CARRIE'S BOARD AND CARE

Official classification

Type A

Official code

1569.149

Regulation authority

HSC

What the official deficiency says

§1569.149 Fire clearance... ... the facility shall secure and maintain a fire clearance... This requirement is not met as evidenced by: Based on observation the licensee did not comply with the section cited above as two facility emergency exit doors attached to bedrooms #3 & 4 were deliberately blockaded from the outside of the facility which posed an immediate safety risk to clients in care.

Official plan of correction

Administrator had the barricades removed at the time of the visit. Administrator agreed to conduct an in-service training with all facility staff on the importance of ensuring all emergency exit ways remain clear and free from obstruction. Additionally, the Administrator agreed to conduct training on... ...appropriate staff responses to resident's with wandering behaviors, redirection techniques, and emergency notification procedures for resident elopement. Administrator agreed to submit proof of the completed trainings to CCLD no later than POC due date.

Deadline recorded: Jul 17, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87464(f)(1)

Regulation authority

CCR

What the official deficiency says

87464 Basic Services (f) Basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement is not met as evidenced by: Based on observation the licensee did not comply with the section cited above as three staff members followed the Administrator's instructions and utilized an ambulatory aid inappropriate to the resident's current condition which posed an immediate safety concern to clients in care.

Official plan of correction

Administrator agreed to conduct an in-service training with staff members on appropriate assistance techniques and devices when assisting residents with ambulation through the facility. Additionally, Administrator agreed to train facility staff about voicing safety concerns and modifying instructions to... ...better care for the residents and to ensure no resident is placed in harm's way due to following instructions as given. Administrator agreed to submit proof of the completed trainings to CCLD no later than POC due date.

Deadline recorded: Jul 17, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87468.1(a)(3)(6)

Regulation authority

CCR

What the official deficiency says

87468.1(a)(3)(6) Personal Rights of Residents in All Facilities (a)Residents in all residential care facilities for the elderly shall have all of the following personal rights: To be free from punishment,humiliation, intimidation… other actions of a punitive nature,... (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 does not prohibit a licensee from …such as locking doors at night to protect residents…with permission from the Department. This requirement is not met as evidenced by: Based on observation, the staff did not meet the requirement due to placing a nail to prevent residents from opening front door, and threatening residents. The Administrator removed the nail from front door frame during the inspection visit.

Official plan of correction

POC: Licensee/Administrator agrees to review regulation for understanding and submit a self-certification of reviewing and understanding the regulations.

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

Official classification

Type B

Official code

1569.887(a)(c)

Regulation authority

HSC

What the official deficiency says

1569.887 (a)(c) Signature of resident on admission agreement; copy of agreement to go to resident or resident’s representative; review. (a) The admission agreement shall be signed and dated, acknowledging the contents of the document, by the resident or the resident's representative. (c) The licensee shall provide a copy of the signed and dated admission agreement to the resident or the resident's representative, if any. (d) The admission agreement shall be reviewed at the time of the compliance visit and in response to a complaint involving the admission agreement. This requirement is not met as evidenced by: Based on information obtained, the Licensee did not comply with the above citation, as one (1) out of four (4) residents' records were not available at facility upon request for review, which poses a potential health and safety risk to residents.

Official plan of correction

Licensee will provide copies of the LIC604A to the resident and resident's legal representative and to the LPA by the end of the day on 01/14/2025.

Deadline recorded: Jan 14, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.1(b)(8)

Regulation authority

CCR

What the official deficiency says

87468.1 (b)(8)-Deny or restrict medical or nonmedical care that is appropriate to a resident’s organs and bodily needs or provide medical or nonmedical care to the resident in a manner that, to a similarly situated reasonable person, unduly demeans the resident’s dignity or causes avoidable discomfort. This requirement was no met as evidenced by: Based on interviews the licensee did not comply with the above regulation as R1 sustained a fall, with visible bruises to the left side (forehead, wrist and knee) and pain in knee, and timely medical attention was not provided which poses a potential personal rights risk to residents in care.

Official plan of correction

Licensee or a qualified instructor will provide training to staff on providing immeadite care to residents in facility. Licensee will email a sign in sheet and copies of the materials used for the training by 01/24/2025.

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

Official classification

Type B

Official code

87506(a)(8-10)

Regulation authority

CCR

What the official deficiency says

The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff, and emergency personnel…This requirement is not met as evidenced by: Licensee did not comply with the above citation, as one (1) out of four (4) residents' records were not available at facility upon request for review, which poses a potential health and safety risk to residents.

Official plan of correction

Licensee to submit proof by 12/31/2024 of residents' Emergency Information readily available for review upon request by EMT and CCL personnel, and training for staff to be informed of the facility's procedures and documentation of residents' files.

Deadline recorded: Dec 31, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87311

Regulation authority

CCR

What the official deficiency says

87311 Telephones All facilities shall have telephone service on the premises. Facilities with a capacity of sixteen (16) or more persons shall be listed in the telephone directory under the name of the facility. This requirement is not met as evidenced by: Based on interviews and observation the licensee failed to comply with the section cited above as the facility's telephone was observed to fail to make telephone calls which poses a potential personal rights and safety risk to clients in care.

Official plan of correction

Licensee will submit proof of a functioning facility telephone to CCLD no later than POC due date.

Deadline recorded: Nov 14, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87457(c)

Regulation authority

CCR

What the official deficiency says

87457 (c) Pre-Admission Appraisal - General (c) Prior to admission a determination of the prospective resident's suitability for admission shall be completed...This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above as R1 did not have pre-admission appraisals, which posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

The Licensee stated that she will submit a statement of understanding about the regulation by due date.

Deadline recorded: Jun 30, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87468.2(a)(4)

Regulation authority

CCR

What the official deficiency says

87468.2(a) (4)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 as evidenced by: Based on medical records, licensee did not comply with the section cited as staff did not provide the necessary care and supervision resulting in R1 sustaining pressure injuries while in care, which posed an immediate health and safety risk to residents in care.

Official plan of correction

Licensee agreed to submit a plan on how they will ensure that residents are provided with proper care and supervision to meet their individual health care needs. Submit to CCL by POC due date.

Deadline recorded: May 31, 2024. A deadline is not proof that correction was completed.

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 staff did not have the required training which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/17/2023 Plan of Correction The Licensee said that all staff will complete required annual training, including herself by due date.

Official classification

Type A

Official code

87705(f)(2)

Regulation authority

CCR

What the official deficiency says

(f) The following shall be stored inaccessible to residents with dementia: (2) Over-the-counter medication, nutritional supplements or vitamins, alcohol, cigarettes, and toxic substances such as certain plants, gardening supplies, cleaning supplies and disinfectants. 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 there were disinfectant wipes and alcohol accessible which poses an immediate health risk to persons in care.

Official plan of correction

POC Due Date: 09/16/2021 Plan of Correction The Licensee has agreed to do the following: 1. The items were removed upon observation. Plan of Correction met.