JASMINES RESIDENTIAL CARE FOR ELDERLY

Official classification

Type A

Official code

87468.1(a)(8)

Regulation authority

CCR

What the official deficiency says

Personal Rights Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (8) To have their representatives regularly informed by the licensee of activities related to care or ervices, including ongoing evaluations, as appropriate to their needs. This requirement was not: Licensee did not call R1's responsible party to inform them of R1's change of condition on 05/23/2026 at 7:40am. This poses an immediate risk to the health, safety, or personal rights of persons in care.

Official plan of correction

The licensee will draft a plan that will discuss how residents representatives will be regularly informed by the licensee regarding activities related to a resident’s care services, including ongoing evaluations, as appropriate to their needs. Plan must be received via email.

Deadline recorded: Jun 27, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)(1)(A)

Regulation authority

CCR

What the official deficiency says

(a) Each licensee shall furnish to the licensing agency such reports as the Department may require: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified. (A) Death of any resident from any cause regardless of where the death occurred. This requirement was not met as evidenced by: Licensee could not provide proof R2's death report was submitted to this department within 7 days of 05/23/2026.

Official plan of correction

Licensee will draft a plan and explain how the facility will comply with this regulation in the future. Plan must be received by 6/11/2026.

Deadline recorded: Jun 11, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87465(a)(5)(D)

Regulation authority

CCR

What the official deficiency says

(a) A plan for incidental medical shall be developed.The plan shall encourage medical care,provide for assistance in obtaining such care, compliance with the following: (5) staff may assist persons with self-administration. Assistance with self administered medications shall be limited to the following: (D) Assistance with self administration does not hiding,camouflaging medications in other substances without the resident's knowledge and consent, or infringing upon a resident's right to refuse to take a medication. This requirement was not met: Staff crushed R1's meds and put in R1's juice w/o a Dr order.

Official plan of correction

Licensee will obtain physician's order to specify the name of the medication to be crushed and specific dosage by 06/11/26

Deadline recorded: Jun 11, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)(1)

Regulation authority

CCR

What the official deficiency says

(1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview and record review, the licensee did not comply with the section cited above in two (2) residents, because the death report for Resident #1 and incident report for Resident #2's hospitalization was not received by the licensing agency, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/12/2026 Plan of Correction Administrator is to ensure that incident and death reports are submitted to the department in the appropriate time frames at all times. Administrator shall fax the incident report and death report to LPA and submit facility's plan on how incident and death reports will be sent to LPA by the POC due date.

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 record review and observation, the licensee did not comply with the section cited above in 3 out of 3 residents, because all residents have half-rails on their beds however they do not have physician orders in their records, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/12/2026 Plan of Correction Administrator is to ensure that physician orders for half rails are obtained for all residents and kept in their file at all times. Administrator is to obtain the physician orders for the half-rails for the 3 residents and submit them to LPA by the POC due date.

Official classification

Type A

Official code

87705(f)(2)

Regulation authority

CCR

What the official deficiency says

(f) Licensees that lock exterior doors or perimeter fence gates shall meet the following initial and continuing requirements: (2) The licensee shall ensure that the fire clearance includes approval of locked exterior doors or perimeter fence gates and that facility staff on all shifts have access to, and know how to use, equipment needed to unlock exterior doors or perimeter fence gates. 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 in 4 out of 4 residents, becuase the sole side exit is kept locked with a padlock, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/16/2025 Plan of Correction Administrator is to ensure that residents are not locked within the perimiter of the facility at all times. Administrator is to unlock the padlock and email LPA proof that it has been rmeoved by the POC due date.

Official classification

Type B

Official code

1569.625(b)(2)

Regulation authority

HSC

What the official deficiency says

(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. 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 5 out of 5 staff, because there was no documented retraining on dementia care, hospice care, restricted health conditions, or postural supports, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/12/2025 Plan of Correction Administrator is to ensure that retraining on the identified topics are documented and kept in the staff files at all times. Administrator is to conduct training on dementia care, hospice care, postural supports, and restricted health conditions amongst staff by the POC due date.

Official classification

Type B

Official code

87458(a)

Regulation authority

CCR

What the official deficiency says

(a) Prior to a person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment, signed by a licensed medical professional acting within the scope of their practice and made within the last year, to be kept in the resident's record. 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 1 out of 4 residents, as 1 residents did not have a physician's report dated within the past year, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/12/2025 Plan of Correction Administrator is to ensure that residents have a physician's report completed within the past year and kept in their files at all times. Administrator is to complete physician's reports for the 2 identified residents and email them to LPA by the POC due date.

Official classification

Type B

Official code

87463(a)

Regulation authority

CCR

What the official deficiency says

(a) The pre-admission appraisal, as specified in Section 87457, Pre-Admission Appraisal, shall be updated, in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition, as defined in Section 87101, Definitions, and to keep the appraisal accurate. For the purposes of this section, the updated pre-admission appraisal shall be referred to as the reappraisal. 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 2 out of 4 residents, because there was no reappraisal conducted within the past year for 2 residents, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/12/2025 Plan of Correction Administrator is to ensure that reappraisals are conducted once per year and kept in the resident's file at all times. Administrator is to perform a reappraisal for the 2 identified residents and email them to the LPA by the POC due date.

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 record review, the licensee did not comply with the section cited above in 4 out of 4 residents, as there was no documented disaster drill kept at the facility, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/12/2025 Plan of Correction Administrator is to ensure that the facility is to document disaster drills conducted at all times. Administrator is to conduct a disaster drill and email LPA the documented drill by the POC due date.

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 record review, the licensee did not comply with the section cited above in 4 out of 4 residents, because the plan of operation was not held at the facility for review, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/19/2024 Plan of Correction Administrator is to ensure that the Plna of Operation is held at the facility at all times. Administrator is to email the Plan of Operation to LPA by POC due date.

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 record review, the licensee did not comply with the section cited above in 4 our of 4 residents, because the last documented disaster drill was conducted in 2020, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/19/2024 Plan of Correction Administrator is to ensure that disaster drills are documented at least once every 3 months. Administrator is to hold a drill and submit documentation of the drill to LPA by the POC due date.

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 [(observation) (interview) (record review)], the licensee did not comply with the section cited above as Plan of Operation file was not observed in the facility, 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 / Administrator will create Binder with Plan of Operation to keep on file by POC due date. LPA to be provided with picture image of file being on site of the facility.