KAEGO'S RICHMAN GARDENS

Official classification

Type A

Official code

87202(a)

Regulation authority

CCR

What the official deficiency says

(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and interview, the licensee did not comply with the section cited above in two out of three exits which poses an immediate health, safety or personal rights risk to persons in care. Facility has has two emergency exits locked on the right side of the building when facing the facility.

Official plan of correction

POC Due Date: 08/11/2026 Plan of Correction Licensee to send Statement of Understanding and conduct an in-service training and send proof to LPA by POC due date. Licensee to keep doors unlocked. If it is decided the doors are to be locked, licensee to notify licensing to request new fire clearance.

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 observation, the licensee did not comply with the section cited above due to a Memantine pill that was signed as administered but was found in Residents 10 medication tray which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/11/2026 Plan of Correction Licensee to send Statement of Understanding and In-service training to LPA by POC due date.

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 documents, the licensee did not ensure R1, R2, R3, R4, and R5 had appraisals updated within the past year, which poses a potential safety risk to persons in care.

Official plan of correction

POC Due Date: 09/25/2025 Plan of Correction Licensee stated they will reappraise these residents, submit proof to LPA by POC due date, and ensure all residents have annual reappraisals.

Official classification

Type A

Official code

87203

Regulation authority

CCR

What the official deficiency says

All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. This req is not being met as evidenced by: Based on observation, Licensee failed to ensure fire safety is being conformed to. Exit gates are secured by either a keypad or key locks prohibiting residents from leaving in an emergency. This poses an immediate health and safety risk to residents in care. CIVIL PENALTY ASSESSED

Official plan of correction

Licensee to ensure exit gates are unlocked and forward proof to LPA by POC due date.

Deadline recorded: Dec 24, 2024. 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

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 req is not being met as evidenced by: Based on interviews conducted, Licensee failed to ensure R1 received appropriate care and supervision resulting in R1 eloping and sustaining multiple injuries including a fractured jaw. This poses an immediate health and safety risk to residents in care. CIVIL PENALTY ASSESSED.

Official plan of correction

Licensee to provide retraining on basic services and forward proof to LPA by POC due date.

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

Official classification

Type A

Official code

87207

Regulation authority

CCR

What the official deficiency says

False Claims- No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility. This req is not being met as evidenced by: Based on interviews conducted, Licensee failed to ensure employees did not make false claims regarding R1’s fall. Two caregivers confirmed providing false statements to R1’s family which was which was confirmed by R1’s family. This poses an immediate health and safety risk to residents in care.

Official plan of correction

Licensee to read the regulation and provide a statement of understanding to LPA by POC due date.

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

Official classification

Type A

Official code

87705(j)

Regulation authority

CCR

What the official deficiency says

Care of Persons with Dementia- The licensee shall have an auditory device or other staff alert feature to monitor exits, if exiting presents a hazard to any resident. This requirement was not met as evidenced by: Based on interviews conducted, Two of two staff confirmed auditory alarms are turned off and one staff reported alarms are difficult to hear resulting in R1 elopement and subsequent injuries. This poses an immediate health and safety risk to residents in care.

Official plan of correction

Licensee to conduct an in-service on elopements and forward proof to LPA by POC due date.

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

Official classification

Type A

Official code

87705(h)

Regulation authority

CCR

What the official deficiency says

Outdoor facility space used for resident recreation and leisure shall be completely enclosed by a fence with self-closing latches and gates, or walls, to protect the safety of residents. This requirement was not met as evidence by: Based on interviews conducted, Two of two staff reported observing staff propping open exterior leading gates for ease of access, thus, incapacitating the ability to self close and latch. This poses an immediate risk to safety to residents in care.

Official plan of correction

Licensee to provide an in-service to staff regarding resident safety and foward proof to LPA by POC due date.

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

Official classification

Type A

Official code

87203

Regulation authority

CCR

What the official deficiency says

All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. This req is not being met as evidenced by: Based on observation, Licensee failed to ensure fire safety in the facility. All exit gates are locked posing an immediate health and safety risk to residents in care.

Official plan of correction

Licensee to ensure exit gate is accesible for exiting without a lock or keypad and forward proof to LPA.

Deadline recorded: Oct 18, 2024. 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

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 req is not being met as evidenced by: Based on observation, Licensee failed to ensure facility is in good repair. Exit gate on north side of property has a broken delayed egress push lever. This poses a potential health and safety risk to residents in care.

Official plan of correction

Licensee to repair replace push lever and forward proof to LPA by POC due date.

Deadline recorded: Oct 31, 2024. 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

87303 Maintenance and Operation (e) … (2) … Hot water temperature controls shall be maintained … to attain a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C). This requirement was not met as evidenced by: Deficient Practice Statement Based on observation, the hot water tested at 126, 138, 85, and 109 degrees F in the Tea Rose, Jasmine Calla Lilly, and Apple Blossom buildings, respectively, which poses an immediate safety risk to persons in care.

Official plan of correction

POC Due Date: 08/14/2024 Plan of Correction Licensee stated they will adjust the temperature and submit a protocol to regularly test water temperatures to LPA by POC due date.

Official classification

Type B

Official code

87468.2(a)(19)

Regulation authority

CCR

What the official deficiency says

87468.2 Additional Personal Rights… (a) … (19) To have prompt access to review all of their records ... within two (2) business days... This requirement was not met as evidenced by: Based on interviews and documents, the licensee did not ensure R1 had access to their records within two business days of the request dated December 28, 2023, which poses a potential personal rights risk to persons in care.

Official plan of correction

Licensee stated they will properly respond to the request for R1’s Resident File and submit proof to LPA by POC due date.

Deadline recorded: Jun 27, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

1569.605

Regulation authority

HSC

What the official deficiency says

… all residential care facilities for the elderly … shall maintain liability insurance covering injury to residents and guests in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in the total annual aggregate, caused by the negligent acts or omissions to act of, or neglect by, the licensee or its employees. This requirement was not met as evidenced by: Based on interviews and records review, the licensee did not maintain liability insurance covering injury to residents and guests in the amounts specified which posed an immediate Health, Safety, or Personal Rights risk to up to 26 persons in care.

Official plan of correction

Licensee stated they will obtain liability insurance that complies with Health & Safety Code section 1569.605 and submit proof to LPA by POC due date.

Deadline recorded: May 24, 2023. A deadline is not proof that correction was completed.

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 records, the licensee did not ensure 4 out of 5 staff files contained documentation of staff training, which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 01/04/2023 Plan of Correction Licensee stated they will document training for all staff, provide any missing training, and provide proof to LPA by POC due date.

Official classification

Type B

Official code

87506(b)(15)

Regulation authority

CCR

What the official deficiency says

(b) Each resident's record shall contain at least the following information: (15) The admission agreement and pre-admission appraisal, specified in Sections 87507, Admission Agreements and 87457, Pre-admission Appraisal. This requirement is not met as evidenced by: Deficient Practice Statement Based on records, the licensee did not ensure 4 out of 5 resident files reviewed contained a current appraisal, which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 01/04/2023 Plan of Correction Licensee stated they will gather all appraisals, conduct additional appraisals as necessary, and provide proof to LPA by POC due date.