HARBOR HEIGHTS ASSISTED LIVING AND MEMORY CARE

Official classification

Type A

Official code

87464(f)(1)

Regulation authority

CCR

What the official deficiency says

87464(f)(1) Basic Services The licensee shall provide care and supervision. This requirement was not met as evidenced by: Based on and records reviewed, the licensee failed to provide adequate care and supervision to Resident 1 (R1). R1 exited the facility unsupervised and was returned to the facility by the police department. This posed an immediate health and safety risk to R1.

Official plan of correction

Licensee shall ensure a designated staff member is stationed at the exit door at all times to monitor residents who are unable to leave the facility unassisted.

Deadline recorded: May 21, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87411(a)

Regulation authority

CCR

What the official deficiency says

87411 Personnel Requirements - General (a)Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. In facilities licensed for sixteen or more, sufficient support staff shall be employed to ensure provision of personal assistance and care... This requirement is not met as evidence by: Per Unusual Incident/Injury Report (UIIR) dated 2/11/25, on 1/21/25 at 10:30 AM R1 left the facility unassisted. Per Physician Report (LIC602A) R1 is not Able to Leave Facility Unassisted.

Official plan of correction

Licensee to read regulation and write a statement of understanding. Licensee to submit a Plan of Correction on how to prevent future elopements. Licensee to email LPA POC by due date.

Deadline recorded: Apr 13, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87463(f)

Regulation authority

CCR

What the official deficiency says

87463(f) Reappraisal (f) The licensee shall immediately, or as soon as reasonably possible, communicate with the resident and, if applicable, the resident's representative, about any significant change in condition and the recommendation, if any, of the appropriate licensed medical professional, and if applicable, other specialized care provider. Documentation of such communication shall be added to the resident’s record. This requirement is not being met as evidenced by: Facility staff failed to notify Resident 1 (R1) family of a medication change ordered December 6, 2024. This poses a potential health and safety risk for residents in care.

Official plan of correction

Facility representative agrees to review the regulation requirement and send a signed statement of acknowledgement and understanding to LPA Haley. Facility representative agrees to email the POC to LPA Haley by 5:00pm on the POC due date.

Deadline recorded: Feb 25, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87411(a)

Regulation authority

CCR

What the official deficiency says

87411(a) " ...agency may require any facility to provide additional staff whenever it determines through documentation that the needs of the particular residents, the extent of services provided, or the physical arrangements of the facility require such additional staff for the provision of adequate services. " This requirement is not being met as evidenced by record review and interviews: Licensee did not provide the one-on-one care for residents which poses an immideate health and safety to residents in care

Official plan of correction

Facility will keep record of of all RH residents and maintain the one-on-one staff for qualified residents and log hours. and send proof to LPA by POC due date.

Deadline recorded: Jan 5, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87463(b)

Regulation authority

CCR

What the official deficiency says

87463(b) " reappraisal shall document changes in the resident's physical, mental, cognitive, behavioral, or functional condition,as specified in Section 87466 " This requirement is not being met as evidenced by record review. Licensee did not maintain updated reappraisal for four out of four residents which poses a potential health and safety to residents in care

Official plan of correction

Licensee to update reappraisal documents for residents and send proof to LPA by POC due date

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

Official classification

Type A

Official code

87465(g)

Regulation authority

CCR

What the official deficiency says

87465(g) Incidental Medical and Dental. The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health including but not limited to, an apparent life-threatening medical crisis This requirement was not met as evidence by: Licensee did not seek immediate medical attention following R1 sustaining

Official plan of correction

Licensee will conduct training to all facility staff on when to call emergency services to residents who are in need of immediate hospitalization and well send traning log to LPA by POC due date an unwitnessed fall on February 12, 2025, despite of persistent pain, developing swelling, bruising and losing the ability to complete ADLs, which poses an immediate risk to resident’s health in care.

Deadline recorded: Aug 20, 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(f)(1) Basic Services: Basic services shall at a minimum include: Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement was not met as evidenced by: Licensee did not re-evaluate care needs following R1 sustaining eight falls within a five month period resulting in R1 being hospitalized with shoulder

Official plan of correction

Licensee will ensure re-evaluate residents and document all updates when incidents of injures and such occurs to ensure the safety od residents in care. and humerus fractures. This poses an immediate risk to resident’s health in care

Deadline recorded: Aug 20, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87463(b)(1)(E)

Regulation authority

CCR

What the official deficiency says

87463(b)(1)(E) The reappraisal shall document significant changes in the resident's physical, mental, cognitive, behavioral, or functional condition, including those required to be documented as specified in Section 87466, Observation of the Resident. This requirement was not met as evidence by: Licensee did not update needs and services plan as required by section above.

Official plan of correction

Facility will sel-certify the understanding of reappraisals for residents who require an updated Needs & services plan and e mail LPA the by POC due date This poses an immediate risk to resident’s in health care.

