SEDONA GUEST HOME

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

(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. 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 having the kitchen vent pipe and sink are in disrepair, kitchen vent filters are missing, underneath the kitchen sink there was water damage and the walls/wood are crumbling, kitchen cabinets need to be deep cleaned to remove dead vermin, dust, grease which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/01/2026 Plan of Correction The Licensee has agreed to create a plan to address said issues and submit pictures for proof of correction to Socorro.Leandro@dss.ca.gov

Official classification

Type B

Official code

87305(a)

Regulation authority

CCR

What the official deficiency says

(a) 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 and record review, the licensee has not updated their facility sketch to match the facility’s physical plant, the garage has 2 staff bedrooms which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/01/2026 Plan of Correction The Licesee will email updated facility sketch to Socorro.Leandro@dss.ca.gov

Official classification

Type B

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could 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: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in having cleaning solutions and medications (the garage/laundry room was unlocked and the cleaning solutions were out) accessible to resident in care which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/01/2026 Plan of Correction The Licensee has agreed to create a plan to address said issues and submit plan and trainings to Socorro.Leandro@dss.ca.gov

Official classification

Type B

Official code

87412(a)

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: 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 not maintaining complete and current personnel records in the facility, Staff 1 (S1) to Staff 4 (S4) had incomplete records ranging from mandatory trainings, CPR/First Aid Certificates, Job Application/Personnel Record, Health Screening Report, TB Test, etc. which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/01/2026 Plan of Correction The Licensee has agreed to create a plan to address said issues and submit plan and proof of complete personnel records to Socorro.Leandro@dss.ca.gov

Official classification

Type B

Official code

87555(b)(27)

Regulation authority

CCR

What the official deficiency says

(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 in having dead and live vermin in the kitchen area which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/01/2026 Plan of Correction The Licensee has agreed to create a plan to address said issues and submit plan and proof of correction which include but not limited to cleaning schedules, pictures of all kitchen cabinets, amount of times exterminators have serviced the facility, their records and their advice to the facility email proof to Socorro.Leandro@dss.ca.gov

Official classification

Type B

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. 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 in keeping unlocked medication in resident rooms while their Medical Assessments indicate that they are unable to manage medication which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/01/2026 Plan of Correction The Licensee has agreed to create a plan to address said issues and submit plan and trainings to Socorro.Leandro@dss.ca.gov

Official classification

Type B

Official code

87465(h)(5)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. 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 in not maintaining medication in its original container which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/01/2026 Plan of Correction The Licensee has agreed to create a plan to address said issues and submit plan and trainings to Socorro.Leandro@dss.ca.gov

Official classification

Type B

Official code

87465(d)(3)

Regulation authority

CCR

What the official deficiency says

(d) If the resident is unable to determine his/her own need for a prescription or nonprescription PRN medication, and is unable to communicate his/her symptoms clearly, facility staff designated by the licensee, shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: (3) The date and time the PRN medication was taken, the dosage taken, and the resident's response shall be documented and maintained in the resident's facility record. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, and record review, the licensee did not comply with the section cited above in not documenting the time medication was taken and the residents’ response which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/01/2026 Plan of Correction The Licensee has agreed to create a plan to address said issues and submit plan and trainings to Socorro.Leandro@dss.ca.gov

Official classification

Type B

Official code

87465(e)

Regulation authority

CCR

What the official deficiency says

(e) For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician on a prescription blank, maintained in the resident's file, and a label on the medication. Both the physician's order and the label shall contain at least all of the following information. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, and record review, the licensee did not comply with the section cited above in having PRN medication without an order from the physician on a prescription which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/01/2026 Plan of Correction The Licensee has agreed to create a plan to address said issues and submit plan, order of the physician and trainings to Socorro.Leandro@dss.ca.gov

Official classification

Type B

Official code

87506(a)

Regulation authority

CCR

What the official deficiency says

(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 observation, interview, and record review, the licensee did not comply with the section cited above in not maintaining complete and current resident records, Resident 1 (R1) to Resident (5) had incomplete records ranging from incomplete Admission Agreements and I.D. And Emergency Information, not having TB Test record and Personal Rights, not having current Medical Assessment and Appraisal & Needs Services Plan which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/01/2026 Plan of Correction The Licensee has agreed to create a plan to address said issues and submit plan and email complete and current resident record (R1-R5) to Socorro.Leandro@dss.ca.gov

Official classification

Type B

Official code

87628(a)

