CARVER SENIOR HOMES 1

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 in two of five resident files which poses a potential health risk to persons in care.

Official plan of correction

POC Due Date: 01/26/2026 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

87307(a)

Regulation authority

CCR

What the official deficiency says

(a) Living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents, staff, and others who may reside in the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above as staff is currently residing in a detached storage building located in the backyard of the facility, which poses a potential safety and personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/26/2026 Plan of Correction AD stated staff will remove personal belongings and no longer in the detached storage building and picture proof provided to LPA 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 record review, the licensee did not comply with the section cited above in three of three staff files which poses a potential health, safety and personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/19/2025 Plan of Correction Staff Espina stated staff training will be completed and proof provided to LPA 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 record review, the licensee did not comply with the section cited above in one of one staff files which poses a potential health, safety and personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/19/2025 Plan of Correction Staff Espina stated 10 hours of initial training consisting of 6 hours of hands-on shadowing training will be documented and a copy provided to LPA via email by POC date.

Official classification

Type A

Official code

87470(a)(2)(D)

Regulation authority

CCR

What the official deficiency says

(a) A licensee shall ensure that infection control practices are maintained as follows: (2) Environmental cleaning and disinfection activities shall be performed following the manufacturers' instructions for proper use of the cleaning and disinfecting products. These activities shall be completed, at a minimum, as follows: (D) Facility items that cannot be disinfected shall be discarded immediately in an appropriate waste receptacle with a tight-fitting cover or otherwise made inaccessible to human contact or transmission. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and resident interview, the licensee did not comply with the section cited above as a resident is urinating into a urinal plastic container and the urine filled container is stored without a lid in the resident's room, which poses an immediate health and personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/30/2024 Plan of Correction AD stated urinal plastic container would be disposed of by staff immediately after use and will no longer be stored in resident's bedroom. AD stated infection control training would be completed for staff and proof submitted to LPA via email by POC date.

Official classification

Type B

Official code

87470(a)(2)(A)

Regulation authority

CCR

What the official deficiency says

(a) A licensee shall ensure that infection control practices are maintained as follows: (2) Environmental cleaning and disinfection activities shall be performed following the manufacturers' instructions for proper use of the cleaning and disinfecting products. These activities shall be completed, at a minimum, as follows: (A) Surfaces such as floors, chairs, toilets, sinks, counters and tabletops shall be cleaned and disinfected on a regular basis to ensure they are safe and sanitary. These surfaces shall also be disinfected when these surfaces are contaminated and visibly soiled with blood or body fluids or other potentially infectious material. 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 hallway and resident's bedroom floors, which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 06/05/2024 Plan of Correction AD stated a staff cleaning log would be maintained to ensure daily disinfecting of floors. AD stated they will submit proof to LPA 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 staff file review, the licensee did not comply with the section cited above as facility staff have not completed eight hours of dementia care training, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 06/28/2024 Plan of Correction AD stated remaining required annual staff training would begin to be completed immediately. AD stated they will submit proof to LPA 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 record review, the licensee did not comply with the section cited above as staff's 6 hours of hands-on shadowing training is not being documented, which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 05/30/2024 Plan of Correction AD stated staff's 6 hours of hands-on shadowing training will be documented and proof will be submitted to LPA via email.

Official classification

Type B

Official code

87456(a)(2)

Regulation authority

CCR

What the official deficiency says

(a) Prior to accepting a resident for care and in order to evaluate his/her suitability, the facility shall, as specified in this article 8: (2) Perform a pre-admission appraisal. 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 five resident files, which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 06/28/2024 Plan of Correction AD stated resident appraisals would be completed and pre-admission appraisals completed for all future residents. AD stated proof will be submitted 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 record review, the licensee did not comply with the section cited above in two out of five resident files, which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 06/28/2024 Plan of Correction AD stated resident appraisals will be completed and proof will be submitted to LPA via email by POC date.

Official classification

Type B

Official code

87507(c)

Regulation authority

CCR

What the official deficiency says

(c) Admission agreements shall be signed and dated, acknowledging the contents of the document, by the resident or the resident's representative, if any, and the licensee or the licensee's designated representative no later than seven days following admission. Attachments to the agreement may be utilized as long as they are also signed and dated as prescribed above. 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 five resident files, which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 06/28/2024 Plan of Correction AD stated all admission agreements would be signed and dated for currently residents and signed and dated within seven days for any new resident. AD stated proof will be submitted to LPA via email by POC date.

Official classification

Type A

Official code

87411(g)(2)

Regulation authority

CCR

What the official deficiency says

(g) Prior to employment or initial presence in the facility, all employees and volunteers subject to a criminal record review shall; (2) request a transfer of a criminal record clearance as specified in Section 87355(c) This requirement is not met as evidenced by: Staff 1 (S1) and Staff 2 (S2) are not associated to the facility. This poses an immediate health and safety risk to persons in care.

Official plan of correction

Licensee provided CCLD with LIC 9182, LIC 508 and copy of CA Drivers License to LPA to associate S1 and S2

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

Official classification

Type B

Official code

87305(a)

Regulation authority

CCR

What the official deficiency says

87305 Alterations to Existing Building or New Facilities (a) Prior to construction or alterations, all facilities shall obtain a building permit. This regulation was not met as evidence by: Facility built a double door in resident 1 (R1) room without a permit. This poses a potential safety risk to persons in care.

Official plan of correction

Licensee applied for permit on 10/18/2022. Licensee to show proof of permit when it is obtained by the city and forward proof to LPA by POC due date.

Deadline recorded: Nov 23, 2022. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87405(a)

Regulation authority

CCR

What the official deficiency says

Administrator - Qualifications and Duties. All facilities shall have a qualified and currently certified administrator...The administrator...to permit adequate attention to the management and administration of the facility as specified in this section...documentation This is not met as evidence by there is no Administrator associated to the facility after the passing of the licensee/administrator. This poses an immediate health and safety risk to persons in care.

Official plan of correction

Licensee to associate administrator to the facility by POC due date and forward proof to LPA

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