RESERVE AT THOUSAND OAKS, THE

Official classification

Type B

Official code

87468.1(a)

Regulation authority

CCR

What the official deficiency says

Personal Rights of Residents in All Facilities:(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2)To be accorded safe, healthful and comfortable accommodations... Based on interviews conducted with residents, the licensee did not comply with the section cited above, as outside agency contractors (painters) were allowed access to resident units without supervision and without making sure resident was aware that the contractors will be working in the unit.

Official plan of correction

Executive Director (ED)stated that they discussed the issue with the Maintence Director and will be providing in-service to staff by 05/29/2026. Copy inservice will be sent to LPA by

Deadline recorded: May 1, 2026. 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

Personal Rights of Residents in All Facilities:(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2)To be accorded safe, healthful and comfortable accommodations... This requirement is not met as evidenced by: Based on interviews conducted with random residents, the licensee did not comply with the section cited above, as residents living in the outer buildings felt unsafe and uncomfortable room temp. during the SCE power shut off in 1/2025. Room temp. were freezing cold and there was no emergency

Official plan of correction

Executive Director state thatg since the SCE power outage, emergency lighting is placed on the outer buildings; and they are in the process of updating the facility emergency disaster plan. Submit copy of addendum to the facility Emergency Disaster Plan. lighting the exist, walkways and stairs.

Deadline recorded: Nov 17, 2025. 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 as water in room F7 measured at 138.4 degrees F and water in E1 measured at 133.1 degrees F, which poses an immediate safety risk to persons in care.

Official plan of correction

POC Due Date: 07/16/2024 Plan of Correction During today's visit, water was adjusted in both resident rooms. Maintenance informed LPA that each individual unit has their own water heater and that random water temperature inspections occur monthly. LPA advised to inspect units more regularly to ensure water temperature remains within the appropriate range.

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 and interview, the licensee did not comply with the section cited above as the ceiling in the main building second floor common area was covered in plastic and observed to be leaking water and has been for about a month, which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 07/23/2024 Plan of Correction Associate Executive Director indicated that the area is pending repair at this time. Management will provide plan for repair by 07/23/2024 and subsequent proof of repair to CCL upon completion.

Official classification

Type B

Official code

87555(b)(27)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (27) All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above as fruit/drain flies were observed in both the kitchen and in the server station just outside the kitchen, which poses a potential health and personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/23/2024 Plan of Correction Associate Executive Director indicated that pest control will be coming out on Friday to address the situation. Management will provide proof to CCL by POC due date of pest control service.

Official classification

Type B

Official code

87705(f)(1)

Regulation authority

CCR

What the official deficiency says

(f) The following shall be stored inaccessible to residents with dementia: (1) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s). This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above as the Fitness Room in the main building was observed to be unlocked and unattended and contained accessible scissors and screwdrivers, laundry detergent was left unattended in the laundry room, as well as an additional staff office was left unattended and contained staff's persoal items, personal care items and COVID tests, which poses a potential safety risk to persons in care.

Official plan of correction

POC Due Date: 07/30/2024 Plan of Correction Doors to the Fitness Room were closed, laundry detergent was returned to the resident it belonged to, and the staff returned to the room. Relevant staff training will be conducted and proof sent to CCL by POC due date.

Official classification

Type A

Official code

87465(g)

Regulation authority

CCR

What the official deficiency says

87465(g) Incidental Medical and Dental Care. (g) The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health including ... an apparent life-threatening medical crisis ... This requirement is not met as evidenced by: Based on interview and record review, the licensee did not comply with the section cited above, as staff failed to call 9-1-1 when R1 was experiencing chest pains and instead called R1’s responsible party, which poses an immediate health and safety risk to residents in care.

Official plan of correction

The Administrator agreed to do the following: Hold an in-service training with staff, discussing the protocol as it pertains to contacting emergency services. Training must begin by 7/28/2023 and must conclude no later than 8/4/2023.

Deadline recorded: Jul 28, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(a)(4)

Regulation authority

CCR

What the official deficiency says

87465(a)(4) Incidental Medical and Dental Care. The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Deficient Practice Statement Based on the medication audit, the licensee did not comply with the section cited above, as the medication count was off for 1 out of 5 residents (R1), which poses an immediate health and safety risk to residents in care.

Official plan of correction

POC Due Date: 07/14/2023 Plan of Correction The Administrator agreed to do the following: 1. Conduct a medication audit with medication technicians, ensuring that staff are up-to-date regarding medication administration procedures. Training must begin within the next 48 hours, to be completed by 7/21/2023.

Official classification

Type B

Official code

87411(c)(1)

Regulation authority

CCR

What the official deficiency says

87411(c)(1) Personnel Requirements – General. Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross. 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 3 out of 6 staff files (S1, S2, S3), which poses a potential health and safety risk to residents in care.

Official plan of correction

POC Due Date: 07/21/2023 Plan of Correction The Administrator has agreed to do the following: 1. Obtain valid first aid certification for the three staff no later than 7/21/2023

Official classification

Type A

Official code

87468.1(a)(1)

Regulation authority

CCR

What the official deficiency says

87468.1(a)(1) Personal Rights of Residents in All Facilities. (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement is not met as evidenced by: Based on interviews, the licensee did not comply with the section cited above, as S1 admitted to hugging and kissing R1 on the forehead, as well as accepted gifts from residents, which poses an immediate personal rights risk to residents in care.

Official plan of correction

The Administrator agreed to do the following: 1. S1 was placed on leave as of 5/24/2022 and has since resigned. 2. Facility staff will review Regulation 87468 and the internal policy regarding accepting gratuities. Proof of completion provided no later than 8/30/2022.

Deadline recorded: Aug 30, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87217(b)

Regulation authority

CCR

What the official deficiency says

87217(b) Safeguards for Resident Cash, Personal Property, and Valuables Every facility shall take appropriate measures to safeguard residents' cash resources, personal property and valuables which have been entrusted to the licensee or facility staff. This requirement is not met as evidenced by: Based on the investigation, the licensee did not comply with the section cited above as it related to R1's air mattress, which poses a potential personal rights risk to residents in care.

Official plan of correction

The Administrator has agreed to do the following: 1. Submit a Plan of Action, detailing how the facility will ensure that resident personal property is safeguarded. Submit plan to CCLD no later than POC due date of 6/10/2022.

Deadline recorded: Jun 10, 2022. A deadline is not proof that correction was completed.