COMFORT FIRST HOME CARE

Official classification

Type A

Official code

87464(f)(1)

Regulation authority

CCR

What the official deficiency says

87464(f)(1)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). This requirement is not met as evidenced by: Based on observation, interview, and record review, the licensee did not comply with the section cited above. Facility staff did not provide appropriate care and supervision to R1 which resulted in R1 sustaining serious injuries while wandering around the neighborhood. This poses/posed an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee will provide training to all staff regarding proper care and supervision of all residents. Licensee stated they will send proof of all corrections to CCLD via email to edward.kim@dss.ca.gov by POC due date May 27, 2026. *Civil Penalty Assessed "

Deadline recorded: May 27, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87461(a)(1)

Regulation authority

CCR

What the official deficiency says

87461 Mental Condition (a)The facility shall determine the amount of supervision necessary by assessing the mental status of the prospective resident to determine if the individual: (1) tends to wander; This requirement is not met as evidenced by: Based on observation, interview, and record review, the licensee did not comply with the section cited above. Facility staff did not provide appropriate care to monitor R1 which resulted in R1 wandering from the facility undetected This posed an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee stated they will assess all residents and create a plan of care and will send proof of correction to CCLD via email to Edward.kim@dss.ca.gov by POC due date May 27, 2026.

Deadline recorded: May 27, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87465(a)(6)

Regulation authority

CCR

What the official deficiency says

87465 (a)A plan for incidental medical and dental care shall be developed by each facility... (6)When requested by the Department, a record... of ... medication shall be maintained by the facility. This requirement is not met as evidenced by: Based on observation, interview, and record review, the licensee did not comply with the section cited above. Facility staff did not maintain the resident #1’s medication records as needed. This poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee stated they will ensure all medical records for all residents such as Medication Administration Record, Centrally Stored Medical Destruction Record, and other necessary documents. Licensee will train all staff and sent a copy of the training and all participants who attended with signature to CCLD via email to edward.kim@dss.ca.gov by POC Due date June 5, 2026.

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

Official classification

Type B

Official code

87211(a)(1)

Regulation authority

CCR

What the official deficiency says

87211 Reporting Requirements (a (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence. This requirement is not met evidenced by: Based on observation, interview, and record review, the licensee did not comply with the section cited above. Facility did not notify the department of the incident within seven days of occurrence. This poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee stated they will send a copy of the Incident report and send copy of an agreement that they read, understood, and signed to follow the regulation CCR 87211(a)(1) to CCLD via email to edward.kim@dss.ca.gov by POC due date June 5, 2025.

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

Official classification

Type A

Official code

87555(b)(27)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (27) All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects. 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 LPA observing rodent droppings and traps in one of the bathroom drawers and throughout the kitchen which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/10/2025 Plan of Correction Licensee stated they will clean the droppings and make an appointment with a pest control company by POC due date and send the report to LPA one obtained.

Official classification

Type A

Official code

87465(c)(2)

Regulation authority

CCR

What the official deficiency says

(c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication, but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: (2) Once ordered by the physician the medication is given according to the physician's directions. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview and record review, the licensee did not comply with the section cited above in 2 of 3 residents not getting their medication as prescribed due to facility staff not requesting a refill until they are completely out of medication which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/10/2025 Plan of Correction LPA observed the medication had been refilled and delivered to the facility and has been given as prescribed as of December 9, 2025. Licensee stated they will send LPA a medication policy on refills and do an in-service to staff on said policy by COB December 16, 2025.

Official classification

Type A

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 in LPA not observing a disaster drill being conducted which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/10/2025 Plan of Correction Licensee stated they will conduct a disaster drill and send proof to LPA by POC due date.

Official classification

Type B

Official code

87458(a)

Regulation authority

CCR

What the official deficiency says

(a) Prior to a person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment, signed by a licensed medical professional acting within the scope of their practice and made within the last year, to be kept in the resident's record. 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 of 3 residents not having a medical assessment with a tb test on file, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/30/2025 Plan of Correction Licensee stated they will obtain a medical assessment with a tb test and send proof to LPA by POC due date.

Official classification

Type A

Official code

87355(e)(2)

Regulation authority

CCR

What the official deficiency says

87355 Criminal Record Clearance (e) All individuals subject to a criminal record review... shall prior to working, residing, or volunteering in a licensed facility: 2) Obtain a California clearance or a criminal record exemption... This requirement is not met as evidence by: Based on observation, record review, and interviews, the licensee did not comply with the section cited above. LPA Kim observed S1 working, and two visitors resided in the facility not having background clearance. This poses an immediate health and safety risk to persons in care.

Official plan of correction

Licensee states they will have background clearance on S3 before they are allowed back on the facility. Licensee will send proof of completion background clearance and association to CCLD through email to edward.kim@dss.ca.gov by POC due date March 18, 2025.

Deadline recorded: Mar 19, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87412(a)

Regulation authority

HSC

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. This requirement is not met as evidence by: Based on observation, interviews, and record review, the Licensee did not comply with the section cited above. LPA Kim observed personnel records of S1-S3 were missing LIC503, LIC501, and training hours. This poses a potential health and safety risk to persons in care.

Official plan of correction

Licensee states they will provide LIC501, LIC503, and training hours for S1-S3 to CCLD through email to edward.kim@dss.ca.gov by POC due date April 1, 2025.

Deadline recorded: Apr 1, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87506(a)

Regulation authority

CCR

What the official deficiency says

87506 Resident Records (a)The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility...readily available to facility staff and to licensing agency staff. This requirement is not met as evidence by: Based on observation, interviews, and record review, the Licensee did not comply with the section cited above. LPA Kim observed individuals R1-R6 did not have residents with admissions agreement, physician’s report, pre-appraisal, and other pertinent documents.

Official plan of correction

Licensee states they will maintain records for the indviduals at the facilty with physician's report, pre-appraisal, LIC621, consent forms, and LIC613C and send proof to CCLD via email to edward.kim@dss.ca.gov by POC due date April 1, 2025.

Deadline recorded: Apr 1, 2025. A deadline is not proof that correction was completed.