LA MIRADA VILLA FOR THE ELDERLY

Official classification

Type B

Official code

87411(f)

Regulation authority

CCR

What the official deficiency says

(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure. A report shall be made of each screening, signed by the examining physician. The report shall indicate whether the person is physically qualified to perform the duties to be assigned, and whether he/she has any health condition that would create a hazard to him/herself, other staff members or residents. A signed statement shall be obtained from each volunteer affirming that he/she is in good health.Personnel with evidence of physical illness or emotional instability that poses a significant threat to the well-being of residents shall be relieved of their duties. 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 2 out of 4 staff, because two staff members do not have a health screening in their records, which poses 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 Administrator is to ensure that all staff have health screening in their records at all times. Administrator shall obtain health screenings for the two identified staff members and email them to LPA by the POC due date.

Official classification

Type B

Official code

87412(d)

Regulation authority

CCR

What the official deficiency says

(d) The licensee shall maintain documentation that an administrator has met the certification requirements specified in Section 87406, Administrator Certification Requirements or the recertification requirements in Section 87407, Administrator Recertification Requirements. 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 6 out of 6 residents, because the administrator does not have an active administrator's certificate, which poses a potential health and safety risk to clients in care.

Official plan of correction

POC Due Date: 07/10/2026 Plan of Correction Administrator is to ensure that their administrator certificate remains active at all times. Administrator shall recertify their administrator certificate or provide update to LPA on the progress of the recertification and email it 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 observation and interview, the licensee did not comply with the section cited above in 3 out of 6 residents, because there are 3 residents with half-bed rails but do not have a physician order for the rails, which poses 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 Administrator is to ensure all residents that have half-rails on their beds shall have accompanying physicians orders for the rails at all times. Administrator shall obtain physicians orders for the rails and email the orders for the 3 identified residents to LPA by the POC due date.

Official classification

Type A

Official code

87465(a)(4)

Regulation authority

CCR

What the official deficiency says

(a) A plan for incidental medical and dental care shall be developed by each facility. (...) (4) The licensee shall assist residents with self-administered medications as needed. This regulation is not met as evidenced by: Based on staff/client interviews and a review of medication records, LPA determined that facility staff did not administer medications as prescribed or obtained discontinue orders for 2 out of 5 resdients (R1 - R2), which poses an immediate health and safety threat to residents in care.

Official plan of correction

The licensee shall submit a plan to address the medication discrepancies for R1 - R2. In addition, an in-service training regarding medications shall be provided and log shall be submitted to LPA by the POC due date.

Deadline recorded: Feb 6, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87618(b)(1)

Regulation authority

CCR

What the official deficiency says

(b) In addition to Section 87611(b), the licensee shall be responsible for the following: (1) Monitoring of the resident's ongoing ability to operate the equipment in accordance with the physician's orders. This regulation is not met as evidenced by: Based on observation, staff/client interviews and a review of physician orders, LPA determined that facility staff did not monitor resident's ability to operate oxygen equipment and could not provide an order for 1 out of 5 residents (R1), which poses a potential health and safety threat to residents in care.

Official plan of correction

Administrator is to obtain a physician order of oxygen administration for R1 and provide it to LPA, along with a plan with how the facility will ensure the order is followed to LPA by the POC due date.

Deadline recorded: Feb 26, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(a)(4)

Regulation authority

CCR

What the official deficiency says

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility. (4) The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Based on medication review, 3 out of the 6 residents were not receiving their medications as prescribed by the physician which poses an immediate health and safety risk to residents in care.

Official plan of correction

The licensee shall submit a plan to address the medication discrepancies for Residents #2, #3, and #4. In addition, an in-service training regarding medications shall be provided and log shall be submitted to LPA by 1/30/26.

Deadline recorded: Jan 30, 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 is not met as evidenced by: Based on medication review, 3 out of the 6 residents were not receiving their medications as prescribed by the physician which poses an immediate health and safety risk to residents in care.

Official plan of correction

The licensee shall submit a plan to address the medication discrepancies for Residents #2, #3, and #4. In addition, an in-service training regarding medications shall be provided and log shall be submitted to LPA by 1/16/26.

Deadline recorded: Jan 16, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87355(e)(3)

Regulation authority

CCR

What the official deficiency says

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (3) Request a transfer of a criminal record clearance as specified in Section 87355(c) or 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 2 out of 4 staff members, as 2 of them were not associated, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/06/2025 Plan of Correction Administrator is to associate the 2 staff members in Guardian by the POC due date.

Official classification

Type A

Official code

87465(a)(4)

Regulation authority

CCR

What the official deficiency says

(4) The licensee shall assist residents with self-administered medications as needed. 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 2 out of 4 residents, as 2 residents did not have their medications supplied at the facility, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/06/2025 Plan of Correction Administrator is to email LPA the facility's plan for how they will obtain the medication for the identified clients.

Official classification

Type B

Official code

87412(a)(11)

Regulation authority

CCR

What the official deficiency says

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (11) A health screening as specified in Section 87411, Personnel Requirements - General. 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 2 out of 4 staff members, as 2 staff did not have a completed health screening with TB clearance on file, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/04/2025 Plan of Correction Administrator is to ensure that medical assessments for all staff are kept on file at all times. Administrator is to obtain the health screenings with TB clearances for the 2 staff members and email them to LPA by the POC due date.

Official classification

Type B

Official code

87411(c)(1)

Regulation authority

CCR

What the official deficiency says

(1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross. 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 1 out of 4 staff, as one of the staff members did not have a CPR certificate on file, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/04/2025 Plan of Correction Administrator is to ensure that all staff have active CPR certificates on file at all times. Administrator is to email the identified staff member's CPR certificate by the POC due date.

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 2 out of 4 clients, as Resident #1 and Resident #2 who both have a dementia diagnosis did not have a physician's report completed within the past year, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/04/2025 Plan of Correction Administrator is to ensure that all residents with dementia have a physician's report completed within the past year at all times. Administrator is to obtain the physician's reports and email them to LPA by the POC due date.

Official classification

Type B

Official code

1569.625(b)(2)

Regulation authority

HSC

What the official deficiency says

(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview and record review, the licensee did not comply with the section cited above in 5 out of 5 staff members, because staff have not conducted annual retraining on topics related to dementia care, hospice care, postural supports, and restricted health conditions, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/28/2024 Plan of Correction Licensee is to ensure that staff will be trained annually on topics related to dementia care, hospice care, postural supports, and restricted health conditions. Administrator is to email LPA the facility's plan on how they will conduct the required annual retraining on the required topics by the POC due date.