PHAMILY HOME ELDERLY CARE 2

Official classification

Type A

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

(e) Water supplies and plumbing fixtures shall be maintained as follows: (2) 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 degrees C) and not more than 120 degree F (49 degrees C). This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, LPA observed bathroom #1 measure at 143.7 degrees Fahrenheit and bathroom #2 measure at 144.1 degrees Fahrenheit. The licensee did not comply with the section cited above in two out of two bathrooms which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/25/2024 Plan of Correction Licensee adjusted the temperature to bathroom #1 to measure at 106.1 degrees Fahrenheit and bathroom #2 meaure at 108.3 degrees Fahrenheit. Licensee states they will send a water temperature log for every 2 hours measuring the water temperature of each sink from October 24, 2024, 5:00pm to October 25, 2024, 5:00pm.

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 and interview, LPA observed the front left burner on the oven was not lighting up. The licensee did not comply with the section cited above in one out of six burners which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/07/2024 Plan of Correction Licensee states they will send POC correction to CCLD via email to edward.kim@dss.ca.gov by POC due date November 7, 2024.

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 observation, interview, and record review, LPA observed S1, S2, S3, S4, S5, and S6 training hours of 2024 were not available from the facility at the time of the visit. The licensee did not comply with the section cited above in six out of six staff members which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/07/2024 Plan of Correction Licensee states they will send the missing 2024 training hours for S1, S2, S3, S4, S5, and S6 to CCLD via email to edward.kim@dss.ca.gov by POC due date November 7, 2024.

Official classification

Type B

Official code

87705(c)(5)

Regulation authority

CCR

What the official deficiency says

(c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (5) Each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, both of which shall include a reassessment of the resident's dementia care needs. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, and record review, LPA observed R2 and R3 did not have a current medical assessment. R2, R3, R4, and R5 did not have a current reappraisal and needs service plan The licensee did not comply with the section cited above. This poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/07/2024 Plan of Correction Licensee states they will send the an updated Phsyicians report for R2 and R3, and reappraisal for R2, R3, R4, and R5 to CCLD via email to edward.kim@dss.ca.gov by POC due date November 7, 2024.

Official classification

Type A

Official code

87457(a)(c)

Regulation authority

CCR

What the official deficiency says

(a)(c)(1)Prior to admission a determination of the prospective resident's suitability for admission shall be completed and shall include an appraisal of his/her individual service needs in comparison with the admission criteria specified in Section 87455, Acceptance and Retention Limitations. This requirement was not met as evidence by: Based on records reviewed LPA did not observed a Pre-Admission Appraisal for R1. This poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee to complete a preadmission Appraisal and email proof to LPA by POC due date.

Deadline recorded: Sep 25, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87224(a)(3)(4)

Regulation authority

CCR

What the official deficiency says

87224 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...(3)Failure of the resident to comply with general policies of the facility. (4) If, after admission, it is determined that the resident has a need not previously identified and a reappraisal has been conducted pursuant to Section 87463... Based on record review and interviews conducted R1 was not issued a 30-Day Eviction notice. This poses a potential health, safety or personal rights risk to persons in care

Official plan of correction

Licensee to issue a 30-Day Eviction notice to R1 and email a copy to LPA by POC due date.

Deadline recorded: Sep 27, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87464(f)(1)

Regulation authority

CCR

What the official deficiency says

(f) Basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement is not met as evidence by: Based on interviews conducted AD reported he is not able to take R1 back into the facility. Per AD he told the Hospital to find a new place for R1. This poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee to read and sign a statement of understanding. Licensee to email a copy to LPA by POC due date.

Deadline recorded: Sep 25, 2024. A deadline is not proof that correction was completed.

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 record review, the licensee did not comply with the section cited above in 3 out of 5 resident files as they did not contain physician's order for postural supports which poses a potential personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/10/2022 Plan of Correction Licensee to remove rails and obtain physician's order for postural supports.

Official classification

Type A

Official code

87705(f)(2)

Regulation authority

CCR

What the official deficiency says

The following shall be stored inacessible to residents with Dementia: 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: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. Licensee did not secure cleaning chemicals/razors which poses immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 10/04/2022 Plan of Correction Licensee corrected during visit.