GOOD HANDS HOME CARE

Official classification

Type A

Official code

87202(a)(2)

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: (2) Bedridden persons This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and staff interviews, the licensee did not comply with the section cited above due to Resident 4 (R4) being unable to turn and reposition herself in bed and is unable to independently transfer. Staff uses hoyer lift to transfer resident and is not licensed for bedridden which poses an immediate health and safety rights risk to persons in care.

Official plan of correction

POC Due Date: 06/05/2026 Plan of Correction Licensee stated they will submit an LIC 200 to apply for bedridden to Regional Office by close of business day tommorow May 6 , 2026. Licensee to notify LPA via email once complete.

Official classification

Type B

Official code

87411(f)

Regulation authority

CCR

What the official deficiency says

(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure. A report shall be made of each screening, signed by the examining physician. The report shall indicate whether the person is physically qualified to perform the duties to be assigned, and whether he/she has any health condition that would create a hazard to him/herself, other staff members or residents. A signed statement shall be obtained from each volunteer affirming that he/she is in good health.Personnel with evidence of physical illness or emotional instability that poses a significant threat to the well-being of residents shall be relieved of their duties. 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 one of two files reviewed which poses a health risk to persons in care. Staff 1 did not have a health screening and TB test.

Official plan of correction

POC Due Date: 05/27/2026 Plan of Correction Licensee to email health screening and Tb test for staff 1 to LPA by POC date .

Official classification

Type B

Official code

87507(d)

Regulation authority

CCR

What the official deficiency says

(d) The licensee shall retain in the resident's file the original signed and dated admission agreement and all subsequent signed and dated modifications. This does not apply to rate increases which have specific notification requirements as specified in Health and Safety Code section 1569.655. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review and staff interview, the licensee did not comply with the section cited above in one of six resident files which poses a potential personal rights risk to persons in care. Admission agreement for Resident 1 was unavailable for review at time of visit.

Official plan of correction

POC Due Date: 05/27/2026 Plan of Correction Licensee to submit admission agreement for Resident 1 to LPA by POC date via email.

Official classification

Type B

Official code

87305(a)

Regulation authority

CCR

What the official deficiency says

(a) Prior to construction or alterations, all facilities shall obtain a building permit. This requirement is not met as evidenced by: Based on LPA observation, the staff room construction in the garage did not have evidence of a permit which poses a potential health and safety risk to persons in care.

Official plan of correction

AD stated building permit is being worked on. Waiting for city to provide additional direction. AD to provide permit or additional information by POC due date.

Deadline recorded: Apr 15, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87305(a)

Regulation authority

CCR

What the official deficiency says

(a) Prior to construction or alterations, all facilities shall obtain a building permit. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA observation and record review, the staff room construction in the garage did not have evidence of a permit which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 05/24/2025 Plan of Correction Licensee to provide building permit for staff room construction in the garage to LPA by POC due date.

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA observation, cleaning supplies were found under the bathroom sink unlocked in bedroom 3 and in the unlocked closet by the entrance which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 05/24/2025 Plan of Correction Cleaning supplies from bathroom were removed and a lock was placed on the closet door during the visit.

Official classification

Type A

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 LPA observation, lock in lower medicine cabinet is broken making medications available to residents which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 05/24/2025 Plan of Correction Facility to repair/replace lock. LPA to return and verify.

Official classification

Type A

Official code

87608(a)(5)(B)

Regulation authority

CCR

What the official deficiency says

(B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA observation and record review, R2 has full bed rails. R2 is not on hospice which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 05/24/2025 Plan of Correction Facility to remove full bed rails from R2's bed. LPA to return and verify.

Official classification

Type B

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 LPA observation, record review, and interviews, the facility has not conducted emergency drills in the last 12 months which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 06/06/2025 Plan of Correction Facility to perform verifiable disaster drills and provide proof to LPA by POC due date.

Official classification

Type A

Official code

87412(c)

Regulation authority

CCR

What the official deficiency says

(c) Licensees shall maintain in the personnel records verification of required staff training and orientation. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA record review and interviews, required new hire staff training has not been conducted for S3 which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 05/24/2025 Plan of Correction Licensee or other qualified individual to conduct required training. Licensee to provide verifiable proof to LPA by POC due date.

