STERLING SENIOR COMMUNITY 8

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 observation, the licensee did not comply with the section cited above, during the inspection LPA Haley observed disabled safety locks securing the cleaning chemicals in the restroom next bedroom #3 and a disabled safety lock on the drawer securing the sharps in the kitchen. This poses an immediate safety risk to persons in care. Photos were taken.

Official plan of correction

POC Due Date: 07/09/2026 Plan of Correction Administrator Tangol will have staff review the regulation requirement and each staff member will provide a signature acknowledging the regulation requirement was read and understood.

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 observation, the licensee did not comply with the section cited above, during the inspection LPA Haley observed a disabled safety lock on the cabinet where resident medications were stored. This poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 07/09/2026 Plan of Correction Administrator Tangol will conduct an in-service training on medication administration and have staff review the regulation requirement cited above. A sign in sheet for all who attended the in-service training will be provided with the topics covered during the training and the duration of the training, and signature from each staff member who reviewed regulation section 87465(h)(2).

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 observation, the licensee did not comply with the section cited above which poses a potential personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/10/2026 Plan of Correction Administrator Sheryl will email LPA Haley a photo of the new PUB475 poster one it is hung on the wall near the entrance of the facility.

Official classification

Type B

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, hedge shears and bolt cutters were unsecured outside next to the garage and Clorox wipes were left unsecured on the counter top in the bathroom which poses/posed a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 07/29/2025 Plan of Correction AD stated, all tools will be stored in the garage. AD to submit proof to LPA 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 record review, S2 did not have verifiable training records to review which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/29/2025 Plan of Correction AD stated she submit proof to LPA by POC due date

Official classification

Type B

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 observation, R2 did not have all of their medications listed in the centrally stored medication record which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 07/29/2025 Plan of Correction AD stated she will have an updated centrally stored medication record and submit proof to LPA by POC due date.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

This requirement is not met as evidenced by: Deficient Practice Statement Based on observation(interview), the licensee did not comply with the section cited above in facility has plumbing that is exposed in hallway and facility threshold between kitchen area hallways and laundry exit needs to be shaved down to avoid tripping hazared which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/04/2024 Plan of Correction Licensee to repair exposed plumbing and facility thresholds by POC due date 12/4/2024

Official classification

Type B

Official code

87705(c)(4)(A)

Regulation authority

CCR

What the official deficiency says

87705 Care of Persons with Dementia (c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (4) There is an adequate number of direct care staff to support each resident’s physical, social, emotional, safety and health care needs as identified in his/her current appraisal. (A) In addition to requirements specified in Section 87415, Night Supervision, a facility with fewer than 16 residents shall have at least one night staff person awake and on duty if any resident with dementia is determined through a pre-admission appraisal, reappraisal or observation to require awake night supervision. This requirement was not met as evidenced by: On 12/12/2023, LPA interviewed two staff (S1-S2). Interviews with S1 and S2 revealed there are two caregivers providing care and supervision to five residents during day shift from 7:00 AM through 7:00 PM. S1 and S2 stated an awake staff is placed to work overtime at night from 7:00 PM - 7:00 AM when any residents pose a restless behavior. Based on interview with S1 and S2 and LPA's records review, it was revealed that four residents (R1, R3, R5 & R6) need close supervision due to their medical conditions, however S1 and S2 stated there are no on-duty staff during night shift unless needed. This poses a potential health, safety, and/or personal rights risk to persons in care.

Official plan of correction

Licensee shall ensure there's always one aware staff during night shift to provide care and supervision to residents with dementia and hospice. Licensee shall self-certify understanding of the section cited herein and shall comply. POC shall be submitted to CCLD via email to ernand.dabuet@dss.ca.gov by the POC due date, 01/05/23.

Deadline recorded: Jan 5, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87506(a)

Regulation authority

CCR

What the official deficiency says

87506 Resident Records (a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. This requirement was not met as evidenced by: Based on record review. LPA reviewed records of 4 out of 6 residents (R1-R6). Service records were incomplete (see LIC 9099-C). This poses a potential health, safety, and/or personal rights risk to persons in care.

Official plan of correction

Licensee shall ensure all resident records are complete and accurate. Administrator agreed to obtain all missing resident records and shall submit copies to CCLD via email to ernand.dabuet@dss.ca.gov by the POC due date, 01/05/24.

Deadline recorded: Jan 5, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87412(a)(11-12)

Regulation authority

CCR

What the official deficiency says

87412 Personnel Records a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information:.... This requirement was not met as evidenced by: Based on record review, staff #3 had an incomplete personnel file and missing required licensing forms. (See LIC 9099-C) This violation poses a potential health and safety to residents in care.

Official plan of correction

Licensee shall ensure all staff records are complete and accurate. House Manager agreed to obtain all missing staff records and shall submit copies to CCLD via email to ernand.dabuet@dss.ca.gov by the POC due date, 01/05/24.

Deadline recorded: Jan 5, 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 requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above. LPA identified window covering missing for room #6 and central stove burner not in working condition. The violaiton which poses/posed a potential health, safety or personal rights risk to persons in care

Official plan of correction

Licensee will ensure the facility is maintained in good repair at all times. Licensee will repair central stove burner and have a window covering for room #6 bathroom. Proof of correction must be sent to LPA by due date: 01/12/24 via email.ernand.dabuet@dss.ca.gov

Deadline recorded: Jan 12, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(2)

Regulation authority

CCR

What the official deficiency says

87465 Incidental Medical and Dental Care (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: Based on observation, the licensee did not comply with the section cited above. LPA identified refrigerated medications for resident (R2 & R5) not locked up storage accessible to other residents. The violaiton which poses/posed an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee will ensure the facility is to store all medications for residents in locked storage not accessible to other residents. Proof of correction must be sent to LPA by due date: 12/13/23 via email.ernand.dabuet@dss.ca.gov

Deadline recorded: Dec 13, 2023. A deadline is not proof that correction was completed.