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Official classification

Type A

Official code

1569.625(b)(1)

Regulation authority

HSC

What the official deficiency says

(1) The department shall adopt regulations to require staff members of residential care facilities for the elderly who assist residents with personal activities of daily living to receive appropriate training. This training shall consist of 40 hours of training. A staff member shall complete 20 hours, including six hours specific to dementia care, as required by subdivision (a) of Section 1569.626 and four hours specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696, before working independently with residents. The remaining 20 hours shall include six hours specific to dementia care and shall be completed within the first four weeks of employment. The training coursework may utilize various methods of instruction, including, but not limited to, lectures, instructional videos, and interactive online courses. The additional 16 hours shall be hands-on training. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, Licensee did not comply with the section cited above. LPA observed 1 of 2 staff files did not have proof of their 40 hours of traning prior to working with residents as required by the Health and Safety Code.This poses an immediate health, safety or personal rights risk to residents in care.

Official plan of correction

POC Due Date: 03/25/2026 Plan of Correction Licensee to submit self-certification that proof of completed training will be completed for Staff Member 2 (S2) by POC due date of 03/25/2026. Licensee to provide proof of completed training for S2 by Friday, 04/03/2026.

Official classification

Type B

Official code

87309(d)(1)

Regulation authority

CCR

What the official deficiency says

(d) Residents may have access to items specified in subsection (c) for personal use unless there is documentation as specified in Section 87457, Pre-Admission Appraisal or Section 87463, Reappraisals, that indicates the resident's or other residents’ safety would be at risk if allowed access. (1) The licensee shall implement reasonable interventions in order to ensure that access to the items specified in subsection (c) does not pose a hazard to other residents. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, Licensee did not comply with the section cited above. Laundry detergent and other cleaning products were observed to be assessible to residents in care during visit and were not properly locked in the cleaning cabinet. This poses an potential health/ safety/personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/03/2026 Plan of Correction Licensee to provide proof of in-service training regarding items that could be hazardous or present a risk to residents. Proof of training to be submitted to Community Care Licensing (CCL) by POC due date of 04/03/2026.

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, Licensee did not comply with the section cited above. 1 of 2 staff members did not have a health screening on file. This poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/03/2026 Plan of Correction Licensee to submit proof of Staff Member 1's health screening to CCL by POC Due Date of 04/03/2026.

Official classification

Type B

Official code

87555(a)

Regulation authority

CCR

What the official deficiency says

(a) The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents an shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. All food shall be selected, stored, prepared and served in a safe and healthful manner. This requirement is not met as evidenced by: Deficient Practice Statement Based on observations made, Licensee did not comply with the section cited above. LPA observed instances of unlabeled and/or expired foods in facility’s fridge. This poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/03/2026 Plan of Correction Licensee to conduct in-service training for staff members reviewing proper food labeling and storage. Training to include the following: Date, Topic, Job Role, Staff Names and Signatures. Training to be submitted to CCL for review and approval by POC due date 04/03/2026.

Official classification

Type B

Official code

87465(h)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: This requirement is not met as evidenced by: Deficient Practice Statement Based on observations made, Licensee did not comply with the section cited above and did not ensure that resident medications were centrally stored and recorded on the LIC622 as required. Log showed errors with missing quantity of medication, incorrect dosage, incorrect expiration and fill dates, and not writing out the complete medication instructions. This is a potential health and safety rights risk to residents in care.

Official plan of correction

POC Due Date: 04/03/2026 Plan of Correction Licensee to submit self certification that proof of correctly documented LIC622 (Centrally Stored Log) will be done. Self-certification to be submitted by 04/03/2026. Proof of central stored log for the next shipment of medications (April 2026) for 3 of 7 residents to be submitted by 04/17/2026.

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, Licensee did not comply with the section cited above. 1 of 4 residents were found to not have an updated Appraisal as required. Resident's last appraisal was conducted in 2024. This poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/03/2026 Plan of Correction Licensee to submit proof of updated resident appraisal to CCL by POC due date of 04/03/2026.

Official classification

Type A

Official code

87309(a)(1)

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. (1) Disinfectants, cleaning solutions, and poisonous substances shall be stored in areas separate from food supplies as specified in Section 87555, General Food Service Requirements. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPAs/Administrator observation and interview, the licensee did not comply with the section cited above in cleaning supplies were accessible to residents in kitchen cabinet under the sink was unlocked and containing cleaning supply. Also, cabinet in the laundry room were containing cleaning supply and lock weren't properly functioning which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/08/2025 Plan of Correction Licensee agrees to remove the cleaning supply under the sink to the laundry cabinet and fix the lock. Licensee will submit pictures to clear capitation by plan of correction date 03/08/2025.

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 LPAs/Administrator observation, interview, and record review, the licensee did not comply with the section cited above in 1 out of 2 staff did not have the health screening completed as required by the Health and Safety Code, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/28/2025 Plan of Correction Licensee agree to submit the health screening report to the CCL as required by Health and Safety Code by by plan of correction date 03/28/2025.

Official classification

Type A

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. LPA observed 2 of 2 staff files did not have the annual trainings completed as required by the Health and Safety Code. This poses an immediate health, safety or personal rights risk to residents in care.

Official plan of correction

POC Due Date: 04/17/2024 Plan of Correction Licensee to submit a written plan outlining how they will ensure all staff on site will obtain their annual 20 hour training as required by Health and Safety Code by POC due date of 04/17/2024. Licensee to provide an update on training status to CCL by 04/26/2024 and submit proof of training hours when 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 was not met as evidence by: Based on interviews, facility had an unstable chair in the dining room. This is a potential risk to the health and safety of residents in care.

Official plan of correction

Facility has fixed the chair. Deficiency is clear.

Deadline recorded: Dec 19, 2022. A deadline is not proof that correction was completed.