Official classification

Type A

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 record review and interviews, S1 and S2 have not completed their required annual training within the last 12 months which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 05/24/2025 Plan of Correction Licensee or qualified individual to conduct required annual training. Licensee to provide verifiable proof to LPA by POC due date.

Official classification

Type A

Official code

87465(a)(5)(A)

Regulation authority

CCR

What the official deficiency says

(5) Facility staff, except those authorized by law, shall not administer injections, but staff designated by the licensee may assist persons with self-administration as needed. Assistance with self-administered medications shall be limited to the following: (A) Medications usually prescribed for self-administration which have been authorized by the person's physician. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA record review and interviews, R5 has 2 medication pills that are missing and unaccounted for, R1 has medication that is not being administered as prescribed due to missing nebulizer, and R3 is being administered over the counter medication without a physician's order which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 05/24/2025 Plan of Correction Licensee to complete in-service training for medication administration, order nebulizer for R1, and obtain physician's orders for over the counter medication R3. Licensee to send proof of in-service training and physician's orders to LPA by POC due date.

Official classification

Type A

Official code

87465(a)(6)

Regulation authority

CCR

What the official deficiency says

(6) When requested by the prescribing physician or the Department, a record of dosages of medications which are centrally stored shall be maintained by the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA record review and interviews, medication dosage records for R1 are not accurately being recorded and marked as administered when the medication is not available which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 05/24/2025 Plan of Correction Licensee to complete in-service training for medication dosage recording and send proof of training to LPA by POC due date.

Official classification

Type B

Official code

87507(l)

Regulation authority

CCR

What the official deficiency says

(l) The licensee shall attach a copy of applicable resident's rights specified by law or regulation to all admission agreements, and shall include information on the reporting of suspected or known elder and dependent abuse, as set forth in Health and Safety Code Section 1569.889. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA record review, R5 does not have a copy of a signed Personal Rights document in their file which pose a potential personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/06/2025 Plan of Correction Licensee to have Resposible Party sign a Personal Rights document as required by the Department. Licensee to provide copy to LPA by due date.

Official classification

Type B

Official code

1569.695(a)(2)

Regulation authority

HSC

What the official deficiency says

(a)In addition to any other requirement of this chapter, a residential care facility for the elderly shall have an emergency and disaster plan that shall include, but not be limited to, all of the following: (2) Plans for the facility to be self-reliant for a period of not less than 72 hours immediately following any emergency or disaster, including, but not limited to, a short-term or long-term power failure. If the facility plans to shelter in place and one or more utilities, including water, sewer, gas, or electricity, is not available, the facility shall have a plan and supplies available to provide alternative resources during an outage. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA observation and interview, the facility does not have any emergency water to be self sufficient for 72 hours which poses a potential health, safety risk to persons in care.

Official plan of correction

POC Due Date: 06/06/2025 Plan of Correction Facility to purchase at least 15 gallons of water for emergency use and provide LPA with a receipt and picture.

Official classification

Type A

Official code

87207

Regulation authority

CCR

What the official deficiency says

87207 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 requirement is not met as evidenced by: Deficient Practice Statement Based on LPA record review and interviews, it was revealed that staff training for S1, S2, and S3 has been falsified which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 05/22/2025 Plan of Correction Licensee to provide verifiable and measurable training to all staff as required by Title 22. Licensee to provide verifable proof of training and a written Acknowlegment of Understanding document to LPA by POC due date.

Official classification

Type A

Official code

87405(a)

Regulation authority

CCR

What the official deficiency says

87405(a) Administrator - Qualifications and Duties ...When the administrator is not in the facility, there shall be coverage by a designated substitute who shall have qualifications adequate to be responsible... This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA record review and interviews, the facility does not have a qualified designated substitute which poses an immediate health, safety and personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/24/2025 Plan of Correction Licensee to designate a qualified substitute when Administrator if unable to fulfill their duties at the facility. Licensee to notify LPA of assignment by POC due date and provide LPA with an Acknowledgment of Understanding letter.