VERNON COTTAGE

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

(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. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. LPA observed room #2 (resident's room) did not have window screen (missing). This which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/11/2026 Plan of Correction Licensee will comply with Title 22 - 87303(a) and ensure that the facility is in good repair at all times. Licensee will purchase a window screen for room #2. Proof of correction of work order/purchase receipt and photo must be sent by fax 424-544-1016 att: LPA Dabuet by POC date: 08/11/26.

Official classification

Type B

Official code

87468.2(a)(1)

Regulation authority

CCR

What the official deficiency says

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (a) In addition to...87468.1, Personal Rights of Residents in All Facilities, residents...shall have all of the following personal rights: (1) To have a reasonable level of personal privacy in...visits, communications, telephone conversations,...and family groups. This has not been met as evidenced by: Licensee has agreed to follow the POA wishes by informing POA any time another family member arrives to visit with R1.

Official plan of correction

Licensee has agreed to conduct in-staff training at the above-mentioned facility. All staff will read, in a language they understand, CCR 87468.2(a)(1-7) and licensee will provide a sign-in sheet, date(s)/time(s) included. Each staff will also review PIN 21-48-ASC and will sign names as " reviewed " . Licensee will send sign-in sheet to LPA via email at MARIO.LEON@DSS.CA.GOV

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

Official classification

Type B

Official code

1569.698(f)

Regulation authority

HSC

What the official deficiency says

1569.698 Building standards; adoption; locked and secured perimeters in residential care facilities; persons with dementia (f) Any person who is not a conservatee...shall sign a statement of voluntary entry. The facility shall retain the original statement and shall send a copy of the statement to the department. This has not been met as evidenced by: Licensee did not allow a family member to take R1 on outings.

Official plan of correction

Licensee has agreed to conduct in-staff training at the above-mentioned facility. All staff will read, in a language they understand, HSC 1569.698(f) and licensee will provide a sign-in sheet, date(s)/time(s) included. Licensee will send sign-in sheet to LPA via email at MARIO.LEON@DSS.CA.GOV

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

Official classification

Type B

Official code

87303(a)(c)

Regulation authority

CCR

What the official deficiency says

(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. (c) All window screens shall be clean and maintained in good repair. This requirement is not met as evidenced by: Deficient Practice Statement Based on (observation), the licensee did not comply with the section cited above. LPA identified (4) items needing repairs. A bedroom window screen, sliding door screen, (2) bathroom windows with cracks. The violation which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/05/2023 Plan of Correction Licensee will adhere to Title 22 Sec 87303 and will ensure to have the facility in good repairs at all times. Window screen, sliding door screen and small bathroom windows in bathroom #2 & #3 will need to be replaced. Proof of correction must be sent to LPA by POC 09/05/23.

Official classification

Type A

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

87303 Maintenance and Operation (e) Water supplies and plumbing fixtures shall be maintained as follows: (2) Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F and not more than 120 degree F. Based on LPAs observation the water temperature did not meet Title 22 regulations and measured 75.2 F in the kitchen and 77.3 in one bathroom at 12:05pm. This violation poses an immediate health and safety risk to residents in care.

Official plan of correction

Licensee adjusted water immediately on the tankless water heater to meet Title 22 regulations. Licensee will send LPA contract for the plumber who is coming out to look at tankless water heater.

Deadline recorded: Oct 26, 2022. A deadline is not proof that correction was completed.