ANGELS HOME LLC

Official classification

Type B

Official code

87468(c)(2)(A)

Regulation authority

CCR

What the official deficiency says

(c) Licensees shall prominently post personal rights, nondiscrimination notice, and complaint information in areas accessible to residents, representatives, and the public. (2) Information on the appropriate reporting agency in case of a complaint or emergency, including procedures for filing confidential complaints, shall be posted as follows: (A) Licensees may use the Residential Care Facility for the Elderly (RCFE) Complaint Poster (PUB 475) or may develop their own poster as provided in this section. A poster developed by the licensee shall contain the same content as the PUB 475. The poster that is posted shall be 20” x 26” in size and be posted in the main entryway of the facility. PUB 475 may be accessed, downloaded, and printed from the www.ccld.ca.gov website. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's observation PUB 475 did not meet department standards of 20x26. This poses as a potential risk to resident's personal rights for residents in care

Official plan of correction

POC Due Date: 11/21/2025 Plan of Correction Facility will order new PUB 475 poster that meets department standard. Licensee will provide proof of correction by POC due date.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

Maintenance and Operation ... 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 requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's observation during the physical plant tour of the facility, LPA noted cracks in the bathroom mirror wall. LPA also observed one of the stove burner not working. This poses as a potential health and safety risk to residents in care.

Official plan of correction

POC Due Date: 11/21/2025 Plan of Correction Licensee will replace with new stove and replace the mirror in the bathroom. And provide proof by POC due date.

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 LPA's review of staff records, one staff does not have current first aid/CPR training. Which poses as a potential health and safety risk to residents in care.

Official plan of correction

POC Due Date: 12/16/2024 Plan of Correction Licensee/Administrator will provide proof of first aid/CPR training for staff by POC due date.

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 LPA's review of staff records, there were no annual staff training on file. This could pose a potential health and safety risk to residents in care.

Official plan of correction

POC Due Date: 12/16/2024 Plan of Correction Licensee/Administrator will provide proof of completed annual 20 hour staff training by POC due date.

Official classification

Type A

Official code

87468.1

Regulation authority

CCR

What the official deficiency says

(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature... This requirement is not met as evidenced by: Based on S1 and Licensee admission, LPA determined that staff threatened client, which poses an immediate safety and personal rights risk to persons in care.

Official plan of correction

Licensee stated staff training will be conducted regarding resident personal rights and a copy provided to LPA via email by POC.

Deadline recorded: Aug 16, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

8768.1(a)(16)

Regulation authority

CCR

What the official deficiency says

To receive or reject medical care or other services. This requirement is not met as evidence by: Based on Licensee admission, they did not provided medical care to R1, after they sustained a fall resulting in an injury, which poses an immediate health and safety risk to persons in care.

Official plan of correction

Licensee immediately called 911, and emergency services arrived to transport R1 to hospital. Licensee stated staff training will be conducted regarding resident personal rights and a copy provided to LPA via email by POC.

Deadline recorded: Aug 16, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87468.1

Regulation authority

CCR

What the official deficiency says

(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (16) To receive or reject medical care or other services. This requirement is not met as evidence by: Based on Licensee admission, they did not provided medical care to R1, after they sustained a fall resulting in an injury, which poses an immediate health and safety risk to persons in care.

Official plan of correction

Licensee immediately called 911, and emergency services arrived to transport R1 to hospital. Licensee stated they will conduct staff training regarding resident personal rights immediately and a copy provided to LPA via email by POC.

Deadline recorded: Aug 3, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87468.1

Regulation authority

CCR

What the official deficiency says

(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature... This requirement is not met as evidenced by: Based on S1 and Licensee admission, LPA determined that staff threatened client, which poses an immediate safety and personal rights risk to persons in care.

Official plan of correction

Licensee stated they will conduct staff training regarding resident personal rights immediately and a copy provided to LPA via email by POC.

Deadline recorded: Aug 3, 2024. A deadline is not proof that correction was completed.