CHLOIE'S COTTAGE II

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

87303 Maintenance and Operation (a) 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. Per interviews with 6 staff and 2 residents revealed that there was a leak in the bathroom, the toilet would overflow and leak; and there was mold observed in the bathroom that R2 resides in.

Official plan of correction

LPA toured facility, tested toilets and washer and there were no signs of leaks. LPA toured restrooms and residnet rooms, checked for signs of mold and did not observe any. POC is cleared and the clearance letter will be emailed to Administrator at a later date.

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

Official classification

Type A

Official code

87606(c)

Regulation authority

CCR

What the official deficiency says

(c) To accept or retain a bedridden person, other than for a temporary illness or recovery from surgery, a facility shall obtain and maintain an appropriate fire clearance as specified in Section 87202(a). 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 one (1) out of six (6) residents physicians's report stated bedridden and facility does not have fire clearance for bedridden 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 Assistant Administartor agrees to obtain documentation for fire clearance and email LPA all required proof.

Official classification

Type B

Official code

1569.605

Regulation authority

HSC

What the official deficiency says

On and after July 1, 2015, all residential care facilities for the elderly, except those facilities that are an integral part of a continuing care retirement community, shall maintain liability insurance covering injury to residents and guests in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in the total annual aggregate, caused by the negligent acts or omissions to act of, or neglect by, the licensee or its employees. 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 could not provide valid insurance at time of visit which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/20/2024 Plan of Correction Assistant Administrator will email current liability insurance to LPA.

Official classification

Type B

Official code

87305(a)

Regulation authority

CCR

What the official deficiency says

Prior to construction or alterations, all facilities shall obtain a building permit. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above garage was converted into room with walls and closet which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/27/2024 Plan of Correction Facility will provide proof of city permits or show application process to LPA via email. Assistant Administrator stated they might tear down room. Proof will be provided with pictures if they decide to do so.

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. Water measured 98.1-102.0 degrees F. which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/06/2023 Plan of Correction ****Water temperature was adjusted during visit, no further action required****

Official classification

Type B

Official code

87303(c)

Regulation authority

CCR

What the official deficiency says

(c) All window screens shall be clean and maintained in good repair. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. One screen in front room and one screen on side of home is in need of repair or replacement which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/12/2023 Plan of Correction Administrator will repair or replace screens by POC date and send proof to LPA.

Official classification

Type B

Official code

87303(e)(6)

Regulation authority

CCR

What the official deficiency says

(e) Water supplies and plumbing fixtures shall be maintained as follows: (6) Toilet, handwashing and bathing facilities shall be maintained in operating condition. Additional equipment shall be provided in facilities accommodating physically handicapped and/or nonambulatory residents, based on the residents' needs. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. One facet in the bathroom adjacent to washing machine and dryer is broken which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/12/2023 Plan of Correction Administrator will repair and replace the water facet in small restroom and send proof to LPA by POC date.

Official classification

Type A

Official code

87204(a)

Regulation authority

CCR

What the official deficiency says

87204 Limitations - Capacity and Ambulatory Status (a) A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including specification of the maximum number of persons who may receive services at any one time. An exception may be made in the case of catastrophic emergency when the licensing agency may make temporary exceptions to the approved capacity. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and nterviews, the licensee did not comply with the section cited above, which poses an immediate health, safety or personal rights risk to persons in care. Facility is overcapcity due to having a 7th resident.

Official plan of correction

POC Due Date: 10/29/2022 Plan of Correction Licensee will meet with R7's daughter and find a facility to relocate R7 and submit a plan how this will be done to CCLD. This deficiency will result in an immediate civil penalty for operating beyond the approved capacity.