AN ELITE CHATEAU

Official classification

Type B

Official code

87555(b)(26)

Regulation authority

CCR

What the official deficiency says

(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: Based on LPAs' observations, there were no sufficient food supplies for nonperishable foods for a minimum of one week and perishable foods for a minimum of two days on the premises. This poses a potential health, safety, or personal rights risk to residents in care

Official plan of correction

The Assistant Administrator will purchase sufficient food supplies for nonperishable foods for a minimum of one week and perishable foods for a minimum of two days. Proof of groceries will be sent to the LPA by the POC date.

Deadline recorded: Oct 31, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87307(e)(2)(A)

Regulation authority

CCR

What the official deficiency says

(e) The licensee shall supervise residents as needed... when there is use of the following items: (2)...swimming pools...(A) The licensee shall ensure... are inaccessible... when not in active use by residents. This requirement is not met as evidenced by: Based on observation and record review, the licensee did not comply with the section cited above in allowing access to a pool from two gates when not in active use by residents which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Assistant administrator closed the gates during visit and agreed to submit a picture with the gate locked with a chain to LPA by POC due date 10/30/2025.

Deadline recorded: Oct 30, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87465(h)(5)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored:(5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers.This requirement is not met as evidenced by: Based on observation and record review, the licensee did not comply with the section cited above six (6) out of (6) resdients having medication transfered between containers which poses an potential health, safety or personal rights risk to persons in care.

Official plan of correction

Medication organizers shall be removed and residents medication shall be stored in their originally received containers. Assistant Administrator agreed that all staff responsible for providing residents with medication assistance of self administration will complete medication training and submit sign in sheet with training material covered to LPA by POC due date 11/14/2025.

Deadline recorded: Nov 14, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87465(h)(5)

Regulation authority

CCR

What the official deficiency says

h)The following requirements shall apply to medications...(1) Medications shall be centrally stored under the following circumstances: (C) Because of potential dangers... due to physical arrangements in the facility and the condition or the habits of other persons in the facility... This requirement is not met as evidenced by: Based on observation and record review, the licensee did not comply with the section cited above in two (2) out of (6) residents storing medication in their bedrooms which poses an potential health, safety or personal rights risk to persons in care.

Official plan of correction

The facility will centrally store all medications as indicated in their Program. Assistant Administrator will notify LPA that the medication will be centrally stored.

Deadline recorded: Oct 30, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)(1)

Regulation authority

CCR

What the official deficiency says

(a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to...the following: (1)A written report shall be submitted to the licensing agency...This requirement is not met as evidenced by: This requirement is not met as evidenced by: Based record review and interview, the licensee did not comply with the section cited above in one (1) out of (6) residents had a medical emergency and then started Hospice Services without notification or report submitted to Licensing which poses an potential health, safety or personal rights risk to persons in care.

Official plan of correction

The assistant administrator agreed to submit incident report and statement of understanding for the regulation cited to LPA by POC due date.

Deadline recorded: Oct 29, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87463(h)(1)

Regulation authority

CCR

What the official deficiency says

(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... added to the resident's record. Based on interviews and record review, the licensee did not comply with the section cited above 1 out of 6 residents having an LIC602 form 2023 even with a change in condition and diagnoses which poses an potential health, safety or personal rights risk to persons in care.

Official plan of correction

Assistant Administrator agreed to schedule R3 for a medical assesment and obtain an updated LIC602 and submit a copy to LPA by POC due date 11/14/2025.

Deadline recorded: Nov 14, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87355(e)(1)

Regulation authority

CCR

What the official deficiency says

Criminal Record Clearance. Prior to resi- ding or volunteering.. all individuals... a criminal record review shall obtain a clearance or ..exemption. During visit, LPA met with Administrator's son who is residing in the facility and indicated that his sister also lives here. Based on interview and review of Facility Personnel Report Summary Son & Daughter are not Criminal Background Clearanced or Transferred & Associated to this facility. No documentation has been submitted to CCLD. This poses a potential risk to residents in care.

Official plan of correction

Assistant Administrator will ensure that residents completed Criminal Background Clearance or Transferred & Associated to facility. Staff will provide documents to LPA. Son exit the facility and will not return until transferred and Associated. Daughter was not present at the time of this visit.

Deadline recorded: Feb 24, 873. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87458(a)

Regulation authority

CCR

What the official deficiency says

(a) Prior to a person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment, signed by a licensed medical professional acting within the scope of their practice and made within the last year, to be kept in the resident's record. 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 three (03) out of six (06) residents did not have accurate Physician's Report which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/05/2025 Plan of Correction Assistant Administrator will obtain updated complete Physician's Reports for the residents and email them to CCL by POC due date. Assistant Administrator will also keep a copy in resident's record.

Official classification

Type B

Official code

87305(a)

Regulation authority

CCR

What the official deficiency says

87305(a) Alterations to Existing Building or New Facilities (a) Prior to construction or alterations, all facilities shall obtain a building permit. This requirement is not met as evidenced by: Activity room has been converted into Administrator's son bedrooms. There is no permit for the alteration. Deficient Practice Statement Based on inspection and observation, the licensee did not comply with the section cited above. The licensee made alteration to the existing facility without prior notification to the Licensing Office which poseshhhnnnn a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/31/2025 Plan of Correction Licensee will submit new facility sketch including identifying recent changes made to physical plant. In addition written statement will be provided explaining when and how the facility will obtain approved permits for alteration of exisiting bulding as needed.