NEWCOMB GUEST MANOR

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 record review, the licensee did not comply with the section cited above in 1 out of 6 staff members, because 1 staff did not have active CPR training on file, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/31/2025 Plan of Correction Administrator is to ensure that all staff members have active CPR certificates on file at all times. Staff member is to obtain updated CPR training and administrator is to email the certificate to the 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 6 residents, because 2 residents did not have a reappraisal conducted 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: 07/22/2025 Plan of Correction Administrator is to ensure that all residents have a reappraisal conducted each year. Administrator is to conduct reappraisals for the 2 identified residents and email them to the LPA by the POC due date.

Official classification

Type A

Official code

87555(b)(26)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises. This requirement is not met as evidenced by: Based on interview and observation, LPA determined that there was not a sufficent 2-day supply of perishable foods within the facility for residents, which poses a potential health and safety risk for residents in care.

Official plan of correction

Administrator is to ensure that the food supply requirement is maintained on the premises at all times. Administrator is to increase the facility's perishable food supply and submit proof to LPA that it has been restocked by the POC due date.

Deadline recorded: Sep 11, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87555(b)(26)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises. This requirement is not met as evidenced by: Based on interview and observation, LPA determined that there was not a sufficent 2-day supply of perishable foods within the facility for residents, which poses a potential health and safety risk for residents in care.

Official plan of correction

Administrator is to ensure that the food supply requirement is met at the facility at all times. Administrator is to increase the facility's perishable food supply and submit proof to LPA that it has been restocked by the POC due date.

Deadline recorded: Jul 30, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.1(a)(11)

Regulation authority

CCR

What the official deficiency says

(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (11) To have their visitors (...) permitted to visit privately during reasonable hours (...) provided that the rights of other residents are not infringed upon. This regulation is not met as evidenced by: Based on interviews conducted, LPA determined that R1 has been denied visitation from his family members during his stay at the facility, which poses a potential health and safety risk to residents in care.

Official plan of correction

Administrator is to ensure that all residents are allowed visitors at all times if the resident agrees they wish to see the visitors. Administrator is to submit a written plan on how the facility will mee the requirement going forward by the POC due date.

Deadline recorded: Jul 30, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.2(a)(1)

Regulation authority

CCR

What the official deficiency says

(a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (1) To have (...) telephone conversations (...) and meetings of resident and family groups. This regulation is not met as evidenced by: Based on interviews, LPA determined that the resident had not been allowed to speak with their family members on the phone when they called the facility, which poses a potential health and safety risk to residents in care.

Official plan of correction

Administrator is to ensure that all residents are allowed to speak with their family members when they call the facility number. Administrator is to submit to LPA the facility's plan on how they will meet the regulation by the POC due date.

Deadline recorded: Jul 30, 2024. A deadline is not proof that correction was completed.

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 observation, the licensee did not comply with the section cited above in 5 out of 5 residents, because all 3 restrooms had a hot water temperature that fell below the required range of 105 - 120 degrees Fahrenheit, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/05/2024 Plan of Correction Administrator is to ensure that the hot water in the resident bathrooms remains within the required range of 105 - 120 degrees Farenheit at all times. Administrator is to keep a water log showing that the water temperature is within the required range and email it to LPA by the POC due date.

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 record review, the licensee did not comply with the section cited above in 1 out of 5 staff, because 1 staff does not have a health screening/physician's report in their file, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/12/2024 Plan of Correction Administrator is to ensure that all staff working at the facility have a physician's report and health screening in their file at all times. Administrator is to obtain a health screening with a TB clearance for the staff member and email it to the LPA by the POC due date.

Official classification

Type A

Official code

87411(d)

Regulation authority

CCR

What the official deficiency says

Personnel Requirements - General (d) All personnel shall be given on the job training or have related experience in the job assigned to them. This training and/or related experience shall provide knowledge of and skill in the following, as appropriate for the job assigned and as evidenced by safe and effective job performance: This requirement was not met evidenced by: Based on interviews conducted the findings indicate that former live-in staff (S5) allowed boyfriend to sleep at the facility. Staff (S5) and boyfriend were heard having sex and arguing on multiple times; which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator shall submit a written plan of correction that states what was done. Submit proof of staff training regarding the regulation, and staff conduct. POC is due tomorrow.

Deadline recorded: Jan 14, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87355(e)(2)

Regulation authority

CCR

What the official deficiency says

Criminal Record Clearance. (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). Based on record review and interviews conducted staff (S4) began working at the facility in late Dec. 2022, and as of today has not been associated to the facility. In addition, former staff (S5's) boyfriend was residing at the facility without criminal record clearance; which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator shall submit proof that staff (S4) has been associated via Guardian database. In addition, a written plan shall be submitted that states what was done regarding staff visitors sleeping in the premises. Submit proof of staff training.

Deadline recorded: Jan 14, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87307(a)(2)(A)

Regulation authority

CCR

What the official deficiency says

Personal Accommodations and Services. (a) Living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations .... (2) Resident bedrooms shall ... (A) Bedrooms shall be large enough to allow for easy passage between and comfortable usage of beds and other required items of furniture specified below, and any resident assistant devices such as wheelchairs or walkers. Based on observation, three (3) out of four (4) resident bedrooms had doorways that were narrow in size. Assist devices could not safely exit the room door if there was a door. This poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator shall submit a written plan of correction of how this was corrected. Submit picture proof evidence by POC due date.

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

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

Maintenance and Operation. (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 was not evidenced by: Based on observation, flooring trim transitions were observed througout the facility, as well as, raised concrete pavers in the backyard that contained nails that were sticking out. The north side yard door exit had a lock that required a key; which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator shall submit picture proof corrections made and a written statement of what was done to correct the deficiency.

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