PALACE OF JOY

Official classification

Type B

Official code

87411(d)(3)

Regulation authority

CCR

What the official deficiency says

87411-Personnel Requirements General-(d)(3)Skill and knowledge required to provide necessary resident care and supervision, including the ability to communicate with residents.,.This requirement is not met as evidenced by: Based on LPA Ngo-Castaneda’s interviews and observation, the administrator does not have staff available to communicate with residents to provide care which poses a potential risk to the residents in care.

Official plan of correction

The Administrator agreed to have at least one English-speaking staff on each shift. The administrator will monitor staff schedules and resident interactions weekly to ensure compliance. Currently the Administrator has one staff on each shift who speaks English. POC cleared during today's visit.

Deadline recorded: Dec 30, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87307(d)(6)

Regulation authority

CCR

What the official deficiency says

Personal Accommodations and Services: (d) The following space and safety provisions shall apply to all facilities: (6) All outdoor and indoor passageways and stairways shall be kept free of obstruction. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA’s observation, licensee did not comply with the section cited above by blocking the exit door in bedroom #4 by putting resident's wheelchair. This poses a potential health and safety risk to residents in care.

Official plan of correction

POC Due Date: 11/24/2025 Plan of Correction During today's visit, the Administrator cleared the passageways from the obstruction in bedroom #4. The Administrator also agreed to review the section cited and inform LPA via e-mail by POC due date.

Official classification

Type B

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

87303 Maintenance and Operation (e)(2) Faucets used by residents for personal care..... the temperature of hot water used by residents to attain a temperature of not less than 105-degree F (41 degree C) and not more than 120-degree F (49 degree 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, LPA measured the hot water in one of the bathrooms to be 131.5F, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/24/2025 Plan of Correction The Administrator agreed to keep a log of water temperature for one week and submit the proof to LPA by POC due date.

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

87465 Incidental Medical & Dental Care (h) the following... shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place…. 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. LPA observed medication unlocked and accessible to resident in care in bedroom #4, which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 11/19/2025 Plan of Correction Administrator agreed to schedule vendorized medication training for all staff by 11/19/2025 and submit to CCL the vendor information and scheduled date of training. Training certifications to be submitted to CCL upon completion.

Official classification

Type A

Official code

87465(c)(2)

Regulation authority

CCR

What the official deficiency says

87465- Incidental Medical and Dental Care: c) If the resident's physician has stated in writing... 2) Once ordered by the physician the medication is given according to the physician's directions. This requirement is not met as evidenced by: Deficient Practice Statement Based on (observation) (interview) (record review)], the licensee did not comply with the section cited above in not assuring that R2's prescribed medications were given as prescribed, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/19/2025 Plan of Correction Administrator agreed to schedule vendorized training for all staff by 11/19/2025 and submit to CCL the vendor information and scheduled date of training. Training certifications to be submitted to CCL upon completion. Administrator also agreed to notify doctor and submit LIC 624 to CCL regarding the incident.

Official classification

Type B

Official code

87303(i)

Regulation authority

CCR

What the official deficiency says

(i) Facilities shall have signal systems which shall meet the following criteria: 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 one (1) out of three (3) alarms not functional and operational which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/24/2025 Plan of Correction During today's visit the Administrator installed the batteries. Plan of correction met during today's visit.

Official classification

Type B

Official code

87219(h)(2)

Regulation authority

CCR

What the official deficiency says

(h) The licensee shall provide sufficient space to accommodate both indoor and outdoor activities. Activities shall be encouraged by provision of: (2) Outdoor activity areas that are easily accessible to residents, protected from traffic, and have adequate shady areas. 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 by not having a shaded area in the backyard of the facility to residents in care which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/24/2025 Plan of Correction The Administrator agreed to buy appropriate outdoor shade for the outdoor furniture to accommodate residents in care.

Official classification

Type B

Official code

87411(d)(3)

Regulation authority

CCR

What the official deficiency says

87411-Personnel Requirements General-(d)(3)Skill and knowledge required to provide necessary resident care and supervision, including the ability to communicate with residents.,.This requirement is not met as evidenced by: Based on LPA’s interview and observation, the administrator does not have staff available to communicate with residents to provide care which poses a potential risk to the residents in care.

Official plan of correction

Administrator/Licensee agrees to put in writing their plan for hiring or ensuring English Speaking staff are always on shift and submit the plan by the POC date. Additionally, Administrator shall submit an updated LIC500 to reflect all staff.

