GOLD MEDAL SENIOR LIVING GARDENS

Official classification

Type A

Official code

87309(a)(1)

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. (1) Disinfectants, cleaning solutions, and poisonous substances shall be stored in areas separate from food supplies as specified in Section 87555, General Food Service Requirements. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation made during the facility walkthrough, the licensee did not comply with the section cited as LPA observed the lock on the kitchen cabinet containing cleaning chemicals was broken, making the toxic substances accessible to residents, which poses an immediate health and safety risk to persons in care. which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/27/2026 Plan of Correction Licensee shall repair or replace the lock on the kitchen cabinet used to store cleaning chemicals to ensure toxic substances are inaccessible to residents. The licensee shall submit proof of correction, including photographs of the repaired/replaced lock and a written statement describing the measures implemented to maintain toxic substances in a locked location, to LPA by the POC due date.

Official classification

Type B

Official code

87608(a)(5)(A)

Regulation authority

CCR

What the official deficiency says

(A) A bed rail that extends from the head half the length of the bed and used only for assistance with mobility shall be allowed. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in two (2) out of four (4) resident records reviewed. LPA observed that R3 and R4 did not have physician's orders authorizing the use of half bed rails in their files. which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/10/2026 Plan of Correction Licensee shall obtain physician's orders authorizing the use of half bed rails for R3 and R4. Copies of the physician's orders shall be submitted to LPA by the POC due date.

Official classification

Type B

Official code

87608(a)(5)(B)

Regulation authority

CCR

What the official deficiency says

(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 the need for full bed rails. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in one (1) out of four (4) resident records reviewed. LPA observed that R1 did not have a bed rail exception on file authorizing the use of full bed rails which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/10/2026 Plan of Correction The licensee shall submit a full bed rail exception request for R1 to LPA by POC due date.

Official classification

Type B

Official code

80072(a)(2)

Regulation authority

CCR

What the official deficiency says

(a) Except for children’s residential facilities, each client shall have personal rights which include, but are not limited to, the following: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above. LPA observed video cameras installed throughout the facility. During record review, LPA reviewed the facility's Photo/Video Recording Consent Form which indicated that the cameras record both video and audio. The use of audio recording in the facility constitutes a violation of residents' personal rights. which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/03/2026 Plan of Correction Licensee shall ensure that all video surveillance cameras within the facility do not record audio, as audio recording is prohibited in licensed residential care facilities. The licensee shall revise the facility's Photo/Video/Recording Consent Form to remove any reference to audio recording and ensure the form accurately reflects the facility's surveillance practices. The licensee shall submit a written statement verifying that all audio recording capabilities have been permanently disabled or removed from the surveillance system, along with proof of the revised Photo/Video/Recording Consent Form, to the Licensing Program Analyst (LPA) by the Plan of Correction due date.

Official classification

Type A

Official code

87411(c)(6)

Regulation authority

CCR

What the official deficiency says

(6) The licensee shall maintain documentation pertaining to staff training in the personnel records, as specified in Section 87412(c)(2). For on-the-job training, documentation shall consist of a statement or notation, made by the trainer, of the content covered in the training. Each item of documentation shall include a notation that indicates which of the criteria of Section 87411(c)(3) is met by the trainer. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and record review, documentation of staff annual trainings were NOT in personnel records when LPA reviewed personnel records, the licensee did not comply with the section cited above in 1 out of 2 personnel records, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/11/2025 Plan of Correction Licensee will certify a plan on how the facility will comply with this regulation moving forward and re-train staff on this regulation by 8/11/25. Proof of plan and re-training must be recieved via email to LPA Ramirez by 8/11/25.

Official classification

Type B

Official code

87211(a)(1)(D)

Regulation authority

CCR

What the official deficiency says

(a) Each licensee shall furnish to the licensing agency such reports as the Department may require, the following: (1) A written report shall be submitted to the licensing agency within seven days of the occurrence of any of the events in (A) through (D). This report shall include resident's name, date, nature of event; findings,treatment, if any.(D) Any incident which threatens the welfare, safety or health of any resident. This requirement was not met: Staff did not send these reports to LPA. This poses a potential risk to the health, safety, or personal rights of persons in care.

Official plan of correction

Licensee agreed to conduct re-training on this regulation by 05/16/2025 and send proof via email to LPA Ramirez.

Deadline recorded: May 16, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87618(b)(3)(E)

Regulation authority

CCR

What the official deficiency says

(b) In addition to Section 87611(b), the licensee shall be responsible for the following: (3) Ensuring that the use of oxygen equipment meets the following requirements: (E) Oxygen tanks that are not portable shall be secured in a stand or to the wall. This requirement was not met: 2 oxygen tanks were observed to not be secured to a wall or in a stand. This poses a potential risk to the health, safety, or personal rights of persons in care.

