FOUNTAIN VALLEY SENIOR HOMES 2

Official classification

Type B

Official code

1569.618(c)(3)

Regulation authority

HSC

What the official deficiency says

(c)The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staff to provide CPR. 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 three of three staff on duty not having a valid CPR/FIrst aid certification. Which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 06/02/2026 Plan of Correction Administrator agrees to assign all staff members to complete CPR/First Aid Certification training. Administrator will submit proof of correction to LPA via email by P.O.C due date.

Official classification

Type B

Official code

1569.626(a)(2)

Regulation authority

HSC

What the official deficiency says

(a) All residential care facilities for the elderly shall meet the following training requirements, as described in Section 1569.625, for all direct care staff: (2) Eight hours of in-service training per year on the subject of serving residents with dementia. This training shall be developed in consultation with individuals or organizations with specific expertise in dementia care or by an outside source with expertise in dementia care. In formulating and providing this training, reference may be made to written materials and literature on dementia and the care and treatment of persons with dementia. This training requirement may be satisfied in one day or over a period of time. This training requirement may be provided at the facility or offsite and may include a combination of observation and practical application. 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 three of three staff on duty not having updated annual training which poses a potential health, safety and personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/09/2026 Plan of Correction Administrator agrees to complete all staff training by P.O.C due date. Administrator will send proof of correction to LPA via email by P.O.C due date.

Official classification

Type B

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation the licensee did not comply with the section cited above as LPA observed the medicine cabinet to have a faulty lock installed; meaning broken due to staff not having a key for the lock. Which poses potential health risk to persons in care.

Official plan of correction

POC Due Date: 06/02/2026 Plan of Correction Administrator agrees to fix the lock and have a key readly available to all staff on duty. Administrator will provide proof of correction to LPA before P.O.C Due date.

Official classification

Type B

Official code

80072(a)(1)(2)(3)

Regulation authority

CCR

What the official deficiency says

80072(a)(1)(2)(3) each client shall have personal rights which include, but are not limited to, the following:(1)To be accorded dignity in his/her personal relationships with staff and other persons. (2) To be accorded safe...This requirement is not being met as evidenced by:CONTINUED BELOW... CONT(3)To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including but not limited to: interference with the daily living functions, including CONT... An anonymous video was received by the department on 10/11/2023. (CG1) verified audion on video recording indicating " Yes, that was me. I'm so sorry but I was very tired and we were short staffed. " LPA was able to confirm the violation pertained to Resident 1 (R1) in care. CONTINUED...

Official plan of correction

(L/AD) agreed to conduct personal rights training to staff and provide proof & updated LIC 500. (L/AD) will submit sign in sheet for training and updated LIC 500 by POC due date of 3/1/24. (L/AD) advised LPA the facilty has hired 1:1 staff for R1 to be able to meet R1s needs according to N & S plan. CONT...eating, sleeping, or toileting; or withholding of shelter, clothing, medication or aids to physical functioning. This poses a potential health and safety risk to residents in care.

Deadline recorded: Mar 1, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

80087(g)

Regulation authority

CCR

What the official deficiency says

Buildings and Grounds: 80087(g)Disinfectants, cleaning solutions, poisons, firearms and other items that could pose a danger if readily available to clients shall be stored where inaccessible to clients.This requirement was not met as evidenced by: on or about 12:18pm, while touring kitchen area along with Caregiver Villanueva and Ombudsman Linda Bock, LPA Quiroz observed unlocker drawer underneath the kitchen sink were Caregiver Villanueva verified disinfectants were stored. CONTINUED...

Official plan of correction

L/AD Almiranez will provide staff identified on LIC 500 (Personnel Report) training on CCR80087(g) and submit proof of training by 10/18/2023. This poses a potential risk to clients in care.

Deadline recorded: Oct 18, 2023. A deadline is not proof that correction was completed.