TESSIE'S PLACE LOVING CARE HOME #2

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on observation, the licensee did not comply with the section cited above as the two fire extinguishers present display outdated maintenance tags dated December 2022 which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/24/2025 Plan of Correction Licensee will conduct a fire extinguisher maintenance and provide proof thereof to licensing staff

Official classification

Type B

Official code

87204(a)

Regulation authority

CCR

What the official deficiency says

(a) A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including specification of the maximum number of persons who may receive services at any one time. An exception may be made in the case of catastrophic emergency when the licensing agency may make temporary exceptions to the approved capacity. 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 1 out of 6 residents, Facility is 1 resident above their current hospice waiver which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/31/2025 Plan of Correction Licensee agrees to request a hospice waiver increase and to submit a statement showing they have read and understand and agree to comply with CCR 87204 and CCR 87633.

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 records reviewed, the licensee did not comply with the section cited above as annual training records for staff member S1 only display relevant annual training for 2024 and nothing on file for 2025. This poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/31/2025 Plan of Correction Annual training for S1 to be conducted and documented before the plan of corrections due date.

Official classification

Type B

Official code

87608(a)(3)

Regulation authority

CCR

What the official deficiency says

(a) Based on the individual's preadmission appraisal, and subsequent changes to that appraisal, the facility shall provide assistance and care for the resident in those activities of daily living which the resident is unable to do for himself/herself. Postural supports may be used under the following conditions: (3) A written order from a physician indicating the need for the postural support shall be maintained in the resident's record. The licensing agency shall be authorized to require other additional documentation if needed to verify the order. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and records reviewed, the licensee did not comply with the section cited above as multiple residents whose beds are equipped with postural supports do no have any physician orders on file. This constitutes a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/31/2025 Plan of Correction Licensee will obtain physician orders for all residents requiring the use of postural supports prior to the plan of corrections due date. Orders to be submitted for review to licensing staff.

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 records reviewed, the licensee did not comply with the section cited above as a total of four beds equipped with full rails or two half-rails back-to-back are observed on the premises, even though only three residents are admitted onto hospice at the time of the visit. This constitutes a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/31/2025 Plan of Correction Full rails to be substituted with half rails with relevant physician orders for residents not admitted on hospice.

Official classification

Type A

Official code

87203

Regulation authority

CCR

What the official deficiency says

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 is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above, LPA observed there are no smoke detectors in 3 out of 5 resident bedrooms, which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 01/09/2025 Plan of Correction Licensee agrees to install smoke detectors in the 3 resident rooms and to always have working smoke detectors in the facility as required.

Official classification

Type A

Official code

87204(a)

Regulation authority

CCR

What the official deficiency says

(a) A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including specification of the maximum number of persons who may receive services at any one time. An exception may be made in the case of catastrophic emergency when the licensing agency may make temporary exceptions to the approved capacity. 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 1 out of 6 residents, Facility is 1 resident above their current hospice waiver which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/09/2025 Plan of Correction Licensee agrees to request a hospice waiver increase and to submit a statement showing they have read and understand and agree to comply with CCR 87204 and CCR 87633.

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, It is not possible to walk through the storage room because the amount of boxes and furniture in the room, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/15/2025 Plan of Correction Licensee agrees to clear the room of boxes and furniture so it is possible to walk to each door in the room without hinderance.

Official classification

Type A

Official code

87203

Regulation authority

CCR

What the official deficiency says

The California Code of Regulations Section 87203 regarding 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 is not being met as evidenced by: Facilty has installed padlocks on the perimeter gates located on both sides of the physical plant. Based on observation, the licensee did not comply with the section cited above. LPAs observed both exit gates are secured. One gate is secured with a padlock and one gate is secured. This poses an immediate health and safety risk to residents in care. CIVIL PENALTY ASSESSED. Licensee removed lock during visit. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interviews and record review), the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/16/2022 Plan of Correction Licensee removed padlocks during the conducted inspection visit. Licensee informed of the requirements for the approval of locked gates.

Official classification

Type B

Official code

87705(f)

Regulation authority

CCR

What the official deficiency says

The California Code of Regulations Section 87705(f) on theCare of Persons with Dementia states: " The following shall be stored inaccessible to residents with dementia: (1) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s). (2) Over-the-counter medication, nutritional supplements or vitamins, alcohol, cigarettes, and toxic substances such as certain plants, gardening supplies, cleaning supplies and disinfectants. This requirement is not met as evidenced by: Laundry detergent, cleaning supplies and staff personal medication were observed to be accessible due to unlocked doors or a non-functional cabinet lock. Deficient Practice Statement Based on observation, 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: 01/15/2023 Plan of Correction Licensee will conduct in-service training of facility staff on the secure storage of potentially dangerous items and substances. Licensee will also replace the non-functional magnetic lock of the cabinet under the kitchen sink.

Official classification

Type A

Official code

1569.605

Regulation authority

HSC

What the official deficiency says

On and after July 1, 2015, all residential care facilities for the elderly, except those facilities that are an integral part of a continuing care retirement community, shall maintain liability insurance covering injury to residents and guests in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in the total annual aggregate, caused by the negligent acts or omissions to act of, or neglect by, the licensee or its employees. This requirement is not being met as evidenced by, facility does not have a record of insurance coverage and Administrator reported that the coverage has expired. This poses an immediate health and safety risk to residents in care.

Official plan of correction

LIcensee agrees to purchase insurance for the facility as required by the Health & Safety code and to provide proof of insurance to the Agency by 12/14/2021.

Deadline recorded: Nov 30, 2021. A deadline is not proof that correction was completed.