GOLDEN YEARS RESIDENTIAL CARE HOME, THE

Official classification

Type A

Official code

85068.5(a)

Regulation authority

CCR

What the official deficiency says

85068.5(a) Eviction Procedures The licensee shall be permitted to evict a client by serving the client with a 30-day written notice...this requirement was not met as evidenced by: Based on interview conducted, facility refused to accept a resident back into the facility and failed to properly evict, which poses an immediate Personal Rights risk to the resident.

Official plan of correction

Licensee stated that implemented new form for discharge and or transfer of new client, provided 30 day eviction letter as well for future use.

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

Official classification

Type B

Official code

87211(a)(d)

Regulation authority

CCR

What the official deficiency says

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following:(D)Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident. The following requirement has not been met as evidenced by: The facility did not report Resident 1's elopement to Licensing, which poses a potential, health, safety or personal rights risk to residents in care.

Official plan of correction

Licensee will conduct training on Reporting Requirements with facility management staff, and submit proof to LPA by POC date of 05/21/2025.

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

Official classification

Type A

Official code

87464(f)(1)

Regulation authority

CCR

What the official deficiency says

87464 Basic Services (f) Basic services shall at a minimum include:(1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). The following requirement has not been met as evidenced by: Resident 1 eloped from the facility approximately 2:35 a.m. on 02/03/2025 depsite Physicians report documenting he is not allowed to leave the facility unassisted, which poses an immediate health, safety, or personal rights risk to residents in care.

Official plan of correction

Licensee will conduct training with facility staff and client Care and Supervision, and reviewing client documents submit proof to LPA by POC date of 05/08/2025.

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

Official classification

Type B

Official code

87303a

Regulation authority

CCR

What the official deficiency says

87303 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 was not observed as evidenced by: The facility failed to maintain clean table counter tops and floors in the facility that did not appear clean and free from clutter. This poses potential health and safety risk to residents in care.

Official plan of correction

The facility offered as a plan of correction to provide receipt for all facility treatment twice in a row, receipt will be provided to LPA via email by POC due date.

Deadline recorded: May 10, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.655(a)

Regulation authority

HSC

What the official deficiency says

Health and Safety Code section 1569.655 provides: (a) If a licensee of a residential care facility for the elderly increases the rates of fees for residents or makes increases … for services, the licensee shall provide no less than 60 days' prior written notice to the residents or the residents' representatives setting forth the amount of the increase, the reason for the increase, and a general description of the additional costs, except for an increase in the rate due to a change in the level of care of the resident…. This requirement is not met as evidenced by: Based on records reviewed and interviews conducted, the licensee did not comply with the section cited above when R1 and R2 was provided a notice of rate increase effective on 10/1/22. The notice of the rent increase was given to R1 and R2 on 09/1/22 which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee agrees to submit a plan detailing steps that the facility will take when the rent is increased at the facility to ensure the health and safety code requirements are met by the POC due date.

Deadline recorded: Oct 14, 2022. 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

87303 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 is not met as evidenced by: 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. LPA observed mold in the male communal shower. LPA observed two sofas in common areas cushions and fabric were ripped and in bad condition. LPA observed the facility's roof drip edge deteriorating. LPA observed several unused furniture, mattresses, chairs, cabinets and refrigerator in the back-parking lot of the facility, which poses potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/27/2022 Plan of Correction Licensee shall remove all items from the back-parking lot and removed the mold from the male communal shower and will submit photos to CCLD on 05/27/2022. Licensee will repair or replace two sofas for the common area and the facility's roof drip edge by 06/03/2022.

Official classification

Type B

Official code

87412(a)(2)

Regulation authority

CCR

What the official deficiency says

87412 Personnel Records (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: (2) Health screening documents as specified in Section 87411(f). 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. Licensee was uable to provide record of Health Screening for a total of five (5) staff Health Screening forms at the time of the inspection, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/27/2022 Plan of Correction Licensee shall submit Health Screening documents for the five staff by 05/27/2022 to CCLD. Licensee shall a submit a written plan of how to maintain personnel records by 05/27/2022.