CANDLEBERRY CARE

Official classification

Type A

Official code

87202(a)(2)

Regulation authority

CCR

What the official deficiency says

(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: (2) Bedridden persons 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 out of five residents in care, which poses an immediate health and safety risk to persons in care. LPA observed Physician's report for Resident #1 stating resident is bedridden. Facility does not currently have a fire clearance for bedridden residents.

Official plan of correction

POC Due Date: 01/31/2026 Plan of Correction Licensee stated they will submit a written plan with LIC 200 application immediately requesting new fire clearance for Bedridden resident and submit proof to CCLD by POC due date.

Official classification

Type A

Official code

87355(d)(3)

Regulation authority

CCR

What the official deficiency says

(3) The licensee shall submit these fingerprints to the California Department of Justice, along with a second set of fingerprints for the purpose of searching the records of the Federal Bureau of Investigation, or comply with Section 87355(c), prior to the individual's employment, residence, or initial presence in the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, and record review, the licensee did not comply with the section cited above. LPA reviewed S1’s record that they are not associated with the facility. This poses an immediate health, safety, and personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/31/2026 Plan of Correction Administrators stated they will associate S1 to the facility and submit proof to CCLD via email by POC due date of 1/31/2026.

Official classification

Type B

Official code

87468.1(a)(1)

Regulation authority

CCR

What the official deficiency says

87468.1 Personal Rights of Residents in all Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1)To be accorded dignity in their personal relationships with staff, residents, and other persons. Regulation was not met by licensee as evedenced by interviews conducted with staff and residents in care.

Official plan of correction

Administrator will conduct an all staff in service training in regards to personal rights, harrasement, and job functions of all staff. Licensee will send proof of correction to LPA Vanegas via email by P.O.C due date.

Deadline recorded: Apr 30, 2025. A deadline is not proof that correction was completed.

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 LPA observation, medications were found to be stored outside the locked medical cabinet accessible to residents. Medications were observed stored in kitchen upper cabinets above designated medication cabinets. Cabinet does not have a lock. This poses an immediate safety risk to persons in care.

Official plan of correction

POC Due Date: 01/15/2025 Plan of Correction Facility placed all medication into the locked medication cabinet during the visit.

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 LPA observation, medications for Resident 5 (R5) were removed from the original container and placed into a separate pre-poured pill box container. LPA unable to verify R5's medications were being given as prescribed. This poses an immediate safety risk to persons in care.

Official plan of correction

POC Due Date: 01/15/2025 Plan of Correction Facility to contact pharmacy to request repacking into new combined bubble packs. Facility to audit medications. Facility to contact LPA on resolution.

Official classification

Type A

Official code

87465(c)(2)

Regulation authority

CCR

What the official deficiency says

(c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication, but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: (2) Once ordered by the physician the medication is given according to the physician's directions. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA observation and staff interview, Resident 1 (R1) medication is not being administered according to the physician's instructions. R1 was prescribed a stool softner to be given routinely. However, per staff, R1's hospice verbally instructed staff to administer as needed. Facility did not obtain a new written order. LPA unable to confirm order changes. This poses an immediate health risk to persons in care.

Official plan of correction

POC Due Date: 01/15/2025 Plan of Correction Adminstrator will be notified and will have hospice write new order.

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's review, the facility did not concuct an emergency drill in the fourth quarter of 2024. Last drill was conducted on August 09, 2024. This poses a potential safety risk to persons in care.

Official plan of correction

POC Due Date: 01/20/2025 Plan of Correction Facility will conduct emergency drills by January 19th, 2025

Official classification

Type B

Official code

87465(h)(1)(C)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (1) Medications shall be centrally stored under the following circumstances: (C) Because of potential dangers related to the medication itself, or due to physical arrangements in the facility and the condition or the habits of other persons in the facility, the medications are determined by either a physician, the administrator, or Department to be a safety hazard to others. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA observation and interview the licensee did not comply with the section cited above in two of three residents which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/29/2024 Plan of Correction Shellad Yturralde, with AD Almiranez, will update the Medication Administration Record (MAR) to include PRN medications for two residents. PRN meds were immediately taken from restroom and locked with centrally stored medications.

Official classification

Type A

Official code

87202(a)(2)

Regulation authority

CCR

What the official deficiency says

87202(a)(2):Fire Clearance All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department...Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notifythe licensing agency and obtain an appropriate fire clearance approved CONT... CONT...by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal.(2)Bedridden persons. This requirement was not met based on record review for Resident 1(R1). (R1) was admitted into the facility on 5/15/2021 CONTINUED...

Official plan of correction

Licensee to submit for a bedridden fire clearance and forward proof to LPA by POC due date of 3/2/2023. Based on record review, the licensee did not comply with the section cited above. LPA observed (R1) has bedridden status per physician report dated 05/24/2020. Facility does not have bedridden fire clearance. This poses an immediate health and safety risk to persons in care.CIVIL PENALTY ASSESSED.

Deadline recorded: Mar 1, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468(A)

Regulation authority

CCR

What the official deficiency says

87468(A): Personal Rights:Licensees may use the Residential Care Facility for the Elderly (RCFE) Complaint Poster (PUB 475) or may develop their own poster...The poster that is posted shall be 20 " x 26 " in size and be posted in the main entryway of the facility... This requirement was not met CONTINUED... CONT...as evidenced by: Based on today's facility inspection visit and observations made during today's visit, LPA Quiroz did not observe Let Us Know Poster posted in the main entryway of the facility. This poses a potential risk to residents in care.

Official plan of correction

L/AD Almiranez will make copy of poster in 20'' x 26'' measurements and post it in the main entryway of the facility and submit proof to CCL by 10/26/2022.

Deadline recorded: Oct 27, 2022. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87224(a)

Regulation authority

CCR

What the official deficiency says

87224(a) Eviction Procedures: (a)The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required except as otherwise specified in paragraph (5). This requirement was not met as evidenced by: Based on interviews conducted during today's visit. L/AD Almiranez evicted Resident 1 on 10/17/2022 verbally and did not provide a 30 day notice. This was verified with L/AD Amiranez. This poses an immediate risk to residents in care.

Official plan of correction

L/AD Almiranez will read and understand CCR 87224(a) Eviction Procedures and submit proof of understanding to CCL by 10/25/2022.

Deadline recorded: Oct 25, 2022. A deadline is not proof that correction was completed.