FOUNTAIN VALLEY SENIOR HOMES

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 and record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. LPA observed that three out of the five staff did not complete the required twenty hours of annual training in the year of 2025. LPA observed that Staff #1 (S1) completed 9.25 hours, Staff #2 (S2) completed 19 hours, and Staff #3 (S3) completed 15.75 hours, in the year of 2025.

Official plan of correction

POC Due Date: 09/04/2026 Plan of Correction The Licensee stated that he will have the three staff complete the remaining hours of training. The Licensee agreed to provide LPA proof of training via email or fax by POC due date.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

Maintenance and Operation-87303(a): (a) The facility shall be clean, safe, sanitary and in good repair at all times...This requirement is not met as evidenced by, during today's inspection tour LPA Quiroz observed trash/crumbs underneath and on recliner couches. LPA Quiroz observed loose case on lower part of dishwasher and tape on top areas of dishwasher in kitchen area. This was verified by CG1 and L/AD Almiranez. L'AD Almiranez indicated " I will call and have it repaired. " This poses a potential risk to residents in care.

Official plan of correction

L/AD agreed staff wil clean couches and living room area and provide inservice training to facility staff on CCR 87303 and submit proof of training by POC due date of 4/19/2024. L/AD will repair dishwasher in kitchen area and submit proof by POC due date of 4/19/2024.

Deadline recorded: Apr 19, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87211(a)(2)

Regulation authority

CCR

What the official deficiency says

87211(a)(2)Reporting Requirements:(a)Each licensee shall furnish to the licensing agency such reports...(2)Occurrences, such as epidemic outbreaks...shall be reported within 24 hours either by telephone or facsimile to the licensing agency and to the local health officer when appropriate. CONTINUED BELOW This requirement was not met as evidenced by:3 of 3 interviewees indicated " There was Covid few weeks ago, " LPA Quiroz reviewed COVID-19 share-point and COVID FAS entries, and verified there were no reported COVID-19 entries from this facility since CONTINUED...

Official plan of correction

L/AD Almiranez and all staff assisting with reporting requirements will read CCR 87211 Reporting Requirements and submit proof of understanding CCR 87211 by POC due date of 8/26/2022 COB. commencement of COVID-19 Pandemic. At 10:26am, L/AD Almiranez indicated " It was on June 26, and it's been 2 years of this COVID stuff so I didn't feel it was important to notify you guys. " This poses an immediate risk to residents in care.

Deadline recorded: Aug 26, 2022. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87705(f)(2)

Regulation authority

CCR

What the official deficiency says

Care of persons with Dementia: 87705(f)(2):(f)The following shall be stored inaccessible to residents with dementia: (2) Over-the-counter medication, nutritional supplements or vitamins...This requirement was not met as evidenced by:At 9:50am, LPA Quiroz observed... CONT BELOW... cabinet between kitchen and livingroom area opened. LPA Quiroz inquired what was stored in that cabinet. Caregiver Caniga indicated " Oh the medications but it's supposed to be locked. " This was verified with Caregiver Caniga at 9:50am. This poses an immediate risk to residents in care.

Official plan of correction

L/AD will provide training on CARE OF PERSONS WITH DEMENTIA (87705)(f)(2) for all staff working at the facility and submit proof by 8/26/2022 COB.

Deadline recorded: Aug 26, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87303(a)(1)

Regulation authority

CCR

What the official deficiency says

Maintenance and Operation 87303(a)(1): (a)The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services...(1)Floor surfaces in bath, laundry and kitchen areas shall be maintained in a clean, sanitary, and odorless condition. CONTINUED BELOW This requirement was not met as evidenced by: On or about 10:01am-10:12am, while conducting inspection tour of kitchen area and living-room area, LPA Quiroz observed unkept floor not kept free of debris, dust, dirt, what appeared to be pet hair, and what appeared to be food particles in between couches, on couches, and between... CONT

Official plan of correction

L/AD Almiranez will repair toilet seat hand rail and provide prood of understanding of CCR 97303(a)(1) by POC due date of: 8/29/2022. refrigerator and cabinet drawers. This was verified with Caregiver Caniga and Licensee/Administrator Almiranez. At 10:33am, LPA Quiroz observed loose hand rails on toilet seat. This was verified with L/AD Almiranez at 10:30am, indicating " Yeah, I need to change that. " This poses a potential risk to residents in care.

Deadline recorded: Aug 29, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

Incidental Medical and Dental Care (87465)(h)(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 was not met as evidence by: At 9:39am, LPA Quiroz observed R1's Humulin N Kwin pen insulin suspension unlocked being stored on second shelf on side of refrigerator. This poses an immediate risk for residents in care.

Official plan of correction

Licensee/Administrator Almiranez indicated " I should have a box for medication that goes in refrigerator. I purchased one already. " LPA Quiroz observed Caregiver Conrado Caniga place R1's Humulin N Kwin Pen Insulin suspension in locked boxed and placed it inside refrigerator. Licensee/Almiranez agreed to provide medication training, but not limited to medication requiring refrigerator storage by 9/24/2021.

Deadline recorded: Sep 27, 2021. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

Maintenance & Operation 87303(a):The facility shall be clean,safe,sanitary and in good repair at all times...for the safety and well-being of residents, employees and visitors. This requirement was not met as evidenced by: At 9:10am, LPA Quiroz observed broken/ripped screen door leading to patio and R2's bedroom, spider webs throughout facility, mold on 2 shower curtain, dust on top of refrigerator and in pantry, unlocked disinfectants, broken lock where disinfectants are stored and hole on garage door leading to garage area. This poses a potential risk for residents in care.

Official plan of correction

Correction made on the following: Caregiver Campopanes cleaned spider webs, dust on top of refrigerator and pantry during today's visit. Licensee Almiranez agreed to repair screen door leading to patio and R2's bedroom, repair lock in disinfectant drawer, and repair hole on door leading to garage area.

Deadline recorded: Sep 24, 2021. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87705(5)

Regulation authority

CCR

What the official deficiency says

Care of Persons with Dementia (5): Each resident with dementia shall have an annual medical assessment as specified in Section 87458,...reappraisal done at least annually, both of which shall include a reassessment of the resident’s dementia care needs.This requirement was not met as evidence by: During today's visit, at 10:50am, LPA Quiroz observed R2's last physician report was completed on 2/22/2019. This poses a potential risk for residents in care.

Official plan of correction

Licensee/Administrator Almiranez will call and schedule for an annual and will provide CCL with a copy of current physician report for R2 by 9/30/2021.

Deadline recorded: Sep 30, 2021. A deadline is not proof that correction was completed.