MOUNTAIN VIEW COTTAGES - IV

Official classification

Type A

Official code

87303(b)(2)

Regulation authority

CCR

What the official deficiency says

87303 Maintenance and Operation(b) A comfortable temperature for residents shall be maintained...(2)The facility shall cool rooms to a comfortable range, between 78 degrees F (26 degrees C) and 85 degrees F (30 degrees C)... This requirement is not met as evidenced by: Based on interviews and observations, the faciity's indoor was measured at 90 degrees F and resident went to the hospital for dehydration which posed a immediate health and safety risk to residents in care.

Official plan of correction

The licensee shall ensure the facility temperature is at a comfortable range, between 78 and 85 degrees F. A plan to ensure the temperature will stay in the range shall be submitted to LPA by 8/8/26.

Deadline recorded: Aug 8, 2026. 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

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 is not met as evidenced by: Based on observation and interviews, 2 out of the 3 resident rooms do not have air conditioners properly working which poses a potential health and safety risks to residents in care.

Official plan of correction

The licensee shall ensure that all air conditioning units in the facility are working properly. The licensee shall submit proof of installation of new air conditioners or air conditioners in working order by POC due date 8/14/26.

Deadline recorded: Aug 14, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87411(a)

Regulation authority

CCR

What the official deficiency says

87411 Personnel Requirements - General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This requirement was not met as evidenced by: Based on interviews and records review, facility staff failed to provide necessary supervision for (1) of (4) residents who fell at the facility and resulted in a fractured hand, which poses an immediate Health, Safety, or Personal rights risk to persons in care.

Official plan of correction

Licensee will submit a plan in writing on how facility staff will ensure to meet the needs of all residents including proper care and supervision, per their Individual Needs and Services Plans. Written plan to be submitted to LPA via email by POC due date.

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

Official classification

Type B

Official code

87465(g)

Regulation authority

CCR

What the official deficiency says

87465 Incidental Medical and Dental Care (g)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 was not met as evidenced by: Based on interviews and records review, facility staff failed to seek timely medical attention for (1) of (4) residents, after falling in the facility and sustaining a fracture to the right hand, which poses a potential Health, Safety, or Personal Rights risk to persons in care.

Official plan of correction

Licensee will conduct in-service training for all facilty staff on obtaining proper medical care for residents as needed/required. Copy of training material and sign-in sheet to be sent to LPA via email by POC due date.

Deadline recorded: Dec 22, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87303(a)(1)

Regulation authority

CCR

What the official deficiency says

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. (1) Floor surfaces in bath, laundry and kitchen areas shall be maintained in a clean, sanitary, and odorless condition. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, 6x6 gap was observed in bathroom#2 floor near shower, the licensee did not comply with the section cited above in 4out of 4 residents which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/27/2023 Plan of Correction Licensee will repair flooring and send picture via email by 12/4/23. . Licensee will instruct residents,staff, and visitors to use another bathroom till repair is made. Licensee will certift via email plans to address gap in floor.

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, disinfectants and cleaning solutions were observed to be accessible in kitchen hallway cabinet and laundryroom, the licensee did not comply with the section cited above in 3 out of 4 persons with dementia, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/27/2023 Plan of Correction Licensee will secure disinfectants and cleaning solutions and make them inaccessible to residents with dementia. Licensee will certify via email by 11/27/23 plan to address training. Licensee will provide re-training and send proof of training by 12/4/23.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

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: Deficient Practice Statement Based on observation, 2 kitchen cabinet doors located by sink were in disrepair. Cabinet drawer containing paper items was loose and not opening correctly to it's original design. LPA could see exposed nails. Upper cabinet door containing resident plates, cups and other dishware, was missing door knob, the licensee did not comply with the section cited above in 4 out of 4 residents which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/04/2023 Plan of Correction Licensee will repair and send photo proof via email.

Official classification

Type A

Official code

87705(j)

Regulation authority

CCR

What the official deficiency says

(j) The licensee shall have an auditory device or other staff alert feature to monitor exits, if exiting presents a hazard to any resident. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, auditory devices on 3 doors in the facility were not observed to operable,the licensee did not comply with the section cited above in 4 out of 4 residents which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/27/2023 Plan of Correction Licensee will certify via email plan to address re-training and licensee will send proof of re-training by 12/4/23.

Official classification

Type A

Official code

87355(e)(2)

Regulation authority

CCR

What the official deficiency says

Criminal Record Clearance. ... prior to working, residing or volunteering in a licensed facility: (1)Request a transfer of a criminal record clearance. This requirement is not met as evidenced by: Facility was unable to provide evidence that a criminal record transfer was requested for staff Yoseph Husada. Staff#2. Based on observation and file review, it poses/posed a immediate health, safety or personal rights risk to persons in care.

Official plan of correction

The facility will ensure that a criminal record clearance/exemption of all staff had been transferred and associated to the facility prior to working or being present at the facility. Administrator would submit evidence to Licensing that a criminal record clearance transfer and association of staff Yoseph Husada by POC due date on 5/20/23.

Deadline recorded: May 20, 2023. 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

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, LPA observed cockroaches in the kitchen cabinets; which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator agreed to hire a pest control company to evaluate insects/pest issues and will hire a pest control company for pest control treatment. Administrator would submit proof of pest control service invoice by POC due date.

Deadline recorded: Jun 16, 2023. 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

87303(a) Maintenance and Operation.(a) The facility shall be clean, safe, sanitary and in good repair at all times. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, two stove burners on the left side of the stove are not working. Stove top had a chipped hole on the left side. This poses a potential health and safety risk to residents.

Official plan of correction

POC Due Date: 01/04/2022 Plan of Correction Administrator stated the old stove will be replaced with a new stove by the due POC date.