DEL MAR PARK

Official classification

Type A

Official code

87355(e)(3)

Regulation authority

CCR

What the official deficiency says

Criminal Record Clearance 87355 (e) All individuals subject to a criminal record... (b) shall prior to working,residing or volunteering in a licensed facility: (3) request a transfer of a criminal record clearance The above requirement was not met as evidenced by the facility did not transfer S1's Criminal Record Clearance to the facility. S1 was not associated to facility on LIS during LPA's 03/09/26 visit to the facility. This poses an immediate health and safety risk to residents in care.

Official plan of correction

By POC due date Administrator will give a signed statement of understanding of the regulation. Administrator will assoicate S1 on Guardian before S1 resumes working at the facility.

Deadline recorded: May 13, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87355(e)(3)

Regulation authority

CCR

What the official deficiency says

(e) All individuals subject to a criminal record ...(b) shall prior to working, residing or volunteering in a licensed facility: (3) Request a transfer of a criminal record clearance

Official plan of correction

By POC due date facility will associate Staff 1 in Guardian.

Deadline recorded: Mar 10, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.2(a)(15)

Regulation authority

CCR

What the official deficiency says

87468.2 Additional Personal Rights of Residents....(a) In addition to the rights listed in Section 87468.1, Personal Rights...in privately operated residential care facilities for the elderly shall have all of the following personal rights: (15) To reasonable accommodation of their preferences concerning room and roommate choices. This requirement is not met as evidenced by: Based on interviews, records review, the Administrator did not comply with the section cited above in which the staff failed to follow R1’s care plan to accommodate a prescribed adjustable bed for medical reasons, and did not provide important details about the new accommodation including room and roommate choices which poses a potential health, safety or personal rights risk to residents in care.

Official plan of correction

Licensee/Administrator shall develop a written Plan of Correction to ensure compliance with California Code of Regulations Title 22, Section 87468.2(a)(15) and train all staff on the same regulation. Administrator to submit written POC and in service training log to CCL/LPA by POC due date.

Deadline recorded: Nov 17, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.2(a)(16)

Regulation authority

CCR

What the official deficiency says

87468.2 Additional Personal Rights of Residents...(a) In addition to the rights listed in Section 87468.1, Personal Rights of..residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (16) To written notice of any room changes...30 days in advance unless a room change is agreed to by the resident...... This requirement is not met as evidenced by: Based on interviews, records review, the Administrator did not comply with the section cited above in which the staff did not provide R1 of the room change notice 30 days in advance which poses a potential health, safety or personal rights risk to residents in care.

Official plan of correction

Licensee/Administrator shall develop a written Plan of Correction to ensure compliance with California Code of Regulations Title 22, Section 87468.2(a)(16) and train staff on the same regulation. Administrator to submit written POC and in service training log to CCL/LPA by POC due date.

Deadline recorded: Nov 17, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87568.1(a)(6)

Regulation authority

CCR

What the official deficiency says

87468.2 Additional Personal Rights of Residents in Privately Operated Facility (a) In addition...shall have all of the following personal rights: (6) To make choices concerning their daily lives in the facility. This requirement is not met as evidence by: Based on interviews and documents reviewed licensee did not ensure admission agreement for R1 was followed and was moved before notice day which poses an immediate risk to the health, safety, or personal rights of the persons in care.

Official plan of correction

Administrator will certify that they will ensure admission agreement and notices are followed by staff by POC due date 9/5/25.

Deadline recorded: Sep 5, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87411(d)(3)

Regulation authority

CCR

What the official deficiency says

87411 Personnel Requirements - General (d) All personnel shall be given ... shall provide knowledge of and skill in the following, ..: (3) Skill and knowledge required to provide,... including the ability to communicate with residents. This requirement is not met as evidence by: Based on interviews conducted licensee did not ensure staff are able to communicate wtih residents in care which poses a potential risk to the health, safety, or personal rights of the persons in care.

Official plan of correction

Administrator will submit a plan to ensure hiring and all staff are able to communicate with residents in care by POC due date 9/18/25.

Deadline recorded: Sep 18, 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 water temperature was tested between 131.0 - 135.5 degrees F., in resident's bathrooms which is not within 105-120 degrees F., which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/11/2024 Plan of Correction Designee requested maintenance to adjust water temperature during this visit. Staff will keep a daily temperature water log for the next 7 days and will submit a copy to the department by 12/17/24.

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 in last fire drill was provided on 2/8/24 per records reviewed which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/17/2024 Plan of Correction Designee will submit a copy of fire drill conducted for each shift and will ensure they are conducted quarterly by POC due date 12/17/24.

