CARVER SENIOR HOMES 2

Official classification

Type B

Official code

87411(f)

Regulation authority

CCR

What the official deficiency says

(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure. A report shall be made of each screening, signed by the examining physician. The report shall indicate whether the person is physically qualified to perform the duties to be assigned, and whether he/she has any health condition that would create a hazard to him/herself, other staff members or residents. A signed statement shall be obtained from each volunteer affirming that he/she is in good health.Personnel with evidence of physical illness or emotional instability that poses a significant threat to the well-being of residents shall be relieved of their duties. 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 in one out of five staff. LPA observed S1's completed LIC503 was not available at the time of visit, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/26/2025 Plan of Correction Licensee states they will send a completed LIC503 of S1 to CCLD via email to edward.kim@dss.ca.gov by POC due date December 26, 2025.

Official classification

Type B

Official code

87463(a)

Regulation authority

CCR

What the official deficiency says

(a) The pre-admission appraisal, as specified in Section 87457, Pre-Admission Appraisal, shall be updated, in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition, as defined in Section 87101, Definitions, and to keep the appraisal accurate. For the purposes of this section, the updated pre-admission appraisal shall be referred to as the reappraisal. 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 in one out of six residents. LPA observed R1 most recent appraisal was conducted on August 5, 2024, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/26/2025 Plan of Correction Licensee states they will send an updated Reappraisal of S1 to CCLD via email to edward.kim@dss.ca.gov by POC due date December 26, 2025.

Official classification

Type B

Official code

87305(a)

Regulation authority

CCR

What the official deficiency says

Prior to construction or alterations, all facilities shall obtain a building permit. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and interview, the licensee did not comply with the section cited above. LPA observed a storage room in the garage that is not shown on the facility sketch. This poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/31/2024 Plan of Correction Licensee states they will remove the storage room from the garage and send proof that there is no storage room in the garage to CCLD via email to edward.kim@dss.ca.gov by POC due date December 31, 2024. Licensee will contact the city of Yorba Linda to verify if they need a permit to remove the storage room.

Official classification

Type B

Official code

1569.625(b)(1)

Regulation authority

HSC

What the official deficiency says

(1) The department shall adopt regulations to require staff members of residential care facilities for the elderly who assist residents with personal activities of daily living to receive appropriate training. This training shall consist of 40 hours of training. A staff member shall complete 20 hours, including six hours specific to dementia care... The remaining 20 hours shall include six hours specific to dementia care and shall be completed within the first four weeks of employment... 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 observed Staff #1 (S1) only completed 23 hours of training. This poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/31/2024 Plan of Correction Licensee states that Staff #1 will complete the remaining 17 hours of training and send proof to CCLD via email to edward.kim@dss.ca.gov by December 31, 2024.

Official classification

Type B

Official code

87621(a)(2)

Regulation authority

CCR

What the official deficiency says

Colostomy/Ileostomy (a) Except as specified in Section 87611(a), the licensee shall be permitted to accept or retain a resident who has a colostomy or ileostomy under the following circumstances: (2) If assistance in care of the ostomy is provided by an appropriately skilled professional. This requirement is not being met as evidenced by: During interviews with the licensee/Administrator LPA Haley was told they have not been trained by a skilled professional to provide care for the residents ileostomy.

Official plan of correction

Licensee/Administrator agrees to have a skilled professional train all staff members on proper Colostomy/Ileostomy care before admitting a resident who needs ostomy care. Licensee/Administrator agrees to provide this training to the department before admitting a new resident who needs ostomy care.

Deadline recorded: Nov 17, 2022. A deadline is not proof that correction was completed.