HARMONY ONE CARE HOME

Official classification

Type A

Official code

87355(e)(1)

Regulation authority

CCR

What the official deficiency says

Criminal Record Clearance- 87355(e)(1)- 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: Obtain a California clearance or a criminal record exemption as required by the Department. This requirement is not met as evidenced by: Based on interviews conducted and records reviewed, 2 staff were living in a staff room and did not have a background clearance or associated to the building. This poses an Immediate Health, Safety or Personal Rights risk to persons in care.

Official plan of correction

Licensee agrees to ensure all staff receive a criminal records clearance prior to working or residing at the facility. Licensee shall submit evidence of a cleared background clearance and association to the facility by 05/09/2026.

Deadline recorded: May 9, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.625(b)(1)

Regulation authority

HSC

What the official deficiency says

1569.625 Staff training; legislative findings; contents: (b) (1) The department shall adopt regulations to require staff members of residential care facilities for the elderly...This training shall consist of 40 hours of training. This requirement is not met as evidenced by: Based on interviews conducted, Licensee did not provide new staff the required number of training hours. This poses a potential Health, Safety or Personal Rights risk to residents in care.

Official plan of correction

Licensee agrees that all new staff shall receive the required training hours prior to working on their own with residents. Licensee shall submit evidence of completed staff training for S1 and S2 by 05/29/2026.

Deadline recorded: May 29, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87307(d)(6)

Regulation authority

CCR

What the official deficiency says

(6) All outdoor and indoor passageways and stairways shall be kept free of obstruction. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. The emergency exit gate was tied closed, preventing exiting in an emergency, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/10/2026 Plan of Correction Licensee agrees to fix the latch on the gate and submit photo evidence of completion by 03/10/2026.

Official classification

Type A

Official code

87309(a)

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. 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 2 of 2 resident bathrooms. Cleaning products were stored under the sink and the cabinet doors were not secure, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/10/2026 Plan of Correction Licensee agrees to keep cleaning solutions in areas no accessible to residents. Cleaning solutions were relocated to a secure location during visit. Cleared during visit.

Official classification

Type A

Official code

87465(e)

Regulation authority

CCR

What the official deficiency says

(e) For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician on a prescription blank, maintained in the resident's file, and a label on the medication. Both the physician's order and the label shall contain at least all of the following information. 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 of 7 resident records. Records did not contain physician orders for medications, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/10/2026 Plan of Correction Licensee agrees to contact each resident physician and get orders for each medication. Self Certification that each residents physician has been contacted, shall be sent to CCLD by 03/10/2026.

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 observation, the licensee did not comply with the section cited above. Personnel records were not maintained at the facility for all staff. This poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/27/2026 Plan of Correction Licensee agrees to ensure staff records are maintained for all staff and kept at the facility for review. Licensee agrees to submit self certification that all staff have a personnel record at the facility. Self certification shall be submitted to CCL by 03/27/2026.

Official classification

Type B

Official code

87555(b)(23)

Regulation authority

CCR

What the official deficiency says

(23) All readily perishable foods or beverages capable of supporting rapid and progressive growth of micro-organisms which can cause food infections or food intoxications shall be stored in covered containers at appropriate temperatures. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. Left over food was stored in the garage refrigerator, uncovered with other food stores, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/27/2026 Plan of Correction Licensee agrees that all food shall be stored appropriately to prevent food born illnesses. Self certification that all food is stored appropriately shall be submitted to CCL by 03/27/2026.

Official classification

Type B

Official code

87465(h)(5)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. 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 7 of 7 residents. Medications were prepared, in advance, for the day for 7 of 7 residents, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/27/2026 Plan of Correction Licensee agrees that medication will be stored in the original container until the prescribed time. Licensee shall submit self certification that all medications will be stored in original containers until the prescribed time by 03/27/2026.

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, the licensee did not comply with the section cited above in 2 of 7 resident records. Records did not contain current reappraisals, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/27/2026 Plan of Correction Licensee agrees to ensure residents receive reappraisals at least every 12 months or more often as necessary. Self certification of completed reappraisals shall be submitted to CCLD by 03/27/2026.

Official classification

Type B

Official code

87463(h)

Regulation authority

CCR

What the official deficiency says

(h) The licensee shall request that all residents receive an annual routine visit with a licensed medical professional once every twelve months, either in person or by video appointment. 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 3 of 7 resident records. Records did not contain evidence of a visit or refusal, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/27/2026 Plan of Correction Licensee agrees to ensure all residents are seen by a medical professional at least every 12 months or document their refusal. Licensee agrees to submit self certification that Licensee understands and will document resident refusals. Self certification shall be submitted to CCLD by 03/27/2026.

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. Facility has not documented a completed drill since 07/24/2025, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/27/2026 Plan of Correction Licensee agrees to conduct and document an emergency drill quarterly and submit self certification of completed drill. Self certification shall be submitted to CCLD by 03/27/2026.

Official classification

Type A

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

(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: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. Three smoke detectors, living room, hallway and 1 resident room, had their batteries disconnected, preventing them from working in an emergency. This poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/10/2026 Plan of Correction Licensee agrees to ensure all smoke detectors are in working order and to replace them as necessary. Batteries were installed and tested for proper operation. Cleared during visit.

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. Water temperature measured at 121.8 at facauts accessible to residents, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/08/2025 Plan of Correction Licensee adjusted water tempurature during visit. Cleared during visit.

Official classification

Type A

Official code

87307(d)(6)

Regulation authority

CCR

What the official deficiency says

(6) All outdoor and indoor passageways and stairways shall be kept free of obstruction. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. Exit gate in back yard was not operational. This poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/08/2025 Plan of Correction Licensee adjusted gate during visit to allow access. Cleared during visit.

Official classification

Type B

Official code

87307(d)(5)

Regulation authority

CCR

What the official deficiency says

(5) Night lights shall be maintained in hallways and passages to nonprivate bathrooms. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation the licensee did not comply with the section cited above. LPA observed there were no nighlights in the hallway to provide light to the bathrooms. This poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/25/2025 Plan of Correction Licensee shall send self certification to CCLD that a nightlight has been placed in the hallway.

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. Licensee did not have personnel files at the facility, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/25/2025 Plan of Correction Licensee shall send self certification to CCLD that staff files have been reviewed and stored either at the facility or accessible for future visits.

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 5 of 6 resident records reviewed. Appraisals were not updated within the last 12 months, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/25/2025 Plan of Correction Licensee shall send self certification to CCLD that appraisals have been updated.

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. Licensee did not have documentation of a completed drill in the last quarter, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/25/2025 Plan of Correction Licensee shall conduct and document a drill and send self certification of completion.

Official classification

Type B

Official code

87633(b)

Regulation authority

CCR

What the official deficiency says

(b) A current and complete hospice care plan shall be maintained in the facility for each hospice resident and include 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 two of two resident files. Files did not contain hospice care plan, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/25/2025 Plan of Correction Licensee shall send self certification to CCLD that hospice care plans are in the file.