ELDERCARE HOMES, INC.

Official classification

Type B

Official code

1569.605

Regulation authority

HSC

What the official deficiency says

§1569.605 Liability insurance; coverage requirements On and after July 1, 2015, all residential care facilities for the elderly...shall maintain liability insurance... This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above as the facility was unable to provide proof of active liability insurance which posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Liability insurance was received on 03/05/2026. POC cleared.

Deadline recorded: Jun 24, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87309(f)

Regulation authority

CCR

What the official deficiency says

(f) Due to the physical arrangements in the facility, or the condition or the habits of other residents in the facility, or both, the licensee may require the items specified in subsections (a) and (c) to be centrally stored so as not to pose a safety hazard to others. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above as 3 residents were identified by their physician as having their safety at risk if allowed access to personal care and hygiene items which were left unsecured in resident rooms and in common restrooms which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 02/24/2026 Plan of Correction Administrator agreed to secure all hygiene items and personal grooming supplies in the facility and to submit proof of secured items to CCLD no later than POC due date.

Official classification

Type A

Official code

1569.605

Regulation authority

HSC

What the official deficiency says

On and after July 1, 2015, all residential care facilities for the elderly, except those facilities that are an integral part of a continuing care retirement community, shall maintain liability insurance covering injury to residents and guests in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in the total annual aggregate, caused by the negligent acts or omissions to act of, or neglect by, the licensee or its employees. 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 facility was unable to provide proof of active liability insurance which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/24/2026 Plan of Correction Administrator agreed to provide CCLD with proof of active liability insurance no later than POC due date.

Official classification

Type B

Official code

87465(b)

Regulation authority

CCR

What the official deficiency says

(b) If the resident's physician has stated in writing that the resident is able to determine and communicate his/her need for a prescription or nonprescription PRN medication, facility staff shall be permitted to assist the resident with self-administration of his/her PRN medication. 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 two residents had PRN medications without a completed PRN authorization form which poses a potential health risk to persons in care.

Official plan of correction

POC Due Date: 03/09/2026 Plan of Correction Administrator agreed to have a physician fill out the PRN authorization form for the identified individuals and to submit the completed forms to CCLD no later than POC due date.

Official classification

Type B

Official code

87412(g)

Regulation authority

CCR

What the official deficiency says

(g) All personnel records shall be maintained at the facility. 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 one employee file was not located at the facility at the time of the inspection which posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/23/2026 Plan of Correction Administrator printed the employees file at the time of the visit and placed a copy into the facility records. POC cleared.

Official classification

Type A

Official code

87468.1(a)(6)

Regulation authority

CCR

What the official deficiency says

87468.1 Personal Rights of Residents... (a) ...shall have... personal rights: (6) To leave or depart the facility at any time and to not be locked into any room, building, or on facility premises by day or night... This requirement is not met as evidenced by: Based on interviews the licensee did not comply with the section cited above as during an altercation S1 held the door to R1’s room closed and prevented R1 from leaving their room which resulted in R1 suffering a fall which posed an immediate safety and personal rights risk to clients in care.

Official plan of correction

Assistant Administrator agreed to submit their plan on how they will appropriately respond to behavioral expressions of residents. Additionally, Administrator agreed to conduct a training with all staff members on the appropriate response to behavioral expressions and will submit proof of... ...Completed trainings to CCLD no later than POC due date.

Deadline recorded: Oct 24, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.2(a)(7)

Regulation authority

CCR

What the official deficiency says

87468.2 Additional Personal Rights... (a) ...shall have all of the following personal rights: (7) To fully participate in planning their care, ... and involve persons of their choice in this planning... This requirement is not met as evidenced by: Based on interviews and record review the licensee did not comply with the section cited above as R1 was fraduantly enrolled with a hospice company with a falsified signature while under the care and supervision of the facility which posed a potential personal rights risk to persons in care.

Official plan of correction

Assistant Administrator agreed to submit a signed statement of understanding confirming that they understand the importance of residents participating in the planning of their care and confirming that they will review future documents for signs of falsified information/foargaries of signatures... ... Assistant Administrator agreed to submit the statement to CCLD no later than POC due date.

Deadline recorded: Nov 6, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.2(a)(5)

Regulation authority

CCR

What the official deficiency says

87468.2 Additional Personal Rights of Residents... (a) In addition...residents...shall have all of the following personal rights: (5) To be served food... necessary to meet their nutritional needs. This requirement is not met as evidenced by: Based on interviews the licensee did not comply with the section cited above as one resident was served milk while being lactose intolerant which caused them to have 3 bowel movements in a 1 hour timeframe which poses a potential health risk to clients in care.