Regulation authority

CCR

What the official deficiency says

(a) The licensee shall be permitted to accept or retain a resident who has diabetes if the resident is able to perform his/her own glucose testing with blood or urine specimens, and is able to administer his/her own medication including medication administered orally or through injection, or has it administered by an appropriately skilled professional. 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 Resident 2 (R2) is administering their own injections even though their Physicians Report (Medical Assessment) dated 05/21/2019 indicates that they cannot manage their own medications due to poor hand function which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/01/2026 Plan of Correction The Licensee will start to solve this issue with updating R2’s Medical Assessment and verify if R2 can perform their own injections. (If resident has Dementia/Mild Cognitive Impairment/hand mobility issues the caregivers cannot perform hand-over-hand assistance a skilled professional will have to perform injections). Proof of correction will be emailed to Socorro.Leandro@dss.ca.gov

Official classification

Type B

Official code

87305(a)(b)

Regulation authority

CCR

What the official deficiency says

87305 Alterations to Existing Building or New Facilities (a) Prior to construction or alterations, all facilities shall obtain a building permit.The licensing agency may require the facility to acquire a local building inspection...to health and safety exists. This requirement is not as evidence by: Based on observtation and records review the facility failed to notify CCL of alterataions done to the garage as a 2 bedroom living space added to the physical plant. This poses a potential health and safety or personal rights risk to persons in care.

Official plan of correction

Licensee administrator shall read title 22, section 87305 and send a written statement to CCL a plan of action by the due date. LIcensee will request STD 850, Facility Sketch, and LIC200. The plan is due to the CCLD/El Segundo ASC offfice by 06/07/2025 fax at (424)544-1016

Deadline recorded: Jun 7, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87411(c)(1)

Regulation authority

CCR

What the official deficiency says

87411(c)(1) 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 as evidence by: Based on observtationa and records review staff had 3 expired first aid CPR certificates. This poses a potential health and safety or personal rights risk to persons in care.

Official plan of correction

Licensee or administrator shall have first aid certificates for staff 1-3 by due date indicated. The plan is due to the CCLD/El Segundo ASC offfice by 05/21/2025 fax at (424)544-1016

Deadline recorded: May 21, 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(h)(2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement is not met as evidence by: Based on observation LPA observed medications are not stored and locked securely and accessible to residents.This poses an immediate health and safety or personal rights risk to persons in care.

Official plan of correction

Licensee administrator shall read title 22, section 87465 and send a written statement to CCL a plan of action by the due date. The facility shall store all medications in a locked stoarge. The plan is due to the CCLD/El Segundo ASC offfice by 05/08/2025 fax at (424) 544-1016

Deadline recorded: May 8, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

47465(d)(3)

Regulation authority

CCR

What the official deficiency says

47465 If the resident is unable to determine... following requirements are met: (3)The date and time the PRN medication was taken, the dosage taken, and the resident's response shall be documented and maintained in the resident's facility record. This requirement is not as evidence by: Based on observtation and records review staff had incomplete (MAR) since 04/09/2025 This poses a potential health and safety or personal rights risk to persons in care.

Official plan of correction

Licensee administrator shall read title 22, section 47465 and send a written statement to CCL a plan of action by the due date. The facility shall send proof of documentted and maintained (MAR) for residnets in care. The plan is due to the CCLD/El Segundo ASC offfice by 05/21/2025 fax at (424) 544-1016

Deadline recorded: May 21, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

8721187211(a)(1)(A)

Regulation authority

CCR

What the official deficiency says

87211 Reporting Requirements (a) licensee shall furnish to the licensing agency such reports as the Department... (1) A written report shall be submitted to the licensing agency... within seven days..(A) Death of any resident from any cause regardless of where the death occurred... This requirement is not met as evidence by: Based on interview with stafff, Licensee failed to report death of resident 04/09/25 who was on hospice care. This poses a potential Health, Safety, or Personal Rights risk to persons in care.

Official plan of correction

Licensee will adhere to the regulations and will ensure any changes in resident's health condition or death will be reported to CCLD. Licensee will ensure to provide proof of correction sent by fax 424-544-1016 to El Segundo Regional office by 05/21/25.

Deadline recorded: May 21, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87405(d)(1)(2)

Regulation authority

CCR

What the official deficiency says

87405 Administrator - Qualifications and Duties (d) The administrator shall have the qualifications specified in Sections 87405(d).... If the licensee is also the administrator, all requirements for an administrator shall apply. (1) Knowledge of the requirements for providing care and supervision... (2) Knowledge of and ability to conform to the applicable laws, rules and regulations. This requirement is not met, as evidenced by: The administrator's failure to conform to the applicable laws, rules, and regulations led to multiple deficiencies in annual inspection 05/07/25. This poses a potential Health, Safety, or Personal Rights risk to persons in care.

