LOIS GUEST HOME II

Official classification

Type A

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 cited above as there was a layer of small dead insects on the bottom rack of dry goods storage. This poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 10/07/2025 Plan of Correction Facility agreed to clean out storage area and provide proof to LPA by POC due date. Facility agreed to create a cleaning checklist and will provide by 10/07/2025.

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation licensee did not comply with the cited above as sharps such as knives were not secured in kithcen drawer as LPA was able to open drawer as it was not locked. This poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 10/01/2025 Plan of Correction Corrected during the visit.

Official classification

Type A

Official code

87355(e)(3)

Regulation authority

CCR

What the official deficiency says

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (3) Request a transfer of a criminal record clearance as specified in Section 87355(c) or 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 in 2 out of 2 as both Staff 1 and Staff 2 are background cleared but not associated to the facilty. This poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 10/01/2025 Plan of Correction Corrected during visit. Facility agreed to keep facility log for when new employees are hired and associated. An immediate civil penalty is assessed. Facilit

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 observation, the licensee did not comply with the section cited above as the medication cabinet was left unlocked which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 10/01/2025 Plan of Correction Facility corrected during the visit.

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 records reviewed facility did not comply with the cited above as the last drill was conducted on May 31st, 2025, which is not the most recent quarter. This poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 10/14/2025 Plan of Correction Licensee to conduct drill and provide proof to LPA by POC due date.

Official classification

Type B

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C). 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 out of three water testing. Facility water tested at 127.9 and 130.6 degrees F which poses a potential health, and safety risk to persons in care.

Official plan of correction

POC Due Date: 10/15/2024 Plan of Correction Licensee to adjust water temperature and forward proof to LPA by POC due date.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

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. LPA observed kitchen area is being used as storage, the wall in the jack and jill restroom is in need of repair and two smoke detectors are in need of batteries which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 10/15/2024 Plan of Correction Licensee to address noted items and forward proof to LPA by POC due date.

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

The following requirements shall apply to medications which are centrally stored: 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 observation, the licensee did not comply with the section cited above. LPA observed two resident's medications unsecured in the refrigerator (photos) which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 10/02/2024 Plan of Correction Licensee to secure noted items and forward proof to LPA by POC due date.

Official classification

Type B

Official code

87555(b)(8)

Regulation authority

CCR

What the official deficiency says

All food shall be of good quality. Commercial foods shall be approved by appropriate federal, state and local authorities. Food in damaged containers shall not be accepted, used or retained. 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 multiple expired items as well as soiled broccoli (photos) which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 10/15/2024 Plan of Correction Licensee to forward a statement of understanding of the regulation to LPA by POC due date.

Official classification

Type A

Official code

87705(f)(1)(2)

Regulation authority

CCR

What the official deficiency says

Care of persons with Dementia 87705(f)(1)(2)(f)The following shall be stored inaccessible to residents with dementia: (1) Knives...other items that could constitute a danger to the resident(s). (2) Over-the-counter medication, nutritional supplements or vitamins...Based on This requirement was not met as evidenced by:At 1:29pm, LPA Quiroz observed knives drawer next to stove and medication cabinet in kitchen area unlocked. This poses a potential health & safety for residents in care.House Manager and AD Forsyth stated " We forgot to lock it before leaving to lunch. "

Official plan of correction

House Manager Liliosa Manalili locked medication cabinet and knives drawer during today's inspection visit. AD Forsyth agreed to train all staff working in the facility on Care of persons with Dementia (87705) and submit proof of training by POC due date of 11/5/2021.

Deadline recorded: Oct 26, 2021. A deadline is not proof that correction was completed.