SHERWOOD FOREST SENIOR LIVING

Official classification

Type A

Official code

87202(a)

Regulation authority

CCR

What the official deficiency says

(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: This requirement is not met as evidenced by: Deficient Practice Statement Based on the observation and record review, the licensee did not comply with the section cited above in two out of two bedrooms (areas) persons which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/12/2024 Plan of Correction Administration/Licensee will need to contact the fire department to receive immediate fire clearance.

Official classification

Type A

Official code

1569.32

Regulation authority

HSC

What the official deficiency says

Any duly authorized officer, employee, or agent of the department may, upon presentation of proper identification, enter and inspect any place providing personal care, supervision, and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation of, this chapter. This requirement is not met as evidenced by: Deficient Practice Statement Based on the observation, interview and record review, the licensee did not comply with the section cited above in one out of one area (garage) which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/12/2024 Plan of Correction LPA will have to come back to have full access to the garage area.

Official classification

Type B

Official code

87208(a)

Regulation authority

CCR

What the official deficiency says

(a) Each facility shall have and maintain a current, written definitive plan of operation. The plan and related materials shall be on file in the facility and shall be submitted to the licensing agency with the license application. Any significant changes in the plan of operation which would affect the services to residents shall be submitted to the licensing agency for approval. The plan and related materials shall contain the following: This requirement is not met as evidenced by: Deficient Practice Statement Based on the observation, interview and record review, the licensee did not comply with the section cited above in submitting an application for two areas/(bedrooms)/and converted garage (new facility sketch) which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/20/2024 Plan of Correction The licensee will submit a written declaration explaining the steps that they are going to take to complete the project.

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 the observation, interview and record review, the licensee did not comply with the section cited above in two out of two bedrooms (areas) /garage conversion which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/20/2024 Plan of Correction The licensee will submit a written declaration explaining the steps that they are going to take to complete the project.

Official classification

Type B

Official code

87305(a)(b)

Regulation authority

CCR

What the official deficiency says

87305 (a) Prior to construction or alterations, all facilities shall obtain a building permit. (b) The licensing agency may require the facility to acquire a local building inspection where the agency determines that a suspected hazard to health and safety exists. This requirement is not met as evidenced by; Based on record review and observations, the Licensee did not ensure to obtain building permit prior to alteration of existing building. One of the bedrooms was converted to two (02) bedrooms and a change of used from storage to bedroom. This poses a potential health and safety risk to residents in care.

Official plan of correction

The Licensee will submit a written statement explaining the steps that they are going to take to complete the project.

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

Official classification

Type B

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..the following personal rights: (2) To be accorded safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement is not met as evidenced by; Based on record review and observations, Licensee did not inform the department how they are going to ensure that during construction residents continued to be accorded safe, healthful, and comfortable accommodations...This poses a potential personal rights violation to residents in care.

Official plan of correction

The Licensee will review regulation and submit a written letter certifying that, moving forward, they will ensure to follow and adhere to CCR Title 22 87468.1 Personal Rights of Residents in All Facilities; The written letter must be sent to the LPA by the POC due date.

Deadline recorded: May 3, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(a)(1)

Regulation authority

CCR

What the official deficiency says

Incidental Medical and Dental Care: (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following: (1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the condition and needs of the resident: This requirement has not been met as evidenced by: Medical records and interveiws with wound care specialist confirming R1 had stage 3 and 4 pressure wounds were not improving. Licensee placed the responsibility of scheduling R1's wound care treatment solely to their family, causing R1's condition to worsened. Licensee failed to assist R1's familiy with finding alternative placement options when they were aware of their conditions worsening.

Official plan of correction

An immediate civil penalty of $500 assessed. As POC, licensee will obtain training to address this section of the regulation. Proof of the training is due to CCL no later than 04/08/22. Administrator will be appealing the decision.

Deadline recorded: Mar 25, 2022. A deadline is not proof that correction was completed.