COMFORT HOME FOR ELDERLY

Official classification

Type B

Official code

87412(a)(11)

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: (11) A health screening as specified in Section 87411, Personnel Requirements - General. 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 having the LIC 503 form for one staff which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/03/2023 Plan of Correction Administrator will ensure LIC 503 forms are completed and on staff files all the time. Licensee will submitt proof of correction to LPA via email before POC due date.

Official classification

Type B

Official code

87411(c)(1)

Regulation authority

CCR

What the official deficiency says

(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 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 having a CPR card and an expired card on staff files which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/03/2023 Plan of Correction Administrator will ensure all staff CPR cards are not expired and on file. Administrator will submitt proof of correction to LPA via email before POC due date.

Official classification

Type B

Official code

87506(b)(17)(A)

Regulation authority

CCR

What the official deficiency says

(b) Each resident's record shall contain at least the following information: (17) Documents and information requried by the following: (A) Section 87457, Pre-Admission Appraisal; 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 having an appraisal and needs and services plan for resident which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/03/2023 Plan of Correction Administrator will ensure all clients have pre-admission appraisals and Nedd and Services Plan on file. Administrator will submitt proof of correction to LPA via email before POC due date.

Official classification

Type A

Official code

87355(c)(1)(c)

Regulation authority

CCR

What the official deficiency says

87355(c)(1) (c) A licensee or applicant for a license may request a transfer of a criminal record clearance from one state licensed facility to another...to a state licensed facility by providing the following documents to the Department: (1) A signed Criminal Background Clearance Transfer Request, LIC 9182. This requirement is not met as evidenced by: Based on (interview) (record review), the licensee did not comply with the section cited above. Staff #5 (S5) did not have criminal record clearance. This poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee to ensure that all staff prior to working in the facility obtain a Criminal Background Clearance and Criminal Background Transfer Request and provide proof of correction to CCLD by POC due date: 03/23/23. Copies received during the time of visit. ***A CIVIL PENALTY IS BEING ISSUED TODAY***

Deadline recorded: Mar 23, 2023. 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 in water temperature 129.5 degree F in resident's restroom. Which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/27/2022 Plan of Correction Licensee will adjusted the water heater temperature. Licensee will send a picture of water temperature adjusted by POC due date.

Official classification

Type B

Official code

87355(e)(2)

Regulation authority

CCR

What the official deficiency says

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c) or This requirement is not met as evidenced by: Deficient Practice Statement Based on record reviewed, this licensee did not comply with the section cited above in S#1. S#1 which poses/posed a potential health, safety or personal rights risk to persons in care S#1 is only finger printed.

Official plan of correction

POC Due Date: 10/03/2022 Plan of Correction Licensee will request transfer of criminal record clearance for S#1 not associated with the facility. Licensee will submit proof via -email to LPA by due date.

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 all of the following personal rights:To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement was not met as evidenced by: Based on administrator admitting to themselves and staff not wearing a mask during a visit from the LTCO. which presented a potential health and safety risk to resident in care.

Official plan of correction

Facility will retrain all staff on mitgation plan and submit proof to Analyst by POC due date.

Deadline recorded: Apr 21, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87307(b)

Regulation authority

CCR

What the official deficiency says

87309 Storage Space Medicines which are centrally stored shall be stored as specified in Section 87465 and separately from other items specified in (a) above. This requirement was not met as evidenced by: Based on administrator admitting to themselves and staff were not ensuring medication was locked and inaccessible to residents in care. Which presented a potential health and safety risk to resident in care.

Official plan of correction

Facility will have all staff reviews regulation and submit proof to Analyst by POC due date.

Deadline recorded: Apr 21, 2022. A deadline is not proof that correction was completed.