ARBOR VISTA

Official classification

Type B

Official code

87468.1(a)(1)

Regulation authority

CCR

What the official deficiency says

87468.1 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:(1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This Requirement was not met by evidence of: Based on interviews, S5 approached R1 and W2 in the dining room and spoke to R1 about R1's nightly accidents causing R1 to feel ridiculed and humiliated in front of other residents.

Official plan of correction

Administrator to conduct Personal Rights in-service staff training. Submited in-service training to LPA on 11/25/2025.

Deadline recorded: May 21, 2025. A deadline is not proof that correction was completed.

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 in three (3) bathrroms had a reading of BR 11D 125.2, BR 14 121.5, and BR 33 122.5 which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/22/2025 Plan of Correction Administrator will correct water temperature to required reading and send LPA picture as proof by POC due date. Administrator will create water log for one week and send to LPA by 09/29/2025.

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

Official plan of correction

POC Due Date: 10/06/2025 Plan of Correction Administrator will send staff training by POC due date.

Official classification

Type B

Official code

87456(a)

Regulation authority

CCR

What the official deficiency says

(a) Prior to accepting a resident for care and in order to evaluate his/her suitability, the facility shall, as specified in this article 8: 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 four (4) out of six (6) residents did not have pre admission appraisel or appraisel needs and service plan which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/06/2025 Plan of Correction Administrator will send required documents by POC due date. R!- LIC 603 R2-LIC 603,and 625 R3- LIC 602,603,and 625 R5-LIC 603

Official classification

Type B

Official code

87458(a)

Regulation authority

CCR

What the official deficiency says

(a) Prior to a person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment, signed by a licensed medical professional acting within the scope of their practice and made within the last year, to be kept in 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 R3 did not have a physicians report which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/06/2025 Plan of Correction Administrator will send a completed 602 to LPA by POC due date

Official classification

Type A

Official code

87555(b)(27)

Regulation authority

CCR

What the official deficiency says

87555 General Food Service Requirements (b) The following food service requirements shall apply: (27) All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects. This requirement was not met as evidenced by: LPA's observations of rodent droppings in kitchen and staff and resident interviews corroborating allegation. This poses a immediate risk to the health, safety, or personal rights of persons in care.

Official plan of correction

Administrator Kim Commodore agreed to send a plan to address how the facility plans to keep the kitchen area free from rodents. Proof from pest control services that the facility kitchen area is free from rodents, is due by July 1, 2025. Proof must be sent via email to LPA Ramirez.

Deadline recorded: Jun 20, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87411(c)(D)

Regulation authority

CCR

What the official deficiency says

Personnel Requirements - General All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69 Policies and procedures regarding medications, including the knowledge in Section 87411(d)(4). This requirement is not met as evidenced by: Based on interviews conducted facility failed to have Staff S2 receive medication training which caused an Immediate Health and Safety Risk to residents in care.

Official plan of correction

Facility Administrator submitted medication certificate for Staff S2. Deficiency cleared.

Deadline recorded: Dec 9, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)(1)

Regulation authority

CCR

What the official deficiency says

Reporting Requirements. A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below.... This requirement was not met evidenced by: Based on record review and interviews conducted the facility failed to report R1's fall incident dated 4/3/22, and toe injury dated 4/4/22. Staff acknowledged it forgot to submit the incident report. This poses a potential health and safety risk to residents in care.

Official plan of correction

Administrator agrees to conduct staff training on reporting requirements and send a copy of the inservice training log to LPA by POC due date

Deadline recorded: Apr 22, 2022. A deadline is not proof that correction was completed.