EMY'S PLACE OF MISSION VIEJO

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, one out of two staff files did not contain evidence of a health screening and TB exam which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 06/30/2026 Plan of Correction AD stated staff member will get a health screening and TB test by POC due date. AD to send proof to LPA.

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, two out of two staff files did not contain evidence of 20 hours of annual training which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 06/30/2026 Plan of Correction AD stated the two staff member will received training by POC due date. AD to send proof to LPA.

Official classification

Type B

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 record review, there are no physician's orders for over the counter medication for one out of five residents which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 06/30/2026 Plan of Correction AD stated she will get the physician's orders and send proof to LPA 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 interview and record review, the licensee did not comply with the section cited above as both the licensee and administrator appear to have a lapsed CPR certificate as of January 2025, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/30/2025 Plan of Correction Licensee will update their CPR training and provide proof of completion before the plan of corrections due date.

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 interview and record review, the licensee did not comply with the section cited above in as there were only two drills conducted in 2024 and no drills have yet to be documented for 2025. This poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/30/2025 Plan of Correction Licensee will schedule one drilll for every quarter and document attendance as described above. Proof of completion to be provided to LPA before the plan of corrections due date.

Official classification

Type B

Official code

87305(a)

Regulation authority

CCR

What the official deficiency says

Per California Code of Regulations Section 87305 Alterations to Existing Building or New Facilities: " (a) Prior to construction or alterations, all facilities shall obtain a building permit. " This requirement is not met as evidenced by: During the facility walkthrough, it was observed that the main living area had been partitioned to create a room to be used by overnight staff. The room is not reflected on the sketches on file and permits were not sollicited. Deficient Practice Statement Based on observation and review of the facility sketch, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/03/2024 Plan of Correction Licensee will retroactively request permission to add the partition to the physical plant and confirm the compatibility of the alteration with the facility's fire clearance. Documentation to be provided to LPA before the plan of corrections due date.

Official classification

Type B

Official code

1569.312

Regulation authority

HSC

What the official deficiency says

Health and Safety Code section 1569.312 provides that every facility required to be licensed under this chapter shall provide at least the following basic services: (e) Monitoring the activities of the residents while they are under the supervision of the facility to ensure their general health, safety. Based on the file review conducted, this requirement is not being met as evidenced by the fact that resident R1 was able to leave the facility unattended in spite of a physician report requiring supervision to leave the facility.

Official plan of correction

Licensee will obtain an updated Physician Report and update the resident's Individual Service Plan accordingly. Additionally, licensee will hire additional staff to provide supervision at all times as required.

Deadline recorded: Aug 18, 2022. A deadline is not proof that correction was completed.