HOUSE OF GRACE LLC

Official classification

Type A

Official code

87309(a)

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. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above scissors were in unlocked drawer in kitchen which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/14/2025 Plan of Correction Administrator will go over CCR 87309(a) with staff and provide training to LPA by POC due date.

Official classification

Type B

Official code

87305(a)

Regulation authority

CCR

What the official deficiency says

(a) Prior to construction or alterations, all facilities shall obtain a building permit. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above two rooms were buit in garage which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/27/2025 Plan of Correction Administrator will submit permits or contact city for permits and send documents to LPA by POC due date.

Official classification

Type B

Official code

87458(c)(1)(A)

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: (A) Communicable tuberculosis. 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 R2 did not have TB completed on physicians report, and R3 needs a new physicians report which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/27/2025 Plan of Correction Administrator will send both physicians reports by POC due date to LPA.

Official classification

Type B

Official code

87405(d)(5)

Regulation authority

CCR

What the official deficiency says

87405(d)(5) Administrator - Qualifications and Duties (d) The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7). If the licensee is also the administrator, all requirements for an administrator shall apply. (5) Good character and a continuing reputation of personal integrity. 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 Based on record review Administrator was asked to provide physicians report (602) with TB reading. Physicians report with TB was incomplete on R2’s file, Administrator left home to gather additional paperwork and came back with TB information completed LPA asked for old physician’s report (602) and it was removed from R2’s file and could not be found. Fire extinguisher had not been serviced and showed a receipt of January 2022 Administrator came from home with generic tag and stated they had left at another facility. (picture taken). which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/20/2025 Plan of Correction Administrator will insure all documents are not altered and provide a plan on how this will be avoided for future visits and send to LPA by POC due date.

Official classification

Type A

Official code

1569.35(C)(2)

Regulation authority

HSC

What the official deficiency says

1569.35(C)(2) (2) If a local long-term care ombudsman or the State Long-Term Care Ombudsman files a complaint alleging denial of a statutory right of access to a residential care facility for the elderly under Section 9722 of the Welfare and Institutions Code, the department shall give priority to the complaint pursuant to Section 9721 of the Welfare and Institutions Code and notify the Office of the State Long-Term Care Ombudsman that an investigation has been initiated pursuant to this section. This requirement is not met as evidenced by: LTCO staff was not allowed entry into the facility on various dates:(2/26/21, 9/17/21, and 1/14/22). LPA conducted interviews with facility administrator and LTCO staff and reviewed a notice that was mailed from LTCO to facility administrator which stated that administrator denied LTCO access into the facility. This poses an immediate health and safety risk to residents in care.

Official plan of correction

Administrator to review HSC 1569.35(c)(2) and submit written Plan of Correction which states that the facility administrator and staff will ensure the facility is meeting HSC Code and allows entry to LTCO staff into the facility. Administrator to submit a faxed or mailed copy of POC by due date.

Deadline recorded: Jan 27, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

87465 Incidental Medical and Dental Care (h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees... This requirement is not met as evidenced by: Based on interviews, the licensee did not ensure that the eye drop medication was stored and locked in a place not accessible to residents which poses a potential health and safety risk to residents in care.

Official plan of correction

The Administrator shall ensure that all medications are stored and locked making them inaccessible to residents. The plan of correction is due by 9/1/22. **This plan of correction has been cleared as of 8/25/22.

Deadline recorded: Sep 1, 2022. A deadline is not proof that correction was completed.