR

What the official deficiency says

87465(g) Incidental Medical and Dental Care. The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health.... This requirement is not met as evidenced by: Based on the investigation, the licensee did not comply with the section cited above, as staff did not seek medical attention for R1 in a timely manner, which poses/posed an immediate health and safety risk to residents in care.

Official plan of correction

The Administrator has agreed to do the following: Submit a Statement of Understanding, and the steps the facility will take to avoid similar issues from happening again and to ensure compliance to the cited regulation This is a zero tolarance and an immediate civil penalty of $500.00 will be assessed

Deadline recorded: Feb 3, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87411(d)(5)

Regulation authority

CCR

What the official deficiency says

87411(d)(5) Personnel Requirements – General: (d) All personnel shall be given on the job training... This training and/or related experience shall provide knowledge of and skill in the following... (5) Knowledge necessary in order to recognize... the need for professional help. This requirement is not met as evidenced by: Based on the investigation, the licensee did not comply with the section cited above, as the facility staff walked away and left a hot soup on an unstable table and failed to provide an appropriate supervision. Although, the staff was trained with all the required basic services, the staff did not immediately call 911. Instead, they contacted the Administrator who made a decision to wait for R1’s doctors appointment that was already scheduled on a 05/30/23 (5 days after the incident), which poses/posed an immediate health and safety risk to residents in care.

Official plan of correction

Licensee agreed that all personnel (current and or future) will receive the required training. A verification of staff training will be submitted to CCLD by POC date.

Deadline recorded: Feb 3, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87405(b)

Regulation authority

CCR

What the official deficiency says

87405(b) Administrator - Qualifications and Duties: (b) The administrator of a facility or facilities shall have the responsibility and authority to carry out the policies of the licensee. This requirement is not met as evidenced by: Based on the investigation, the Administrator did not comply with the section cited above, failing to follow and carry out an emergency policy, which poses/posed an immediate health and safety risk to residents in care.

Official plan of correction

Licensee agreed that the facility Administrator, designee and all staff will be trained on 911 situations and emergency step-by-step procedure for the residents. Proof of training will be submitted to CCLD by POC date.

Deadline recorded: Feb 3, 2024. 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 Criminal Record Clearance (e) 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... This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above. S2's first day of work was on 01/13/24 and as on 01/17/24 S2 is not associated to the facility which poses an immediate health, safety risk to persons in care.

Official plan of correction

Administrator has agreed to either have the staff get fingerprinted or submit the request for transfer. Administrator will provide an updated LIC500 to reflect new staff.

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

Official classification

Type B

Official code

87211(a)(1)

Regulation authority

CCR

What the official deficiency says

Requirements: (a) Each licensee shall furnish to the licensing agency such reports... (1) A written report shall be submitted to the licensing agency and to the person... ... any of the events specified in (A), (B) & (D)... This requirement is not met as evidenced by: Based on interviews and record reviews, conducted by LPA, the licensee did not comply with the section cited above by failing to notify CCLD regarding the two (2) incidents that occured between December 2023 to January 2024, which poses a potential health and safety risk to persons in care.

Official plan of correction

Licensee shall ensure a written report is submitted to the licensing agency and to the person responsible for the resident within seven (7) days of the occurrence of any of the events. Copies of two (2) incidents for R1, shall be submitted to LPA by POC date.

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

Official classification

Type B

Official code

87211(a)(1)

Regulation authority

CCR

What the official deficiency says

87211(a)(1) A,B & D Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports... (1) A written report shall be submitted to the licensing agency and to the person... ... any of the events specified in (A), (B) & (D)... This requirement is not met as evidenced by: Based on interviews and record reviews, the licensee did not comply with the section cited above by failing to notify CCLD regarding the incident that occured om 05/25/23, which posed/poses a potential health and safety risk to persons in care.

Official plan of correction

Licensee shall ensure a written report is submitted to the licensing agency and to the person responsible for the resident within seven (7) days of the occurrence of any of the events. Copy of the training materials and certificates, for all staff members, shall be submitted to LPA by POC date.

Deadline recorded: Jun 13, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87632(a)(1)

Regulation authority

CCR

What the official deficiency says

87632 Hospice Care Waiver: (a) In order accept or retain terminally ill residents and permit them to receive care from a hospice agency... (1) Specification of the maximum number of terminally ill... This requirement is not met as evidenced by Based on record review the licensee did not comply with the section cited above by addmiting three (3) hospice residents, when theh facility is only approved for one (1). This poses/posed a potential health, safety or personal rights risk to persons in care

Official plan of correction

Licensee agreed to submit a hospice exception for two (2) residents. Proof of the exception letter will be emailed to LPA by POC date.

Deadline recorded: Jun 13, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87608(a)(5)(B)

Regulation authority

CCR

What the official deficiency says

Postural Supports: (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... This requirement is not met as evidenced by: Based on interview and record review, the licensee did not comply with the section cited above by admitting a non-hospice resident (R4) and providing a full bed rail without a doctors approval, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee agreed to remove R4's bed rail immediately, and proof of picture will be submitted to LPA by POC date.

Deadline recorded: Jun 7, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87355(e)(b)(1)

Regulation authority

CCR

What the official deficiency says

Criminal record clearance: (e) All individuals subject to a criminal record review...(b) shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance... This requirement is not met as evidenced by: Based on interview and record review, the licensee did not comply with the section cited above by hiring one (1) staff member (S2) on 06/06/23 without fingerprint clearance, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee agreed to complete S2's fingerprints and associate a staff member to the facility. Copy of proof will be submitted to LPA by POC date. Civil penalty assessed.

Deadline recorded: Jun 7, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87705(f)(2)

Regulation authority

CCR

What the official deficiency says

87705(f)(2) Care of Persons with Dementia Over-the-counter medication, nutritional supplements or vitamins, alcohol, cigarettes, and toxic substances such as certain plants, gardening supplies, cleaning supplies and disinfectants. This requirement is not met as evidenced by: Based on observation, staff did not ensure that cleaning chemicals were inaccessible to residents in care which poses an immediate hazard to the health, safe and personal rights to the residents in care.

Official plan of correction

Cleaning chemicals were removed during the inspection and stored in the garage that is locked. Licensee is to conduct training to all staff on how to properly store and maintain cleaning chemicals inaccessible to residents in care. Training is to be submitted by 11/04/22.

Deadline recorded: Nov 2, 2022. A deadline is not proof that correction was completed.