BENTLEY SUITES

Official classification

Type B

Official code

87468.2(a)(1)

Regulation authority

CCR

What the official deficiency says

Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: This requirement was not met as evidenced by: LPA observed camera in R1's room during the inspection which violates rights of the resident.

Official plan of correction

LPA observed cameras being disconnected during the visit. The POC was done at the time of visit.

Deadline recorded: Aug 12, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87411(f)

Regulation authority

CCR

What the official deficiency says

(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure. A report shall be made of each screening, signed by the examining physician. The report shall indicate whether the person is physically qualified to perform the duties to be assigned, and whether he/she has any health condition that would create a hazard to him/herself, other staff members or residents. A signed statement shall be obtained from each volunteer affirming that he/she is in good health.Personnel with evidence of physical illness or emotional instability that poses a significant threat to the well-being of residents shall be relieved of their duties. 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 [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: Plan of Correction

Official classification

Type B

Official code

87412(a)(12)

Regulation authority

CCR

What the official deficiency says

(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: (12) Hazardous health conditions documents as specified in Section 87411, Personnel Requirements - General. 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 [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: Plan of Correction

Official classification

Type B

Official code

87303(f)(1-2)

Regulation authority

CCR

What the official deficiency says

87303(f)(1-2) Maintenance and Operation (f)Solid waste shall be stored and disposed of as follows: (1)Solid waste shall be stored, located and disposed of ...transmission of a communicable disease or of odors, create a nuisance, provide a breeding place or food source for insects or rodents. (2)Syringes and.. with the California Code of Regulations, Title 8, Section 5193 concerning bloodborne pathogens. Based on observation, and interview, the licensee did not comply with the section cited above in, screens in despair, accessibility, and drywall, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee will fix windows, screens in despair, accessibility, and drywall of the facility by POC due date. Licensee will email proof of correction to David.espana@dss.ca.gov.

Deadline recorded: Jan 14, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87303(a-e)

Regulation authority

CCR

What the official deficiency says

87303 (a-e) Maintenance and Operation (a)The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision... the safety and well-being of residents, employees and visitors. (1) Floor surfaces in bath, laundry and kitchen areas shall be maintained in a clean, sanitary, and odorless condition…(c) All window screens shall be clean and maintained in good repair. (d)There shall be...the use of each room and sufficient to ensure the comfort and safety of all persons in the facility. (e)Water supplies and.... maintained as follows: (1)All community care facilities where water for human consumption is from a private… Based on observation, and interview, the licensee did not comply with the section cited above in, flammable grasses, no access door to side of facility, pigeons and pigeon cages, and flies and insects, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee will address flammable grasses, no access door to side of facility, pigeons and pigeon cages, and flies and insects at the facility by POC due date. Licensee will email proof of correction to David.espana@dss.ca.gov.

Deadline recorded: Jan 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. LPA identified room #1 & 2 had hot water temperature range at 161.2 -165.9 degree F. This violation which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/05/2023 Plan of Correction Hot water temperature must meet the Title 22 regulations requirement of not less than 105. degree F and not more than 120 degree F. Licensee will make correction to reduce the water temperature to meet the requirements at all times. Proof of correction must be sent to LPA Dabuet at: ernand.dabuet@dss.ca.gov no later than 11/05/23. *Corrected during visit 11/04/23* Corrected during visit on 11/04/23.

Official classification

Type A

Official code

87204(b)

Regulation authority

CCR

What the official deficiency says

(b) Resident rooms approved for 24-hour care of ambulatory residents only shall not accommodate nonambulatory residents. Residents whose condition becomes nonambulatory shall not remain in rooms restricted to ambulatory residents. 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. Resident #4 who is bedridden is in a ambulatory room 7A not cleared for bedridden room. The licensee is operating beyond the conditions and limitations specified on the license. This violation which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/05/2023 Plan of Correction The licensee will need to transfer hospice resident #4 to an approved bedriddent room 1,3, 4 or 5 in order to correct this violation. This violation must be completed by due date 11/05/23. Proof of correction must be sent to ernand.dabuet@dss.ca.gov *Immediate Civil Penalty*

Official classification

Type A

Official code

87307(d)(6)

Regulation authority

CCR

What the official deficiency says

(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 observation, the licensee did not comply with the section cited above. LPA identified funiture, mattress, wheelcair and other furnishing supplies obstructing passage way adjacent to room #10. Staff indicated this furnishings have been blocking passage way for several days. This violation which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/05/2023 Plan of Correction Licensee will remove furnishing obstructing passage way immediately. Proof of correction must be sent to LPA at ernand.dabuet@dss.ca.gov by due date 11/05/23. *Corrected during visit on 11/04/23*

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. 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 identified open powder bleach under bathroom sink accessible to dementia residents in care in room #7. This violation which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/05/2023 Plan of Correction LIcensee will adhere to Title 22 regulations section 87309 and ensure that all toxic, hazardous chemical items are store in locked cabinets and not accessible to residents in care. Proof of correction must be sent to LPA at ernand.dabuet@dss.ca.gov by 11/05/23. *Corrected during visit on 11/4/23*

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: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. LPA identified room #19 bathroom baseboards had rust/mold and need to be replaced. This violation which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/04/2023 Plan of Correction Licensee will make necessary repairs and replace with new bathroom baseboards. Proof of correction must be sent to LPA at ernand.dabuet@dss.ca.gov by 12/04/23.

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 observation and record review, the licensee did not comply with the section cited above. LPA identified the facility had not conducted a recent quarterly fire drill. The last drill was completed in June 2023. This violation which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/18/2023 Plan of Correction Licensee will adhere to H & S regulations 1569.695 and continue to conduct quarterly fire drills. Proof of correction must be sent to LPA at ernand.dabuet@dss.ca.gov by due date 11/18/23.