Official plan of correction

Administrator agreed to conduct training with facility staff on the importance of adhering to the dietary needs of facility residents. Licensee will submit proof of training attendance to CCLD no later than POC due date.

Deadline recorded: May 23, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

1569.311

Regulation authority

HSC

What the official deficiency says

Every residential care facility for the elderly shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above as the facility's carbon monoxide alarm was observed to be non-functional at the time of the visit which poses an immediate safety risk to persons in care.

Official plan of correction

POC Due Date: 02/18/2025 Plan of Correction Facility backup Administrator replaced the carbon monoxide alarm at the time of the visit POC cleared.

Official classification

Type A

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

(e) Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. 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 (41 degrees C) and not more than 120 degree F (49 degrees C). This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above as the facility's hot water temparature was measured between 141.4 and 163.6 degrees F which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 02/19/2025 Plan of Correction Licensee will submit proof of appropriate water temparature for all 3 bathroom faucets to CCLD no later than POC due date.

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 as one railing support was observed to be in disrepair which poses a potential safety risk to persons in care.

Official plan of correction

POC Due Date: 03/04/2025 Plan of Correction Licensee will submit proof of completed repairs to the railing support to CCLD no later than POC due date.

Official classification

Type B

Official code

87303(c)

Regulation authority

CCR

What the official deficiency says

(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 as two screen door screens were observed to have tears in the material which poses potential health or safety risk to persons in care.

Official plan of correction

POC Due Date: 03/04/2025 Plan of Correction Licensee will submit proof of replaced or repaired screens for the two identified doors to CCLD no later than POC due date.

Official classification

Type B

Official code

87412(g)

Regulation authority

CCR

What the official deficiency says

(g) All personnel records shall be maintained at the facility. 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 one employees file was observed to not be located at the facility which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/04/2025 Plan of Correction Licensee will submit a complete employee file for the identified employee to CCLD no later than POC due date.

Official classification

Type B

Official code

87412(a)

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: This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited aboveas two employee files were missing documents including LIC 501, LIC 508, LIC 503, and TB test which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/04/2025 Plan of Correction Licensee will submit the completed forms for the identified employees to CCLD no later than 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 record review, the licensee did not comply with the section cited above as no employees had trainings conducted within the last 12 months which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/04/2025 Plan of Correction Licensee will submit proof of completed annual required trainings or enrollment in required annual trainings for all employees providing care and supervision to residents to CCLD no later than 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 record review, the licensee did not comply with the section cited above as one resident was observed to not have a negative TB test on file which poses a potential health risk to persons in care.

Official plan of correction

POC Due Date: 03/04/2025 Plan of Correction Licensee will submit proof of a completed negative TB test for the identified resident no later than POC due date.

Official classification

Type B

Official code

87463(b)

Regulation authority

CCR

What the official deficiency says

(b) The reappraisal shall document significant changes in the resident's physical, mental, cognitive, behavioral, or functional condition, including those required to be documented as specified in Section 87466, Observation of the Resident. 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 one resident was observed to not have an updated medical assessment following a change in condition which poses a potential health risk to persons in care.

Official plan of correction

POC Due Date: 03/04/2025 Plan of Correction Licensee will submit an updated medical assessment for the identified resident to CCLD no later than POC due date.

Official classification

Type B

Official code

1569.695(a)

Regulation authority

HSC

What the official deficiency says

(a)In addition to any other requirement of this chapter, a residential care facility for the elderly shall have an emergency and disaster plan that shall include, but not be limited to, all of the following: 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 facility was using the out of date LIC 610E form which is missing required information which poses safety risk to persons in care.

Official plan of correction

POC Due Date: 03/04/2025 Plan of Correction Licensee will submit proof of a completed and updated emergency disaster plan to CCLD no later than POC due date

Official classification

Type B

Official code

87465(a)(6)

Regulation authority

CCR

What the official deficiency says

(6) When requested by the prescribing physician or the Department, a record of dosages of medications which are centrally stored shall be maintained by the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on medication review, the licensee did not comply with the section cited above in five out of five LIC 622 forms were incorrectly filled out for five out of five residents, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/12/2024 Plan of Correction POC: Administrator will provide medication training for staff, specifically on how to fill out the LIC 622 correctly. Administrator will submit a copy of the training sign in sheet with signatures, date and hours of training, training material, and credential of the professonal providing the training to staff. Additionally, the administrartor will submit and a copy of the updated LIC 622 for all five residents to CCL to indicate the training was completed.