Official plan of correction

Licensee agreed to conduct re-training on this regulation by 05/16/2025 and send proof via email to LPA Ramirez. Licensee agreed to contact R1's hospice company to obtain oxygen tank stands by 5/16/25.

Deadline recorded: May 16, 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, all bathroom water temperatures were measured over 120 degrees F, the licensee did not comply with the section cited above in 6 out of 6 residents, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/21/2024 Plan of Correction **Staff adjusted water heater during visit to clear 24hr immediate correction.** Licensee will retrain staff on above regulation and devolop water log and record water temperature in all grooming areas for the next 3 calendar days. Proof of retraining and water log must be sent to LPA by 6/21/24 via email.

Official classification

Type A

Official code

87705(f)(2)

Regulation authority

CCR

What the official deficiency says

(f) The following shall be stored inaccessible to residents with dementia: (2) 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: Deficient Practice Statement Based on observation, disinfectants and cleaning supplies were accessible in laundry room cabinet, the licensee did not comply with the section cited above in 3 out of 6 dementia residents, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/21/2024 Plan of Correction **Staff moved disinfectants and cleaning supplies to inaccessible location during inspection. This clears 24hr correction** Licensee will retain staff on this regulation and send proof of retraining to LPA by 6/21/24 via email.

Official classification

Type B

Official code

87705(c)(5)

Regulation authority

CCR

What the official deficiency says

(c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (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, R5 did not have annual medical assessment, the licensee did not comply with the section cited above in 1 out of 6 residents which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/21/2024 Plan of Correction Licensee will certify plan to address how updated medical assessment for R5 will be provided and retrain staff on this regulation. Retraining and plan must be emailed to LPA by 6/21/24.

Official classification

Type A

Official code

87615(a)(1)

Regulation authority

CCR

What the official deficiency says

(a) Persons who require health services for or have a health condition including, but not limited to, those specified below shall not be admitted or retained in a residential care facility for the elderly: (1) Stage 3 and 4 pressure sores (dermal ulcers). This requirement is not met as evidenced by: Deficient Practice Statement Based on interview, record review, the licensee did not comply with the section cited above. facility accepted resident (R1) with stage 3 pressure sore which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/17/2023 Plan of Correction Administrator will write a plan on how she will address this issue and attend refresher training on prohibited health conditions and send proof to LPA by POC date. DC date for treatment of sores is 6/28/2023

Official classification

Type B

Official code

87465(h)(4)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (4) All centrally stored medications shall be labeled and maintained in compliance with state and federal laws. No persons other than the dispensing pharmacist shall alter a prescription label. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation record review, the licensee did not comply with the section cited above. None of the PRN for all residents had labels on bottles which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/28/2023 Plan of Correction Administrator will obtain labels for all PRN and send proof to LPA by POC date.

Official classification

Type B

Official code

87465(d)

Regulation authority

CCR

What the official deficiency says

(d) If the resident is unable to determine his/her own need for a prescription or nonprescription PRN medication, and is unable to 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: 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. Facility has not PRN authorization letters on file which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/28/2023 Plan of Correction Administrator will obtain PRN authorization letters for all residents and send proof to LPA by POC date.

Official classification

Type B

Official code

87632(d)(2)

Regulation authority

CCR

What the official deficiency says

(2) The licensee shall notify the Department in writing within five working days of the initiation of hospice care services for any terminally ill resident in the facility or within five working days of admitting a resident already receiving hospice care services. The notice shall include the resident's name and date of admission to the facility and the name and address of the hospice. 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. Facility accepted hospice resident and did not notify the department which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/21/2023 Plan of Correction Administrator will send notification of accepting hospice resident and take refresher training on rules of accepting hospice residents.

Official classification

Type B

Official code

87555(b)(26)

Regulation authority

CCR

What the official deficiency says

87555 General Food Service Requirements (b) The following food service requirements shall apply:(26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises. This requirement is not met as evidenced by: 2 staff stated that the facility did not keep suficent supply of 7days non perishabl because they try to provide fresh food for residents. Receipts show non perishable food purchased recently.

Official plan of correction

Facility staff will purchase non perishable food for 7 days and provide evidence to LPA. ****Non perishable food was purchased before LPA made visit and observed at time of visit, no further action required***

Deadline recorded: Mar 9, 2023. A deadline is not proof that correction was completed.