SWAN LAKE VILLA

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 three staff files require completed annual training, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/09/2026 Plan of Correction Administrator agrees to submit current annual training to LPA by the POC due date of 7/9/26.

Official classification

Type A

Official code

87203

Regulation authority

CCR

What the official deficiency says

This requirement is not met as evidenced by: facility garage being used as two staff bedrooms. Deficient Practice Statement Based on observation 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: 06/13/2023 Plan of Correction Aurora and Licensee Andrew to find alternative living place for two staff. Facility to submit document stating that staff are no longer living in the garage by end of day 6/13/2023. Possibly to convert garage into approved staff living spaces in the future.

Official classification

Type B

Official code

87411

Regulation authority

CCR

What the official deficiency says

This requirement is not met as evidenced by: three staff files not containing TB records. Deficient Practice Statement Based record review, the licensee did not comply with the section cited above in 3 out of 4 staff files reviewed which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/10/2023 Plan of Correction Facility to provide proof of staff TB tests/results by POC date.

Official classification

Type A

Official code

87615(a)(2)

Regulation authority

CCR

What the official deficiency says

Persons who require health services for or have a health condition including, but not limited to, those specified below shall not be admitted or retained in a residential care facility for the elderly: Gastrostomy tubes. The facility accepted resident R1 with a gastrostomy tube.

Official plan of correction

The facility will submit a request for an exception to Title 22 Section 87615 (a)(2) The facility has already submitted an exception request to CCL on this date 10/28/2021.

Deadline recorded: Oct 28, 2021. A deadline is not proof that correction was completed.