Official plan of correction

Licensee will adhere toTitle 22 Reg 87405 and will ensure to read and review. A written confirmation that admnistrator have completed this and send proof of correction to provide proof of correction sent by fax 424-544-1016 to El Segundo Regional office by 05/21/25.

Deadline recorded: May 21, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87633(a)(1)

Regulation authority

CCR

What the official deficiency says

(a) The licensee shall be permitted to accept or retain residents who have been diagnosed as terminally ill by his or her physician and surgeon and who may or may not have restrictive and/or prohibited health conditions, to reside in the facility and receive hospice services from a hospice agency in the facility, when all of the following conditions are met: (1) The licensee has received a hospice care waiver from the department. 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. The facility did not have a hospice waiver on file

Official plan of correction

POC Due Date: 05/08/2024 Plan of Correction Administrator agrees to submit proof of hospice waiver or apply for hospice waiver by the POC date. Sparkle.day@dss.ca.gov

Official classification

Type B

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 LPA's observations, the licensee did not comply with the section cited above in displaying cleaning solutions and knives available 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: 05/01/2023 Plan of Correction Licensee will repair locks in the kitchen area as necessary to remain in state compliance. All maintenance will be documented in media evidence (PHOTO/VIDEO) and submitted to Mario.Leon@DSS.CA.GOV

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 LPA's record review, the licensee did not comply with the section cited above in not providing liability insurance which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/05/2023 Plan of Correction Licensee will update their insurance policy to remain in compliance with state licensing on, or prior to, the POC due date as listed above. All proofs will be submitted to Mario.Leon@DSS.CA.GOV Alternatively, these documents may be dropped off, or mailed to, 1000 corporate center dr, STE100, Monterey Park, CA (attn: Mario)

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 LPA observation, the licensee did not comply with the section cited above in having a broken cabinet below the kitchen sink which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/01/2023 Plan of Correction Licensee will repair the cabinet drawer below the kitchen sink, in the kitchen area, as necessary to remain in state compliance. All maintenance will be documented in media evidence (PHOTO/VIDEO) and submitted to Mario.Leon@DSS.CA.GOV

Official classification

Type B

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 LPA's measurement, the licensee did not comply with the section cited above in having the hot water at 134.2 degrees F which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/01/2023 Plan of Correction Licensee will bring the hot water temperature down, to be within Title 22 regulations as shown above, throughout the house as necessary to remain in state compliance. All maintenance will be documented in media evidence (PHOTO/VIDEO) and submitted to Mario.Leon@DSS.CA.GOV

Official classification

Type B

Official code

87506(a)

Regulation authority

CCR

What the official deficiency says

(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 LPA's record review, the licensee did not comply with the section cited above in having missing resident documents: admission agreements with client signature, updated medical assessments, appraisal/needs & services plans as well as medical consent forms present which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/12/2023 Plan of Correction Licensee will ammend resident paperworks as necessary to remain in state compliance. All files will be documented in media evidence (.doc, .docx or .pdf) and submitted to Mario.Leon@DSS.CA.GOV Alternatively, these documents may be dropped off, or mailed to, 1000 corporate center dr, STE100, Monterey Park, CA (attn: Mario)

Official classification

Type B

Official code

87506(b)(10)

Regulation authority

CCR

What the official deficiency says

(b) Each resident's record shall contain at least the following information: (10) Reports of the medical assessment specified in Section 87458 Medical Assessment, and of any special problems or precautions. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's record review, the licensee did not comply with the section cited above in missing three (3) out of four (4) residents medical assessments which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/12/2023 Plan of Correction Licensee will update resident's records as necessary to remain in state compliance. All files will be documented in media evidence (.doc, .docx or .pdf) and submitted to Mario.Leon@DSS.CA.GOV Alternatively, these documents may be dropped off, or mailed to, 1000 corporate center dr, STE100, Monterey Park, CA (attn: Mario)

Official classification

Type B

Official code

87506(b)(16)

