OLIVE TREE HOME

Official classification

Type B

Official code

87303(f)

Regulation authority

CCR

What the official deficiency says

(f) All waste shall be located, stored, and disposed of in a manner that will not transmit communicable diseases or odors, pose a risk to health and safety, or provide a breeding place or food source for insects or rodents. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, LPA observed a cup with coffee with gnats inside/outside of the cup and on the wall which the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/15/2025 Plan of Correction The facility will ensure that pest control will conduct a visit to reduce the mutiple gnats in the residents room as well as enforce that residents should not eat food and drink inside their rooms to avoid the spread of gnats to the CCLD/El Segundo ASC Office via fax at 424-544-1016 Attn: Zina Brown or via email at zina.brown@dss.ca.gov by the POC due date.

Official classification

Type B

Official code

87555(b)(27)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (27) All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, LPA observed multiple gnats by the sink area of the kitchen, which the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/15/2025 Plan of Correction The facility will ensure that pest control will conduct a visit to reduce the mutiple gnats in the kitchen to the CCLD/El Segundo ASC Office via fax at 424-544-1016 Attn: Zina Brown or via email at zina.brown@dss.ca.gov by the POC due date.

Official classification

Type B

Official code

87458(c)(1)(A)

Regulation authority

CCR

What the official deficiency says

(c) The medical assessment shall include, but not be limited to: (1) A physical examination of the resident indicating the licensed medical professional's diagnosis or diagnoses and results of an examination for all of the following: (A) Communicable tuberculosis. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, and record review, the licensee did not comply with the section cited above in 2 out of 7 residents which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/15/2025 Plan of Correction The facility will submit the proof of correction - TB Test Results for Resident 5 (R5) & Resident 6 (R6) to the CCLD/El Segundo ASC Office via fax at 424-544-1016 Attn: Zina Brown or via email at zina.brown@dss.ca.gov by the POC due date.

Official classification

Type A

Official code

87413(a)(1)

Regulation authority

CCR

What the official deficiency says

(1) When regular staff members are absent, there shall be coverage by personnel with qualifications adequate to perform the assigned tasks. This requirement is not met as evidenced by: Deficient Practice Statement Based on [(observation) (interview), the licensee did not comply with the section cited above in not having available staff for approximately 30 minutes which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/21/2024 Plan of Correction Licensee will ensure there are always available staff at all times. As plan of correction, licensee will re-train facility staff regarding staff avalaibility at the facility. Copy of trainining will sent to LPA via email before POC due date.

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. The licensee did not comply with the section cited above in staff knowing there were bed bugs which were not dealt with through a commercial pest exterminator. This poses a potential Health, Safety or Personal rights risk to residents in care.

Official plan of correction

The licensee has agreed to update the house rules, to include " Residents shall not bring in any outside items, which includes clothing that has not been sanitzed at 120 degrees F or above. " In addition, licensee has agreed to contact a commercial exterminator and follow the guidance provided by this commercial exterminator to prevent any future occurance of infestation at the facility. Licensee will send a copy of the updated facilities' house rules and all exterminator visits and recommendation provided by exterminator to LPA at MARIO.LEON@DSS.CA.GOV

Deadline recorded: Jun 28, 2024. A deadline is not proof that correction was completed.