Deadline recorded: May 27, 2025. 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

87211(a)(1)A,B & D-Reporting 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, the licensee did not comply with the section cited above by not notifying CCLD regarding R1's and R2's incident reports 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. R1's and R2's incident reports shall be submitted to LPA by POC date.

Deadline recorded: May 27, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

87309 Storage Space and Access: (a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects..... pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. This requirement is not met as evidenced by: Based on the credible witness and LPA's observation, the licensee did not comply with the section cited above in by leaving a lighter, a knife, and cleaning solutions accessible to residents in care which poses/posed an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator will properly train staff to keep cleaning agents and chemicals inaccessible to residents and proof of training will be sent to LPA by the POC due date.

Deadline recorded: Mar 28, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

87465 Incidental Medical & Dental Care (h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe & locked place… This requirement is not met as evidenced by: Based on the credible witness and LPA's observation, the licensee did not comply with the section cited above in by leaving medications unlocked and accessible to residents in care which poses/posed an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator agreed to schedule vendorized training for all staff by 03/28/25 and submit to CCL the vendor information and scheduled date of training. Training certifications to be submitted to CCL upon completion.

Deadline recorded: Mar 28, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87555(b)(28)

Regulation authority

CCR

What the official deficiency says

87555(b)(28) General Food Service Requirements All food shall be protected against contamination. Contaminated food shall be discarded immediately upon discovery. This requirement is not met as evidenced by: Based credible witness and LPA's observations the Licensee did not comply by having old/rotten perishable foods and expired milk in the refrigerator which poses a potential health and safety risk to the residents in care.

Official plan of correction

The Administrator has agreed to remove and discard the rotten foods from the refrigerator. This part of the plan of correction met. Train all staff on food service and discarding rotten foods. Submit to CCL the staff sign in sheet and training material.

Deadline recorded: Apr 3, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87555(b)(15)

Regulation authority

CCR

What the official deficiency says

General Food Service Requirements: The following food service requirements shall apply: 15) All persons engaged in food preparation and service shall observe personal hygiene and food services... ...which protect the food from contamination. This requirement is not met as evidence by Based on credible witness and LPA's observations the licensee did not comply with the section cited above by not properly securing the peanut butter jar and an ice cream tub which poses a potential health and safety risk to the persons in care.

Official plan of correction

Administrator will have in service training for current and new staff regarding this section 87555. Copy of in service training will be submitted to LPA.

Deadline recorded: Apr 3, 2025. 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

Resident Records: (a) 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 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. 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

POC Due Date: 11/14/2024 Plan of Correction Licensee/Administrator agreed to complete five (5) out of five (5) resident files and submit proof by POC date.

Official classification

Type B

Official code

87412(a)

Regulation authority

CCR

What the official deficiency says

Personnel Records: (a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: 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. Upon LPA's request Licensee/Administrator was unable to provide complete staff records. This poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/14/2024 Plan of Correction Licensee/Administrator agreed to have a individual file for each staff member along with the training certificate.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

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 is not met as evidenced by: Based on LPA observation during physical plant tour, the licensee failed to ensure that the facility is in good repair which poses a potential health and safety risk to the residents in care.

Official plan of correction

The administrator agreed to have the ceiling repaired immediately and will submit proof of repair on or before the POC date.

Deadline recorded: May 31, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.2(a)(10)

Regulation authority

CCR

What the official deficiency says

Additional Personal Rights of Residents in Privately Operated Facilities (a) residents in…shall have all of the following personal rights: ... The licensee shall post the telephone numbers and addresses for the local offices of the … Ombudsman This requirement was not met as evidenced by: Based on observations, interviews the licensee did not comply with the section cited above by not having the Obudsman poster posted from middle of March 2023 until April 10th, 2023, which posed apontiential health, safety, or Personal rights risk to persons in care.

Official plan of correction

Upon arrival LPA observed Ombudsman poster by the main entryway. Deficiency cleared during the visit.

Deadline recorded: May 12, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87113

Regulation authority

CCR

What the official deficiency says

Posting requirements: The license shall be posted in a prominent location in the licensed facility accessible to public view. This requirement was not met as evidenced by Based on observations made by LPA, during today's visit, the licensee did not comply with the section cited above. LPA did not observe license issued by the Department of Social Services being posted by the main entry door, which poses a potential health, safety risk to persons in care.

