Records and plan of operationType B
- Official classification
- Type B
- Official code
- 87506(b)(15)
- Regulation authority
- CCR
What the official deficiency says
(b) Each resident's record shall contain at least the following information: (15) The admission agreement and pre-admission appraisal, specified in Sections 87507, Admission Agreements and 87457, Pre-admission Appraisal. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA Spaeth's observations, the licensee did not comply with the section cited above by not obtaining a signed admissions agreement for R1m which could pose a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 08/20/2025 Plan of Correction The Administrator will obtain a signed Admissions Agreement from R1 and forward to LPA Spaeth via email.
Dementia careType A
- Official classification
- Type A
- Official code
- 87705(j)
- Regulation authority
- CCR
What the official deficiency says
87705 Care of Persons...(j) the licensee shall have an auditory device...to monitor exits.... This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's observation, the licensee did not comply with the section cited above. The delayed egress mechanisms were not working on four exit doors which poses an immediate health, safety or personal rights risks to persons in care.
Official plan of correction
POC Due Date: 08/15/2025 Plan of Correction The Administrator will send a video of each door when opened does have the proper alarm on the door. The Administrator will send the four videos to LPA's cell phone.
Licensing and administrationType A
- Official classification
- Type A
- Official code
- 1569.72(c)
- Regulation authority
- HSC
What the official deficiency says
1569.72(c) …bedridden persons may be admitted to, and remain in, residential care facilities for the elderly that secure and maintain an appropriate fire clearance. A fire clearance shall be issued to a facility… This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's observation, the licensee did not comply with the section cited above. R1 was not in the correct room, which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 08/15/2025 Plan of Correction R1 will be moved to Room 5. The Administrator will send a snapshot showing R1 was moved from Room 1 to Room 5. The snapshot will be sent to LPA's phone (818-421-2278).
Facility condition and maintenanceType A
- Official classification
- Type A
- Official code
- 87303(c)(2)
- Regulation authority
- CCR
What the official deficiency says
87303 Maintenance..(e) Water supplies…shall be maintained as following: (2) Faucets used by residents…shall deliver hot water. Hot water temperature…of not more than 120 degrees F. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's observation, the licensee did not comply with the section cited above. The hot water temperature was 122 degres F which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 08/13/2025 Plan of Correction During LPA's visit, the water temperature was adjusted. LPA tested the water temperature at 11:45 am and the temperature was 111 degrees F. The deficiency was corrected during LPA's visit.