BONAFIDE HOME CARE

Official classification

Type A

Official code

87506(a)

Regulation authority

CCR

What the official deficiency says

(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 is not met as evidenced by: Based on observation and record review, the licensee did not comply with the section cited above as two resident files were not available for review, which poses an immediate health, safety, and personal rights risk to persons in care.

Official plan of correction

Staff Delos Ama stated a separate, complete, and current record for each resident will be maintained and a copy provided to LPA via email by POC date.

Deadline recorded: Aug 28, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87412(a)

Regulation authority

CCR

What the official deficiency says

(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 is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above due to not being able to present staff records for review which poses/posed a pontental safety risk to persons in care.

Official plan of correction

POC Due Date: 01/30/2026 Plan of Correction

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 in one out of four resident bedrooms, which poses an immediate health and safety rights risk to persons in care. Lysol spray was observed in R3's room accessible to the residents in care.

Official plan of correction

POC Due Date: 01/23/2025 Plan of Correction Administrator immediately removed the Lysol bottle from resident's room and will provide in-service training for toxins. Documentation of training to be submitted to LPA by January 29, 2025.

Official classification

Type A

Official code

87309(a)(1)

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. (1) Disinfectants, cleaning solutions, and poisonous substances shall be stored in areas separate from food supplies as specified in Section 87555, General Food Service Requirements. 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 knives being stored next to uncovered bleach cleaner, which poses an immediate health risk to persons in care.

Official plan of correction

POC Due Date: 01/23/2025 Plan of Correction Administrator immediately removed knives and placed it in a locked cabinet in the kitchen effective today. Administrator to conduct an in-service training by January 29, 2025 and submit proof to LPA.

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, which poses an immediate health risk to persons in care due to unlocked staff bedroom observed to have resident's medications accessible to all the residents while waiting to be destroyed due to previously deceased resident.

Official plan of correction

POC Due Date: 01/23/2025 Plan of Correction Administrator immediately locked staff bedroom and will remain locked at all times effective today. Administrator to submit proof in-service training to LPA by January 29, 2025.

Official classification

Type A

Official code

87465(h)(5)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. This requirement is not met as evidenced by: Deficient Practice Statement Based on medication review, the licensee did not comply with the section cited above in four out of four resident's medications, which poses an immediate health risk to persons in care. Medication is transferred to a separate container and prepared 24 hrs in advance for all residents in care.

Official plan of correction

POC Due Date: 01/23/2025 Plan of Correction Administrator stated that facility will no longer transfer medications to a separate container effective today. Administrator will conduct in-service training and will provide documented proof by January 29, 2025 of training to LPA by POC date.

Official classification

Type A

Official code

87458(a)

Regulation authority

CCR

What the official deficiency says

(a) Prior to a person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment, signed by a licensed medical professional acting within the scope of their practice and made within the last year, to be kept in the resident's record. 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 two out of four resident's files which poses an immediate health, safety or personal rights risk to persons in care. R1 and R3 did not have a medical assessment (Physicians Report) upon record review.

Official plan of correction

POC Due Date: 01/23/2025 Plan of Correction Administrator to submit a written plan on how to correct citation and Administrator will provide by January 29, 2025 the medical assessment for R1 and R3 and submit proof to LPA.

Official classification

Type B

Official code

1569.311

Regulation authority

HSC

What the official deficiency says

Every residential care facility for the elderly shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections. 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 carbon monoxide not functioning at time of visit, which poses a potential safety risk to persons in care.

Official plan of correction

POC Due Date: 02/05/2025 Plan of Correction Administrator to have a working carbon monoxide detector by POC date.

Official classification

Type B

Official code

87307(d)(6)

Regulation authority

CCR

What the official deficiency says

(6) All outdoor and indoor passageways and stairways shall be kept free of obstruction. 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 safety risk to persons in care. The outdoor area was observed with tripping hazards, dried leaves, and gardening tools.

Official plan of correction

POC Due Date: 02/05/2025 Plan of Correction Administrator to clean backyard and remove hazards by POC date. LPA to visit facility to verify POC.

Official classification

Type B

Official code

87412(a)

Regulation authority

CCR

What the official deficiency says

(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 is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in four out of four staff files which poses a potential health and safety risk to persons in care. Staff records were not present at the facility for any of the staff members to review during the inspection.

Official plan of correction

POC Due Date: 02/05/2025 Plan of Correction Administrator to have all staff files by POC date. LPA to conduct a visit to review records.

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 record review, the licensee did not comply with the section cited above which poses a safety risk to persons in care. No proof of disaster drills was able to be provided during today's visit.

Official plan of correction

POC Due Date: 01/27/2025 Plan of Correction Administrator to conduct a fire drill by POC date and will continue to conduct quarterly drills.