PALMCREST GRAND RESIDENCE

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

Storage Space and Access (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 was not met as evidenced by: Based on observations the licensee did not comply with the section cited above by not having knives in locked storage at all times which poses/posed an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Staff removed knive to a secure location. The Administrator has agreed to train staff on locking items that can pose a danger to residents. Email trainings to Socorro.Leandro@dss.ca.gov

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

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 as the Administrator of record has not met the recertification requirements in Section 87407. Administrator has started the classes but has not yet completed the course work to fulfull the recertification requirements, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/15/2025 Plan of Correction Administrator Veronica Gomez plans to complete her course work by POC date of 5/15/25. Once completed, the administrator to forward proof of completion to LPA: Deborah.Lee@dss.ca.gov.

Official classification

Type B

Official code

87413(a)(3)

Regulation authority

CCR

What the official deficiency says

87413 Personnel – Operations (a) In each facility: (3)The licensee shall provide for and encourage all personnel to report observations or evidence of such abuse, exploitation, or prejudice. This requirement is not met as evidenced by: Based on interviews by IB, Staff feared retaliation and were coerced/instructed not to cooperate/speak with authorized agencies about the incident 02/02/24. (A1) provided inconsistent statements to authorities. This poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee/Administrator agreed to comply and review Title 22 Regulation, Section “Personnel Operations” and implement a plan detailing how Licensee/Administrator will ensure all staff are encourage to report incidents. The plan is due by POC date to LPA Dabuet via email: ernand.dabuet@dss.ca.gov Proof of correction sent via email 09/13/24 of completed Incident Report Staff Training.

Deadline recorded: Apr 29, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87405(d)(5)

Regulation authority

CCR

What the official deficiency says

87405 Administrator - Qualifications and Duties (d) The administrator shall have the qualifications specified in Sections 87405(d).... If the licensee is also the administrator, all requirements... shall apply. (5) Good character and a continuing reputation of personal integrity. This requirement is not met as evidenced by: Based on interviews by IB, Staff feared retaliation and were coerced/instructed not to cooperate/speak with authorized agencies about the incident 02/02/24. This violation poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee/Administrator agreed to comply and review Title 22 Regulation, Section “Administrator Qualificaitons and Duties” and will complete an Ethics Training in Senior Care. The plan is due by POC date to LPA Dabuet via email: ernand.dabuet@dss.ca.gov Proof of correction sent via email 09/13/24 of completed Values, Ethics and Code of Conduct Training.

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

Official classification

Type B

Official code

87413(3)

Regulation authority

CCR

What the official deficiency says

87413(3) Personnel – Operations (3) The licensee shall provide for and encourage all personnel to report observations or evidence of such abuse, exploitation, or prejudice. This requirement is not met as evidenced by: Based on interviews by IB, Staff feared retaliation and were coerced/instructed not to cooperate/speak with authorized agencies about the incident 02/02/24. (A1) provided inconsistent statements to authorities. This violation poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee/Administrator agreed to comply and review Title 22 Regulation, Section “Personnel Operations” and implement a plan detailing how Licensee/Administrator will ensure all staff are encourage to report incidents. The plan is due by POC date to LPA Dabuet via email: ernand.dabuet@dss.ca.gov

Deadline recorded: Sep 13, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87405(b)(1)(2)(5)

Regulation authority

CCR

What the official deficiency says

87405 Administrator – Qualifications and Duties (b) The administrator of a facility or facilities shall have the responsibility and authority to carry out the policies of the licensee. (d) The administrator shall have the qualifications..(1) Knowledge of the requirements for providing care and supervision appropriate to the residents. (2) Knowledge of and ability to conform to the applicable laws, rules and regulations. (5) Good character and a continuing reputation of personal integrity. This requirement is not met as evidenced by: Based on interviews by IB, (A1) failed to carry out the policies and ability to conform to the applicable laws, rules and regulations. This violation poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee/Administrator agreed to comply and review Title 22 Regulation, Section “Administrator Qualificaitons and Duties” and will complete an Etnics Training in Senior Care. The plan is due by POC date to LPA Dabuet via email: ernand.dabuet@dss.ca.gov

Deadline recorded: Sep 13, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87224(b)(c)

Regulation authority

CCR

What the official deficiency says

87224 – Eviction Procedures (b) The licensee may, grant approval for the eviction upon a finding of good cause. Good cause exists if the resident is engaging in behavior which is a threat to the mental and/or physical health or safety of himself or to the mental and/or physical health or safety of others in the facility. (c) The licensee shall, in addition to either serving the required thirty (30) days notice , sixty (60) days notice or seeking approval from the Department and service three (3) days notice on the resident, notify or mail a copy of the notice to quit to the resident's responsible person. This requirement is not met as evidenced by: Based on interviews by IB, (A1) wrongfully evicted (R2) by transporting to VA hospital and denied accessed to return to the facility. This violation poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee/Administrator agreed to comply and review Title 22 Regulation, Section “Eviction Procedures” and implement a plan detailing how Licensee/Administrator will ensure all residents are given proper written eviction notice and submit for approval from CCL. The plan is due by POC date to LPA Dabuet via email: ernand.dabuet@dss.ca.gov

Deadline recorded: Sep 13, 2024. A deadline is not proof that correction was completed.

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 interview and record review, the licensee failed to ensure the current administrator on record 9Peggy Clark) has received their recertification which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/10/2023 Plan of Correction Administrator statd that licensee will appoint a certified administrator by POC due date.Licensee shall submit change of administrator packet to licensing by POC due date.

Official classification

Type B

Official code

87468.1(a)(2)

Regulation authority

CCR

What the official deficiency says

87468.1 Personal Rights of Residents in All Facilities Residents in all residential care facilities for the elderly shall have all of the following personal rights: To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee failed to comply with the section cited above as room 424 there was a lock on the outside of the bathroom door preventing resident from accessing the bathroom which poses/posed a personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/31/2023 Plan of Correction Administrator removed lock from the door at the time of the visit, this citation is CLEARED AT TIME OF VSIT.

Official classification

Type A

Official code

87628(a)

Regulation authority

CCR

What the official deficiency says

87628-Diabetes The licensee shall be permitted to accept or retain a resident who has diabetes if the resident is able to perform his/her own glucose testing with blood or urine specimens, and is able to administer his/her own medication including medication administered orally or through injection, or has it administered by an appropriately skilled professional. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, record review, the licensee did not comply with the section cited above as facility staff is assisting residents with glucose testing and insulin injections. Facility staff are not appropriately skilled professionals which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/31/2023 Plan of Correction Licensee to submit a plan outlining the steps the facility will take to ensure compliace with Title 22 regulations 87628 Diabetes by POC due date.