HAWTHORNE TERRACE CARE HOME, LLC

Official classification

Type B

Official code

87468.1(a)(1)

Regulation authority

CCR

What the official deficiency says

Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement is not met as evidenced by: Based on observations, interviews, and records reviewed the licensee did not comply with the section cited above not by residents not being treated with dignity by other residents in the facility.

Official plan of correction

The Administrator has agreed to train staff on resident personal rights, R1’s care plan and create de-escalation methods for R1. The Administrator will email staff trainings to Socorro.Leandro@dss.ca.gov.

Deadline recorded: May 14, 2026. 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, as specified in Section 87457, Pre-Admission Appraisal, shall be updated in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition, as defined in Section 87101, Definitions, and to keep the appraisal accurate. For the purposes of this section, the updated pre-admission appraisal shall be referred to as the reappraisal. This requirement is not met as evidenced by: Based on records reviewed the licensee did not comply with the section cited above not by not having an updated Reappraisals for R1.

Official plan of correction

The Administrator has agreed to update R1’s reappraisal and email it to Socorro.Leandro@dss.ca.gov.

Deadline recorded: May 30, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87463(h)(1-3)

Regulation authority

CCR

What the official deficiency says

Reappraisals (h) The licensee shall request that all residents receive an annual routine visit with a licensed medical professional once every twelve months, either in person or by video appointment. (1) Documentation of the annual routine visit, such as a visit summary, shall be added to the resident's record. (2) Documentation of a resident's refusal to receive an annual routine visit, or if applicable, their representative's refusal on their behalf, shall be added to the resident's record. (3) If a resident refuses to receive an annual routine visit, or if applicable, their representative refuses an annual routine visit on their behalf, but later agrees to one, documentation of the annual routine visit shall be added to the resident’s record. This requirement is not met as evidenced by: Based on records reviewed the licensee did not comply with the section cited above not by not having an updated annual medical assessment for R1.

Official plan of correction

The Administrator has agreed to assist R1 in scheduling a physical exam and have the physician complete the physicians report. The Administrator will email R1’s physicians report to Socorro.Leandro@dss.ca.gov.

Deadline recorded: May 30, 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

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, the licensee did not comply with the section cited above in having rooms 2, 3, and 4 closet doors in disrepair and having 1 bathroom sink in disrepair, which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 10/29/2024 Plan of Correction Licensee agrees to fix closet doors in rooms 2, 3 and 4. Licensee agrees to fix bathroom sink. Licensee will take videos and send them as proof of correction to Socorro.Leandro@dss.ca.gov.

Official classification

Type B

Official code

87468.1(a)(3)

Regulation authority

CCR

What the official deficiency says

Personal Rights of Residents in All Facilities...To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination Based on interview and records review the Licensee did not comply with the section above. License kept R1 February 2024 SSI check although R1 moved out of the facility in January 2024. As of 2/20/2024, the Licensee has not returned the monies to R1 or contacted SSA. This poses a personal rights risk to resident in care.

Official plan of correction

Administrator should reach out to the Social Security Administration regarding R1 February 2024 check. Administrator shall develop a plan to comply with Title 22 Regulations to the department by POC due date.

Deadline recorded: Feb 27, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

Not listed

Regulation authority

Not listed

What the official deficiency says

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... this requirement not met as evidenced by: O 11/23/2021 LPA Cardenas measrued hot water in bathroom and teperature measured at 121.6 degrees F. This poses an immediate health and safety risk to residents in care.

Deadline recorded: Nov 24, 2021. A deadline is not proof that correction was completed.