A MOTHER THERESA CARE

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 record review, the licensee did not comply with the section cited above as two of five resident medical assessments did not include results of examination for TB, which poses a potential health risk to persons in care.

Official plan of correction

POC Due Date: 03/05/2025 Plan of Correction AD stated TB examination results will be obtained and proof provided via email by POC date.

Official classification

Type B

Official code

87303(e)(3)

Regulation authority

CCR

What the official deficiency says

(e) Water supplies and plumbing fixtures shall be maintained as follows: (3) Taps delivering water at 125 degree F (52 degrees C) or above shall be prominently identified by warning signs. 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 two resident bathrooms, which poses a potential safety risk to persons in care.

Official plan of correction

POC Due Date: 05/24/2024 Plan of Correction AD stated water temperature will be maintained between 105 and 120 degrees F in lieu of warning signs. AD stated they will maintain a water temperature log to ensure water temperature is maintained between 105 and 120 degrees F and provide LPA with proof via email by POC 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 observation, AD interview, and record review, the licensee did not comply with the section cited above in as one out of three staff files did not contain the 20 hours of annual staff training required, which poses a potential health, safety and personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/24/2024 Plan of Correction AD stated staff will complete the 20 hours of annual training required, eight of which will be dementia care training. AD stated they will provide LPA with proof via email by POC 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 observation, AD interview, and record review, the licensee did not comply with the section cited above, as staff files did not contain any documentation for initial 6 hours of hands-on shadowing training, which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 05/24/2024 Plan of Correction AD stated training would be re-done and documented and a copy provided to LPA via email by POC date.

Official classification

Type B

Official code

87463(a)

Regulation authority

CCR

What the official deficiency says

(a) The pre-admission appraisal shall be updated, in writing as frequently as necessary to note significant changes and to keep the appraisal accurate. The reappraisals shall document changes in the resident's physical, medical, mental, and social condition. Significant changes shall include but not be limited to: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above in four out of six resident files, which poses a potential health, safety and personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/24/2024 Plan of Correction AD stated that reappraisals would be completed for all four residents and will be updated, in writing, as frequently as neccessary to note significant changes and to keep appraisal accurent. AD stated they will provide LPA with copy of updated appraisals via email by POC date.

Official classification

Type A

Official code

87203

Regulation authority

CCR

What the official deficiency says

Fire Safety. All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. This requirement was not met as evidenced by: LPA observed a storage shed in the back yard to have been converted into a live-in staff room. This was acknowledged by AD and staff. This poses an immediate threat to the health and safety of the residents in care.

Official plan of correction

Administrator agrees to remove furniture including staff's personal belongings from the shed and designate an area within the living area for staff's use and provide adequate living quarters within the facility in conformity to regulatios adopted by the State Fire Marshall. Shed shall only be used for storage,

Deadline recorded: Apr 29, 2022. A deadline is not proof that correction was completed.