Official classification

Type B

Official code

87608(a)(5)(A)

Regulation authority

CCR

What the official deficiency says

(A) A bed rail that extends from the head half the length of the bed and used only for assistance with mobility shall be allowed. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above in resident #5 did not have physician's bed rail request on file which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/17/2024 Plan of Correction Resident Service Coordinator removed bed rails from resident #5's bed during the visit. Deficiency cleared as of 12/10/24.

Official classification

Type B

Official code

87705(j)

Regulation authority

CCR

What the official deficiency says

87705 Care of Persons with Dementia (j) The licensee shall have an auditory device or other staff alert feature to monitor exits, if exiting presents a hazard to any resident. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above in resident #2 and #4 have dementia and facility's exit door do not have an alert feature or auditory device to notify at exits which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/17/2024 Plan of Correction Designee will either add auditory device/alert feature to exit doors, or provide wander guard feature to residents with dementia and provide pictures of either to the department by POC due date 12/17/24.

Official classification

Type A

Official code

87411(a)

Regulation authority

CCR

What the official deficiency says

87411 Personnel Requirements - General: (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This requirement is not met as evidence by: Based on interviews conducted and document review licensee did not ensure that R1 received the correct medication by giving R1 medication that belong to R2 which poses an immediate risk to the health, safety, or personal rights to residents in care.

Official plan of correction

Administrator will provide medication training for S1 which will include shadowing and will submit a copy of training log, topic, description of training, and duration of training by POC due date 2/14/24.

Deadline recorded: Feb 14, 2024. 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 water temperature tested as follow in RB #222 water temperature tested at 124.0 degrees F., RB#233 tested at 123.4 degrees F., RB 231 tested at 98.8 degrees F., and RB#206 tested at 100.9 degrees F. which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/05/2024 Plan of Correction Administrator will adjust water heater and certify in writing that will ensure water temperature is maintain within the required 105-120 degrees F., at all times and submit to the department by POC due date 1/5/24. Administrator will maintain a log of water temperature tested daily in each room at least twice a day and will submit log to the department by 1/11/24.

Official classification

Type B

Official code

87307(d)(2)

Regulation authority

CCR

What the official deficiency says

(2) The premises shall be maintained in a state of good repair and shall provide a safe and healthful environment. 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 The courtyard patios were observed with three uneven cracks on the ground of about 1.5 - 2ft in length. which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/18/2024 Plan of Correction Administrator will ensure the courtyard floor is repair and submit pictures of the repairs to the department by POC due date 1/18/24.

Official classification

Type B

Official code

87555(b)(7)

Regulation authority

CCR

What the official deficiency says

General Food Service Requirements. Modified diets prescribed by a resident’s physician as a medical necessity shall be provided. This requirement was not met evidenced by: Based on record review, resident (R1's) Physician's Report states the resident requires a diabetic diet. However, R1 was not being served a diabetic diet, and had not been added to the restricted diet list; which poses a potential health and safety risk to persons in care.

Official plan of correction

Administrator shall ensure all resident files with special diet physician orders are communicated with kitchen and LVN staff. Submit a written plan of correction by POC due date.

Deadline recorded: Nov 3, 2023. 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

Maintenance and Operation. 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 was not met evidenced by: Based on interviews conducted, resident (R1's) bathroom grab bars were loose and not fixed in a timely manner, which poses a potential health and safety risk to persons in care.

Official plan of correction

Administrator shall submit a written plan of correction by POC due date.

Deadline recorded: Nov 3, 2023. 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 in1 out of 8 resident rooms observed, room #123 water temperature tested at 121.4 which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/18/2023 Plan of Correction Administrator will ensure water temperature is maintain within the required 105-120 degrees F., at all times and submit a LIC 9098 by POC due date 1/18/23.

Official classification

Type A

Official code

87468.1(a)(2)

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:(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement is not met as evidence by: Based on interviews and document review conducted licensee did not ensure that all staff are practicing safety precautions by keeping face mask while providing care and staying home when symptomatic which poses a personal rights, health, or safety risk to the residents in care.

Official plan of correction

Licensee will ensure that all staff/administrator are practicing safety guidelines and will schedule infection control, CDC recommendations, department of public health guidelines and CCLD PINs in - service training for all staff by POC due date 8/26/22. Licensing will submit a copy of all in-services agendas and sign-in logs by 9/8/22.

Deadline recorded: Aug 26, 2022. A deadline is not proof that correction was completed.