NORTHRIDGE VALLEY SENIOR LIVING

Official classification

Type B

Official code

87219(a)

Regulation authority

CCR

What the official deficiency says

87219 Planned Activities(a) Residents shall be encouraged to maintain and develop their quality of life through participation in a variety of planned activities...This requirement was not met by: Based on the LPA observation and interviews the licensee/administrator did not ensure that Planned Activities were displayed on the Activites Plan Sheet were being performed which poses a potential Health, Safety or Personal Rights risks to persons in care.

Official plan of correction

The Licensee/Administrator shall send a statement of why the activities that are displayed on the Plan Activities are not being performed. POC 09/01/25

Deadline recorded: Sep 1, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

1569.269(a)(6)

Regulation authority

HSC

What the official deficiency says

Enumerated rights; severability (a) Residents of residential care facilities for the elderly shall have all of the following rights: (6) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement is not met by: Based on the LPA observation and interviews the licensee/administrator did not ensure the safety of the residents in memory care by leaving them unattended and residents eating crayons which poses an immediate Health, Safety or Personal Rights risks to persons in care.

Official plan of correction

The Licensee/Administrator shall properly train the staff #1 (S1) to care and supervise the residents in memory care. POC 08/19/25

Deadline recorded: Aug 19, 2025. A deadline is not proof that correction was completed.

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 in one (1) out of one (1) area of the garage where there are several mattresses and a sofa in the parking space area which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/29/2025 Plan of Correction The mattresses and sofa are to be removed from the garage area/parking spaces and be placed in a storage area and/or disposed of.

Official classification

Type B

Official code

87705(e)(6)(A)

Regulation authority

CCR

What the official deficiency says

(e) Licensees that use delayed egress devices on exterior doors and perimeter fence gates shall meet the following initial and continuing requirements: (6) For each incident of elopement, as defined in Section 87101, Definitions, the licensee shall report the incident to: (A) The resident's representative, if applicable, immediately upon becoming aware of the incident. A written report shall also be provided to the resident’s representative as specified in Section 87211, Reporting Requirements. Documentation of the report shall be added to the resident’s record. 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 in one (1) out of (1) resident that had eloped from the egress doors from memory care was not reported to the family and/or entered in the resident's file which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/29/2025 Plan of Correction The above facility/administrator/licensee shall advise the family member about the incident regarding resident's elopement from memory care into the assisted living area of the facility and enter it in their file.

Official classification

Type B

Official code

87705(e)(6)(B)

Regulation authority

CCR

What the official deficiency says

(e) Licensees that use delayed egress devices on exterior doors and perimeter fence gates shall meet the following initial and continuing requirements: (6) For each incident of elopement, as defined in Section 87101, Definitions, the licensee shall report the incident to: (B) The licensing agency Officer of the Day, by telephone, e-mail, fax, or hand-delivery no later than the next working day following the incident. If reported by telephone, a written report shall also be submitted to the licensing agency as specified in Section 87211, Reporting Requirements. The report shall be added to the resident's record. 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 in one (1) out of (1) resident that had eloped from the egress doors from memory care was not reported to Community Care Licensing Department and/or LPA which poses/posed a potential health, safety or personal rights risk to persons in care..

Official plan of correction

POC Due Date: 08/29/2025 Plan of Correction The above facility/administrator/licensee shall send the Unusual Incident Report regarding the resident and their elopement via the egress doors.

Official classification

Type A

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

87303(a) 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. This requirement is not met by: Based on the LPA observation and interviews the licensee/administrator did not ensure the safety of both the staff and residents of the garbage disposal being opened and accessible to anyone which poses an immediate Health, Safety or Personal Rights risks to persons in care.

Official plan of correction

The Licensee/Administrator shall buy a lock to keep the garbage disposal locked at all times and inaccessible to all residents. POC 07/09/25

Deadline recorded: Jul 9, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87705(6)(A)

Regulation authority

CCR

What the official deficiency says

Appeal was granted and deficiency was dismissed.

Deadline recorded: Mar 31, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468(a)(4)

Regulation authority

CCR

What the official deficiency says

(a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights:(4)To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications...This requirement is not met by: Based on the LPA observation, record reviews and interviews the licensee/administrator did not ensure proper supervision training for staff from the above facility which poses a potential Health, Safety or Personal Rights risks to persons in care.

Official plan of correction

A training record of staff about personal rights of residents is to be sent to CCLD/LPA. Training of staff was provided to LPA at time of visit. POC Due Date and Cleard on:01/20/26

Deadline recorded: Jan 20, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87219(f)

Regulation authority

CCR

What the official deficiency says

87219 (f) Planned Activites: In facilities licensed for fifty (50) persons or more, one staff member shall have full-time responsibility to organize, conduct and evaluate planned activities, and shall be given such staff assistance as necessary in order for all residents to participate in accordance with their interests and abilities...The responsible employee shall have had at least one year of experience in conducting group activities and be knowledgeable in evaluating resident needs, supervising other employees, and in training volunteers. This requirement is not met by: Based on the observation and staff/resident interviews the licensee did not ensure an activities director/one full time staff member to be at the above facility which poses a potential Health, Safety or Personal Rights risks to person in care.

Official plan of correction

The Licensee shall hire or designate an activities director by POC:01/27/25 and send employee qualifications to Community Care Licensening Department/LPA Saucedo.

Deadline recorded: Jan 27, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87405(a)

Regulation authority

CCR

What the official deficiency says

87405Administrator - Qualifications and Duties(a)All facilities shall have a qualified and currently certified administrator. The licensee and the administrator may be one and the same person. The administrator shall have sufficient freedom from other responsibilities and shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility as specified in this section... there shall be coverage by a designated substitute who shall have qualifications adequate to be responsible and accountable for management and administration of the facility as specified in this section. The Department may require that the administrator devote additional hours in the facility to fulfill his/her responsibilities when the need for such additional hours is substantiated by written documentation. This requirement is not met by: Based on the observation and staff/resident interviews the licensee did not ensure an administrator to be at the above facility for sufficient number of hours to permit adequate attention to the management and administration of the facility which poses a potential Health, Safety or Personal Rights risks to person in care.

Official plan of correction

The Licensee shall hire or designate an administrator by POC:01/27/25 and send all paperwork to Community Care Licensening Department/LPA Saucedo.

Deadline recorded: Jan 27, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(g)

Regulation authority

CCR

What the official deficiency says

87465 Incidental Medical and Dental Care (g) The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident's health including but not limited to, an apparent life-threatening medical crisis. This requirement was not met as evidenced by : The Licensee did not ensure to provide incidental medical care to R1 who was having breathing difficulties. This poses an immediate health and safety hazard to residents in care.

Official plan of correction

The Licensee/ Administrator will notify CCL in writing how they will ensure incidental care to residents in care.

Deadline recorded: Sep 27, 2021. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87307(d)(3)

Regulation authority

CCR

What the official deficiency says

87307 Personal Accommodations and Services (d) The following space and safety provisions shall apply to all facilities: (3) All persons shall be protected against hazards within the facility. This requirement was not met as evidenced by: The Licensee/Administrator failed to notify CCLD of the construction that was to be done and how residents were going to be protected against hazards within the facility. This poses a potential health and safety risk to residents in care.

Official plan of correction

POC cleared on this visit. Administrator sent letter to CCLD about the construction which as been completed.

Deadline recorded: Sep 19, 2021. A deadline is not proof that correction was completed.