CLAREMONT MANOR

Official classification

Type A

Official code

87555(b)(27)

Regulation authority

CCR

What the official deficiency says

General Food Service Requirements- (b) The following food service requirements shall apply: (27) All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects.This requirement was not met as evidenced by: On 2/11/25, facility kitchen was closed down for 5 days due to roach infestation.

Official plan of correction

Licensee made kitchen repairs, conducted kitchen staff retraining and updated their pest control services. *NO FURTHER ACTION IS REQUIRED*

Deadline recorded: Mar 19, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87412(g)(1)

Regulation authority

CCR

What the official deficiency says

87412 Personnel Records (g) All personnel records shall be maintained at the facility and shall be available to the licensing agency for review. (1) The licensee shall be permitted to retain such records in a central administrative location provided that they are readily available to the licensing agency at the facility as specified in Section 87412(f). This requirement is not met as evidenced by: LPA Ramirez could not gain access to personnel records. Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in residents, staff and or visitors, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/29/2024 Plan of Correction Licensee will develop plan to address how this licensing agency will have access to personnel records and re-train staff on this regulation by 6/29/24. LPA Ramirez will return to review personnel records.

Official classification

Type A

Official code

87468.1(a)(1)

Regulation authority

CCR

What the official deficiency says

87468.1(a)(1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement is not met as evidenced by: According to statements from staff, resident was left on the floor for 30 to 40 minutes in soil clothing which posed a health a safety isuue.

Official plan of correction

Administrator will provide traning in personal rights to all staff in memory care units as welll as other staff at facility and provide LPA with signed roster by POC date.

Deadline recorded: Oct 6, 2022. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(c)(2)

Regulation authority

CCR

What the official deficiency says

87465(c)(2) (c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: (2) Once ordered by the physician the medication is given according to the physician's directions. This requirement is not met as evidenced by: Deficient Practice Statement Based on record reviewed, LPAs observed seven (7) residents' PRN medications are not located in the facility which posed the immediate risk to the residents in care

Official plan of correction

POC Due Date: 10/28/2021 Plan of Correction The administrator will review the residents PRN medication and see if it's needed to be discontinued or re-ordered the medication if needed and please send the picture of the re-ordered medication and discontinuation notice to LPA by POC due date.