Official plan of correction

Administrator agreed to post the facility license issued by the Department of Social Services by the entryway and proof of picture will be submitted to LPA by POC date.

Deadline recorded: May 12, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87470(a)(5)

Regulation authority

CCR

What the official deficiency says

87470 infection Control Requirements. (a) A licensee shall ensure that infection control practices are maintained..: (5) All staff... .. shall practice and maintain respiratory etiquette….to minimize exposure to potential illness. .. This requirement was not met as evidenced by: Upon entering the facility, LPA observed staff member was not wearing a mask which poses an immediate health and safety risk to residents in care.

Official plan of correction

During LPA's visit, LPA observed caregivers immediately placed mask while working in the facility. LPA advised staff that all staff are required to wear masks when in the facility.

Deadline recorded: Mar 15, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87705(f)(2)

Regulation authority

CCR

What the official deficiency says

87705 Care of Persons with Dementia. The following items shall be made inaccessible to residents with dementia: Over-the-counter medication, nutritional supplements or vitamins, alcohol, ...and disinfectants. This requirement is not met as evidenced by: Based on todays observation, two bottles of beer were found accessible in the facilitly refrigerator. This poses an immediate health risk to residents in care.

Official plan of correction

Caregivers removed the alcohol from the refrigerator and removed it from the facility which made it inaccessible

Deadline recorded: Mar 15, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87355(e)(1)

Regulation authority

CCR

What the official deficiency says

87355 (e)(1) Criminal record Clearance All individuals subject to a criminal record review pursuant to Health & Safety Code Section 1569.17(b) shall prior to working... in a licensed facility: (1) obtain a California clearance or a criminal record excemption as required by the Dept..... This requirement is not met as evidenced by: LPA observed a caregiver assisting R1 in the living room. Caregiver working at the facility prior to obtaining criminal record clearance which poses an immediate health and safety risk to residents in care.

Official plan of correction

This is a zero tolerance violation. Caregiver was sent home during the visit. LPA stated to Caregiver they cannot come back until they are cleared and associated. Immediate civil penalty of R1 100 X1 day has been issued for a total of $100.

Deadline recorded: Mar 15, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87507(c)

Regulation authority

CCR

What the official deficiency says

87507 Admissions Agreement (c) Admission agreements shall be signed and dated, acknowledging the contents of the document, by the resident or the resident’s representative if any and the licensee…no later than seven days following admissions. This requirement was not met as evidenced by: Based on LPA's interviews of the resident, resident's famly member and Administrator, the Admissions Agreement was not signed by the resident and a payment of $2,500.00 was received by facility staff when R1 moved into the facility.

Official plan of correction

Administrator will send a refund check to the Resident and send a copy of the refund check to LPA Spaeth via email..

Deadline recorded: Mar 20, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.651

Regulation authority

HSC

What the official deficiency says

§1569.651 Preadmission fee (g) If the applicant decides not to enter the facility prior to the facility’s completion of a preadmission appraisal or if the facility fails to provide full written disclosure of the preadmission fee charges and refund conditions, the applicant shall be entitled to a refund of 100 percent of the preadmission fee. Based on interviews, the licensee did not comply with the section cited above in 1 out of 1 preadmission fees which poses a potential risk to the Heatlh, Safety, or Personal Rights of persons in care.

Official plan of correction

Licensee refunded P1's money during visit. POC cleared.

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

Official classification

Type A

Official code

87705(f)(2)

Regulation authority

CCR

What the official deficiency says

87705 Care of Persons 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 6 cleaning solutions which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/30/2022 Plan of Correction Licensee stored, locked, and made all hazardous materials inaccessible during visit. Licensee attached a new lock to the storage shed. POC cleared.

Official classification

Type A

Official code

87307(e)

Regulation authority

CCR

What the official deficiency says

87307 Personal Accommodations and Services (e) Facilities providing services to residents who have physical or mental disabilities shall assure the inaccessibility of fishponds, wading pools, hot tubs, swimming pools, or similar bodies of water, when not in active use by residents, through fencing, covering or other means. 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 1 out of 1 pool gate which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/30/2022 Plan of Correction Licensee locked the pool gate during visit. A new lock was attached. POC cleared.

Official classification

Type A

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 interview, the licensee did not comply with the section cited above in 1 out of 3 auditory alarms which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/06/2022 Plan of Correction Licensee to reattach all auditory alarms and send proof of correction by POC due date.