HARTLAND CARE, INC.

Official classification

Type B

Official code

87506(a)

Regulation authority

CCR

What the official deficiency says

87506 Resident Records (a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility... This requirement is not met as evidenced by: Deficient Practice Statement Based on interview and record review, the licensee did not comply with the section cited above in five out of five residents files missing documents or not updated which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/19/2024 Plan of Correction The Administrator will review regulation 87506 and send an email to LPA Rahimi confirming the Administrator did review the regulation. License/Administrator will complete files for all residents. Once completed licensee/administrator will submit a complete files for the residents to LPA by POC due date.

Official classification

Type B

Official code

1569.626(a)(2)

Regulation authority

HSC

What the official deficiency says

(a) All residential care facilities for the elderly shall meet the following training requirements, as described in Section 1569.625, for all direct care staff: (2) Eight hours of in-service training per year on the subject of serving residents with dementia. This training shall be developed in consultation with individuals or organizations with specific expertise in dementia care or by an outside source with expertise in dementia care. In formulating and providing this training, reference may be made to written materials and literature on dementia and the care and treatment of persons with dementia. This training requirement may be satisfied in one day or over a period of time. This training requirement may be provided at the facility or offsite and may include a combination of observation and practical application. This requirement is not met as evidenced by: Deficient Practice Statement (b) Based on record review, the licensee did not comply with the section cited above in [2] out of [2] missing training records for staff and had incomplete personnel records. This poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/19/2024 Plan of Correction Licensee agreed to hire a licensed vendor and provide training to all staff members. Copy of proof will be submitted to LPA by POC 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: (f) The following shall be stored inaccessible to residents with dementia: (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 in three out of three medication storage, Clobetasol Propionate Cream USP 0.05%, Permethrin Cream 5%, and Clindamycin Phosphate Topical solution USP 1% were unlocked and accessible to residents in care which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/14/2024 Plan of Correction Administrator locked medications and agreed to provide training with a vendor. Administrator will submit the schedule of the training with the vendor and the certificates upon completion of the training to LPA Rahimi, by the POC due date.

Official classification

Type B

Official code

87211(a)(1)

Regulation authority

CCR

What the official deficiency says

Requirements (a) Each licensee shall furnish to the licensing agency such reports... (1) A written report shall be submitted to the licensing agency and to the person... ... any of the events specified in (A), (B) & (D)... This requirement is not met as evidenced by: Based on interviews and record reviews, conducted by LPA, the licensee did not comply with the section cited above by failing to notify CCLD regarding the five (5) incidents that occured between 03/16/23 -09/19/23, which poses a potential health and safety risk to persons in care.

Official plan of correction

Licensee shall ensure a written report is submitted to the licensing agency and to the person responsible for the resident within seven (7) days of the occurrence of any of the events. Copies of all 5 incidents, shall be submitted to LPA by POC date.

Deadline recorded: Oct 10, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87506(a)

Regulation authority

CCR

What the official deficiency says

87506 Resident Records: (a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility... This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above. Resident records were incomplete and or missing documents, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee agreed to complete four (4) out of four (4) resident files.

Deadline recorded: Oct 10, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87470(c)

Regulation authority

CCR

What the official deficiency says

87470 (c) An Infection Control Plan shall be developed by the licensee and shall be included in the Plan of Operation. This requirement is not met as evidenced by: Deficient Practice Statement Based on file review, the licensee did not comply with the section cited above in 1 out of 1 Infection Control Plan which poses a potential Health, Safety, or Personal Rights risk to residents in care.

Official plan of correction

POC Due Date: 09/29/2022 Plan of Correction Licensee will submit an Infection Control Plan by the POC due date.

Official classification

Type B

Official code

87470(c)(1)(F)

Regulation authority

CCR

What the official deficiency says

(c) An Infection Control Plan shall be developed by the licensee and shall be included in the Plan of Operation required by Section 87208. (1) The Infection Control Plan shall include all of the following: (F) Staff shall demonstrate knowledge of and skill in infection control, as appropriate to the job assigned and as evidenced by safe and effective job performance. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by not screening 1 out of 1 visitors which poses a potential Health, Safety or Personal Rights risk to persons in care.

Official plan of correction

POC Due Date: 09/29/2022 Plan of Correction Licensee to provide training for the section cited above to all staff. Licensee to record temperature, symptoms, and vaccination status in visitor log. Licensee to submit proof of completion by the POC due date.

Official classification

Type A

Official code

87355(e)(1)

Regulation authority

CCR

What the official deficiency says

87355 Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department. This requirement is not met as evidenced by: Deficient Practice Statement Based on file review, the licensee did not comply with the section cited above in 1 out of 1 employees which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/05/2022 Plan of Correction Licensee will send all staff to obtain fingerprints and criminal background clearances to work in the facilty. Licensee will associate all staff to the facility by POC due date.

Official classification

Type A

Official code

1569.72(c)

Regulation authority

HSC

What the official deficiency says

§1569.72 Residents requiring skilled nursing or intermediate care; bedridden residents (c) ...bedridden persons may be admitted to, and remain in, residential care facilities for the elderly that secure and maintain an appropriate fire clearance. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and interviews the licensee did not comply with the section cited above in 1 out of 1 residents which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/05/2022 Plan of Correction Licensee to relocate the bedridden resident in Bedroom #4 to Bedroom #1 and provide proof by the POC due date.

Official classification

Type B

Official code

87211(a)(1)(A)

Regulation authority

CCR

What the official deficiency says

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) 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... (A) Death of any resident from any cause regardless of where the death occurred, including but not limited to a day program, a hospital, en route to or from a hospital, or visiting away from the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview, the licensee did not comply with the section cited above in 1 out of 1 reports which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/29/2022 Plan of Correction Licensee to submit a Death Report for the resident who most recently resided in Bedroom #1 by the POC due date.

Official classification

Type A

Official code

87633(a)(1)

Regulation authority

CCR

What the official deficiency says

87633 Hospice Care of Terminally Ill Residents (a) The licensee shall be permitted to accept or retain residents who have been diagnosed as terminally ill by his or her physician and surgeon and who may or may not have restrictive and/or prohibited health conditions, to reside in the facility and receive hospice services from a hospice agency in the facility when all of the following conditions are met: (1) The licensee has received a hospice care waiver from the department. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and interview, the licensee did not comply with the section cited above in 1 out of 3 residents receiving hospice services which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/05/2022 Plan of Correction Licensee to submit hospice care plans for all three residents receiving hospice services and request an additional hospice waiver by the POC due date.