Regulation authority

CCR

What the official deficiency says

(b) Each resident's record shall contain at least the following information: (16) Records of resident's cash resources as specified in Section 87217, Safeguards for Resident Cash, Personal Property, and Valuables. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's record review, the licensee did not comply with the section cited above in missing two (2) out of four (4) residents safeguards for property values which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/05/2023 Plan of Correction Licensee will update resident's records as necessary to remain in state compliance. All files will be documented in media evidence (.doc, .docx or .pdf) and submitted to Mario.Leon@DSS.CA.GOV Alternatively, these documents may be dropped off, or mailed to, 1000 corporate center dr, STE100, Monterey Park, CA (attn: Mario)

Official classification

Type B

Official code

87463(c)

Regulation authority

CCR

What the official deficiency says

(c) The licensee shall arrange a meeting with the resident, the resident's representative, if any, appropriate facility staff, and a representative of the resident's home health agency, if any, when there is significant change in the resident's condition, or once every 12 months, whichever occurs first, as specified in Section 87467, Resident Participation in Decision Making. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's record review, the licensee did not comply with the section cited above in missing three (3) out of four (4) residents updated medical assessment paperwork which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/19/2023 Plan of Correction Licensee will update resident's records as necessary to remain in state compliance. All files will be documented in media evidence (.doc, .docx or .pdf) and submitted to Mario.Leon@DSS.CA.GOV Alternatively, these documents may be dropped off, or mailed to, 1000 corporate center dr, STE100, Monterey Park, CA (attn: Mario)

Official classification

Type B

Official code

87468(c)(2)(A)

Regulation authority

CCR

What the official deficiency says

(c) Licensees shall prominently post personal rights, nondiscrimination notice, and complaint information in areas accessible to residents, representatives, and the public. (2) Information on the appropriate reporting agency in case of a complaint or emergency, including procedures for filing confidential complaints, shall be posted as follows: (A) Licensees may use the Residential Care Facility for the Elderly (RCFE) Complaint Poster (PUB 475) or may develop their own poster as provided in this section. A poster developed by the licensee shall contain the same content as the PUB 475. The poster that is posted shall be 20” x 26” in size and be posted in the main entryway of the facility. PUB 475 may be accessed, downloaded, and printed from the www.ccld.ca.gov website. 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 in lacking the above mentioned poster availability which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/01/2023 Plan of Correction Licensee will post the required poster as necessary to remain in state compliance. All maintenance will be documented in media evidence (PHOTO/VIDEO) and submitted to Mario.Leon@DSS.CA.GOV

Official classification

Type B

Official code

87608(a)(3)

Regulation authority

CCR

What the official deficiency says

(a) Based on the individual's preadmission appraisal, and subsequent changes to that appraisal, the facility shall provide assistance and care for the resident in those activities of daily living which the resident is unable to do for himself/herself. Postural supports may be used under the following conditions: (3) A written order from a physician indicating the need for the postural support shall be maintained in the resident's record. The licensing agency shall be authorized to require other additional documentation if needed to verify the order. 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 in having residents lacking physician orders for bed rails which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/12/2023 Plan of Correction Licensee will update resident's documentation as necessary to remain in state compliance. All files will be documented in media evidence (.doc, .docx or .pdf) and submitted to Mario.Leon@DSS.CA.GOV Alternatively, these documents may be dropped off, or mailed to, 1000 corporate center dr, STE100, Monterey Park, CA (attn: Mario)

Official classification

Type B

Official code

87608(a)(5)(B)

Regulation authority

CCR

What the official deficiency says

(B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's observation and record review the licensee did not comply with the section cited above in having two residents without having physician orders for postural supports which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/12/2023 Plan of Correction Licensee will update resident's documentation as necessary to remain in state compliance. All files will be documented in media evidence (.doc, .docx or .pdf) and submitted to Mario.Leon@DSS.CA.GOV Alternatively, these documents may be dropped off, or mailed to, 1000 corporate center dr, STE100, Monterey Park, CA (attn: Mario)

Official classification

Type B

Official code

1569.319(a)

Regulation authority

HSC

What the official deficiency says

(a) A licensee of a facility that has internet service shall provide at least one internet access device, such as a computer, smart phone, tablet, or other device, that can support real-time interactive applications, is equipped with videoconferencing technology, including microphone and camera functions, and is dedicated for resident use. 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 in not having a public device available for tele-health visits for residents which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/05/2023 Plan of Correction Licensee will maintain facility requirements as necessary to remain in state compliance. All documentation will be submitted in media evidence (photo/video, .doc, .docx., .pdf) and submitted to Mario.Leon@DSS.CA.GOV Alternatively, copies of these documents may be dropped off, or mailed to, 1000 corporate center dr, STE100, Monterey Park, CA (attn: Mario)