Fire safety and emergency preparednessType B
- Official classification
- Type B
- Official code
- 87202(a)
- Regulation authority
- CCR
What the official deficiency says
(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: 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 fire extinguisher was not serviced at least annually which poses a potential safety risk to persons in care.
Official plan of correction
POC Due Date: 04/28/2026 Plan of Correction Administrator agreed to submit proof of a completed service of the facility's fire extinguisher to CCLD no later than POC due date.
Staffing, personnel, and trainingType B
- 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 as one employee did not have a completed LIC 503 health screening and one employee did not have proof of a negative TB test in their file which poses a potential health risk to persons in care.
Official plan of correction
POC Due Date: 04/28/2026 Plan of Correction Administrator agreed to obtain a completed LIC 503 and negative TB test for the identified staff members and to send proof of the completed items to CCLD no later than POC due date.
Medical and dental careType B
- Official classification
- Type B
- Official code
- 87465(e)
- Regulation authority
- CCR
What the official deficiency says
(e) For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician on a prescription blank, maintained in the resident's file, and a label on the medication. Both the physician's order and the label shall contain at least all of 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 above as two medications were not logged on their respective CSMDRs which posed a potential health risk to persons in care.
Official plan of correction
POC Due Date: 04/14/2026 Plan of Correction Administrator logged the medications at the time of the visit. POC cleared.
Fire safety and emergency preparednessType B
- Official classification
- Type B
- Official code
- 1569.695(c)
- Regulation authority
- HSC
What the official deficiency says
(c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of residents is not required during a drill. While a facility may provide an opportunity for residents to participate in a drill, it shall not require any resident participation. Documentation of the drills shall include the date, the type of emergency covered by the drill, and the names of staff participating in the drill. 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 did not have a log of the last completed disaster drill which poses a potential safety risk to persons in care.
Official plan of correction
POC Due Date: 04/28/2026 Plan of Correction Administrator agreed to send proof of a completed disaster drill to CCLD no later than POC due date.