WHITTIER COTTAGE

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 locks to the toxin drawer under the sink and the medication cabinet in the kitchen were broken, leaving toxins and medications accessible to residents not assessed as being able to safely handle these items, which poses an immediate health risk to persons in care.

Official plan of correction

POC Due Date: 06/26/2026 Plan of Correction During the inspection, the licensee secured these items and LPA confirmed. Licensee stated they will conduct training on securing dangerous items 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

(a) 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 observation, the facility's fire extinguisher was last serviced on June 10, 2025, which poses a potential safety risk to persons in care.

Official plan of correction

POC Due Date: 07/23/2026 Plan of Correction Licensee stated they will service or replace the fire extinguisher and submit proof to LPA by POC due date.

Official classification

Type B

Official code

87458(c)(1)(A)

Regulation authority

CCR

What the official deficiency says

(c) The medical assessment shall include, but not be limited to: (1) A physical examination of the resident indicating the licensed medical professional's diagnosis or diagnoses and results of an examination for all of the following: (A) Communicable tuberculosis. This requirement is not met as evidenced by: Deficient Practice Statement Based on documents, R3's physician's report does not have a TB test result, which poses a potential health risk to persons in care.

Official plan of correction

POC Due Date: 07/23/2026 Plan of Correction Licensee stated they will obtain R3's TB test result and attach it to R3's physician's report and submit proof to LPA by POC due date.

Official classification

Type B

Official code

87458(c)(7)

Regulation authority

CCR

What the official deficiency says

(c) The medical assessment shall include, but not be limited to: (7) A description of any known behavioral expression as defined in Section 87101, Definitions. This requirement is not met as evidenced by: Deficient Practice Statement Based on documents, the physician's reports for R1, R2, R4, and R5 are on the old form and do not contain required information, including behavioral expressions, which poses a potential safety risk to persons in care.

Official plan of correction

POC Due Date: 07/23/2026 Plan of Correction Licensee stated they will obtain new physician's reports on the new form for these residents and submit proof 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 appraisals for R1, R2, and R4 are more than a year old, which poses a potential safety risk to persons in care.

Official plan of correction

POC Due Date: 07/23/2026 Plan of Correction Licensee stated they will reappraise these residents and submit proof to LPA by POC due date.

Official classification

Type B

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 observation and interview, R5, who is not on hospice, has a full bedrail on their bed which was not locked in place and R5 stated it is not used and they are able to get in and out of bed themselves and walk, which poses a potential personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/26/2026 Plan of Correction During the inspection the licensee removed the bedrail based on lack of doctor's order and LPA confirmed.

Official classification

Type A

Official code

87464(f)(1)

Regulation authority

CCR

What the official deficiency says

87464 Basic Services … (f) Basic services shall at a minimum include: (1) Care and supervision. This requirement was not met as evidenced by: Based on interviews and documents, the licensee did not ensure R1 received care and supervision to meet their needs when they were unsupervised at their doctor’s appointment and decided not to return to the facility, which poses an immediate safety risk to persons in care.

Official plan of correction

Licensee stated they will retrain staff on residents’ ability to leave the facility unassisted and will continue to follow up with R1’s status and provide updates to LPA.

Deadline recorded: Dec 23, 2025. 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 … This requirement was not met as evidenced by: Based on admission and documents, the licensee did not have a complete resident file for R1, which poses potential safety risk to persons in care.

Official plan of correction

Licensee stated they will create a protocol for completing resident files prior to admission and submit proof to LPA by POC due date.

Deadline recorded: Dec 29, 2025. A deadline is not proof that correction was completed.

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 documents, the licensee did not ensure S1, S2, and S3 had health screenings all of whom have been working at the facility for more than 7 days, which poses a potential safety risk to persons in care.

Official plan of correction

POC Due Date: 08/06/2025 Plan of Correction Licensee stated they will obtain health screenings for these staff and 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 documents, the licensee did not ensure S2 had the 20-hour annual training for 2025, which poses a potential health risk to persons in care.

Official plan of correction

POC Due Date: 08/06/2025 Plan of Correction Licensee stated they will complete the training for this staff and submit proof to LPA by POC due date

Official classification

Type B

Official code

1569.69(a)(2)

Regulation authority

HSC

What the official deficiency says

(a) Each residential care facility for the elderly licensed under this chapter shall ensure that each employee of the facility who assists residents with the self-administration of medications meets all of the following training requirements: (2) In facilities licensed to provide care for 15 or fewer persons, the employee shall complete 10 hours of initial training. This training shall consist of 6 hours of hands-on shadowing training, which shall be completed prior to assisting with the self-administration of medications, and 4 hours of other training or instruction, as described in subdivision (f), which shall be completed within the first two weeks of employment. This requirement is not met as evidenced by: Deficient Practice Statement Based on documents and interviews, the licensee did not ensure S2 who assists residents with medications has documented medication training, which poses a potential health risk to persons in care.

Official plan of correction

POC Due Date: 08/06/2025 Plan of Correction Licensee stated they complete the medication training for S2 and submit proof to LPA by POC due date.

Official classification

Type A

Official code

1569.17(c)(1)(A)

Regulation authority

HSC

What the official deficiency says

(c)(1)(A) Subsequent to initial licensure, a person specified in subdivision (b) who is not exempted from fingerprinting shall obtain either a criminal record clearance or an exemption, pursuant to subdivision (f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in a facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on records, staff Sheryl Borja is not background cleared and has been working at the facility since January 1, 2024 per their staff file, which poses an immediate safety risk to persons in care. CIVIL PENALTY ASSESSED.

Official plan of correction

POC Due Date: 07/09/2024 Plan of Correction During the inspection, the staff left the facility and LPA confirmed. Licensee stated they will have the staff fingerprinted and submit proof to LPA by POC due date and that the staff will not be allowed back at the facility until they are properly cleared and associated.

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 facility's PUB475 is letter-sized and not 20 " x26 " , which poses a potential personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/05/2024 Plan of Correction Licensee stated they will purchase and post a 20 " x26 " PUB475 and submit proof to LPA by POC due date.

Official classification

Type B

Official code

87465(a)(1)

Regulation authority

CCR

What the official deficiency says

(1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents. This requirement is not met as evidenced by: Deficient Practice Statement Based on documents, the facility has not been completing Medication Administration Records (MAR) for 2 out of 5 residents, which poses a potential health risk to persons in care.

Official plan of correction

POC Due Date: 08/05/2024 Plan of Correction Licensee stated they will immediately begin completing MARs for all residents and will submit proof to LPA by POC due date.

Official classification

Type B

Official code

1569.695(f)(1)

Regulation authority

HSC

What the official deficiency says

(f) A facility shall have both of the following in place: (1) An evacuation chair at each stairwell, on or before July 1, 2019. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the facility has two stories with staff living upstairs but does not have an evacuation chair, which poses a potential safety risk to persons in care.

Official plan of correction

POC Due Date: 08/05/2024 Plan of Correction Licensee stated they will purchase and install an evacuation chair and submit proof to LPA by POC due date.

Official classification

Type B

Official code

87465(f)(1)

Regulation authority

CCR

What the official deficiency says

(f) Emergency care requirements shall include the following: (1) The name, address, and telephone number of each resident's physician and dentist shall be readily available to that resident, the licensee, and facility staff. 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 2 out of 3 resident records reviewed which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 05/27/2022 Plan of Correction Facility needs to update forms and email LPA Claudia Gutierrez copies of the forms completed by 05/27/2022.