Deadline recorded: Aug 20, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87705(e)(5)

Regulation authority

CCR

What the official deficiency says

87705(e)(5) Facility staff shall ensure the continued safety of residents if they wander away from the facility....} Based on observation interviews, record review, the licensee did not in sure the safety of the resident who eloped the facility which poses an immediate Health and safety to persons in care.

Official plan of correction

AD will hire additional staff to primarily cover memory care main exit and maintain count of residents.

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

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 in water temperature measured at 93.9 DF and 94.1 DF which poses an immediate health, safety risk to persons in care.

Official plan of correction

POC Due Date: 03/28/2025 Plan of Correction Facility is to submit proof to LPA by POC due date.

Official classification

Type A

Official code

87705(e)(5)

Regulation authority

CCR

What the official deficiency says

87705(e)(5) Facility staff shall ensure the continued safety of residents if they wander away from the facility....} Based on observation interviews, record review, the licensee did not in sure the safety of the resident who eloped the facility which poses an immediate Health and safety to persons in care.

Official plan of correction

AD will retrain staff members and make sure the front Reception is covered and has staff at all times

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

Official classification

Type B

Official code

87555(b)(21)

Regulation authority

CCR

What the official deficiency says

87555 General Food Service Requirements (21) Freezers of adequate size shall be maintained at a temperature of 0 degrees F (-17.7 degrees C), and refrigerators of adequate size shall maintain a maximum temperature of 40 degrees F (4 degrees C). They shall be kept clean and food stored to enable adequate air circulation to maintain the above temperatures. Based on observations, the Licensee did not comply with the regulation cited above due to the refrigerator temperature being set between 42-43 degrees F. This creates a potential health risk to persons in care.

Official plan of correction

Executive Director stated they will create a log to document the refrigerator temperatures. ED also stated they will continue trying to work with maintenance to get the refrigerator temperature below 40 degrees F. LPA will verify the plan of correction via plan of corrections visit.

Deadline recorded: Oct 23, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87555(b)(20)

Regulation authority

CCR

What the official deficiency says

87555 General Food Service Requirements (20) Food preparation equipment shall be placed to provide aisles of sufficient width to permit easy movement of personnel, mobile equipment and supplies. Based on observations, the Licensee did not comply with the section cited above due to a 2-burner stove in the kitchen protruding 17.5 inches into the aisle where kitchen staff work and move.

Official plan of correction

Executive Director stated they will replace the two-burner stove in the facility with a single-burner stove by the assigned POC due date. LPA will verify the correction at a plan of corrections visit.

Deadline recorded: Oct 23, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87555(b)(21)

Regulation authority

CCR

What the official deficiency says

87555 General Food Service Requirements (21) Freezers of adequate size shall be maintained at a temperature of 0 degrees F (-17.7 degrees C), and refrigerators of adequate size shall maintain a maximum temperature of 40 degrees F (4 degrees C). They shall be kept clean and food stored to enable adequate air circulation to maintain the above temperatures. Based on observations, the Licensee did not comply with the regulation cited above due to the refrigerator temperature being set to 46.8 degrees F. This creates a potential health risk to persons in care.

Official plan of correction

Executive Director stated they will have kitchen staff adjust refrigerator temperature. LPA will verify the plan of correction via plan of corrections visit.

Deadline recorded: Sep 12, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87555(b)(23)

Regulation authority

CCR

What the official deficiency says

87555 General Food Service Requirements (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. Based on observations, the Licensee did compy with the regulation cited above due to LPA observations of five perishable foods being uncovered in the kitchen.

Official plan of correction

Executive Director stated they will work with the kitchen staff to continually store food properly according to Title 22 Regulations and hold an in-service training on food storage and preparation. ED stated they will email LPA documentation reflecting the training.

Deadline recorded: Sep 12, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87555(b)(20)

Regulation authority

CCR

What the official deficiency says

87555 General Food Service Requirements (20) Food preparation equipment shall be placed to provide aisles of sufficient width to permit easy movement of personnel, mobile equipment and supplies. Based on observations, the Licensee did not comply with the section cited above due to a 2-burner stove in the kitchen protruding 17.5 inches into the aisle where kitchen staff work and move.

Official plan of correction

Executive Director stated they will move or remove the two-burner stove from the facility by the assigned POC due date. LPA will verify the correction at a plan of corrections visit.

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

Official classification

Type B

Official code

87405(a)

Regulation authority

CCR

What the official deficiency says

87405(a)Administrator - Qualifications and Duties:(a)All facilities shall have a qualified and currently certified administrator... This requirement is not being met as evidenced by, through a record review and interviews it was demonstrated that the facility does not a qualified and currently certified administrator. This poses a potential health and safety risk to residents in care.

Official plan of correction

Licensee agrees to hire a qualified and currently certified administrator and to submit the required documentation for the new administrator to the LPA by the POC due date.

Deadline recorded: May 24, 2024. A deadline is not proof that correction was completed.