RNCARE HOUSE @ EAST ROSEVILLE

Official classification

Type A

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 review and statement, the licensee did not comply with the section cited above in emergency drill log which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/20/2026 Plan of Correction Licensee will provide docuemtnation of emergency drill completed with all current staff by the POC adte of 3/20/26.

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 review and statements, the licensee did not comply with the section cited above in 2 of two files, S1 and S2, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/15/2026 Plan of Correction Licensee will submit docuemntation of all staff S1- S2 completing 20 hours of required traing for the past 12 months by the POC date of 4/15/26.

Official classification

Type B

Official code

87468.2(a)

Regulation authority

CCR

What the official deficiency says

Additional Personal Rights of Residents in Privately Operated Facilities (a)(20) To be protected from involuntary transfers, discharges, and evictions. This requirement was not met based on records and statements. This posed a risk to resident’s rights.

Official plan of correction

POC- licensee will submit a procedure for reappraisal and arrangement for transfer when a resident is deemed to require a higher level of care. POC due 9/2/25.

Deadline recorded: Sep 2, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87505(g)(5)(A)

Regulation authority

CCR

What the official deficiency says

Admission Agreements (g)5) Refund conditions. (A) Facility policy concerning refunds, including the conditions under which a refund for advanced monthly fees will be returned…A refund of any fees … within 15 days after the personal property is removed. This requirement was not met based on records and statements. This posed a risk to resident’s rights. This requirement was not met based on records and statements. This posed a risk to resident’s rights.

Official plan of correction

POC- an accounting of fees paid, daily rate (based on 30 day month), and calculation of refund owed as well as proof of reconciling money owed if applicable. POC due 9/2/25.

Deadline recorded: Sep 2, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87555(a)

Regulation authority

CCR

What the official deficiency says

(a) The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents an shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. All food shall be selected, stored, prepared and served in a safe and healthful manner. This requirement is not met as evidenced by: Deficient Practice Statement Based on observations, the licensee did not comply with the section cited above in that the facility's 2-day perishable and 7-day non-perishable food supply is insufficient (photos taken and detail of observation on LIC812) and spoiled food was observed in the cabinet, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/18/2023 Plan of Correction The facility shall provide a plan to the Department on the facility's food handling practices, to include but not limited to, ensuring that the facility ALWAYS has a sufficient food supply for both 2-day perishable and 7-day non-perishable, along with frequency of grocery shopping and review of stored food for expired and spoiled items. Plan will be implemented after submission.

Official classification

Type A

Official code

1569.695(f)

Regulation authority

HSC

What the official deficiency says

(f) A facility shall have both of the following in place: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and interviews with staff, the licensee did not comply with the section cited above in that the facility has been placing poles in the sliding glass doors in a residents bedroom and in the back of the house rendering them inoperable to staff and emergency personnel, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/18/2023 Plan of Correction The facility shall remove the poles from the sliding doors. All exits shall be free from obstruction at all times and staff and emergency personnel shall have access to all exits. ***Cleared during today's visit***

Official classification

Type B

Official code

87412(a)

Regulation authority

CCR

What the official deficiency says

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and interviews with staff, the licensee did not comply with the section cited above, there was no personnell records avialable for review, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/31/2023 Plan of Correction The licensee shall compile and retain complete personnel records for all staff that work or are present in the facility. These files shall be available for review for licensing upon request. Send proof of completed staff files to the Department by May 31, 2023.

Official classification

Type B

Official code

87506(b)

Regulation authority

CCR

What the official deficiency says

(b) Each resident's record shall contain at least the following information: This requirement is not met as evidenced by: Deficient Practice Statement Based on records reviews, the licensee did not comply with the section cited above in resident files -R1 needs single sided admission agreement, R1 & R2 need the facility representative needs to sign the admission agreement, All 3 residents missing a signed peronal rights form and safeguard for personal property, R3 missing emergency ID, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/31/2023 Plan of Correction The licensee shall compile and retain complete residentl records for all residents that are accepted or retained in the facility. These files shall be available for review for licensing upon request. Send proof of correction of missing information in resident records by May 31, 2023.

Official classification

Type B

Official code

87458(b)(1)

Regulation authority

CCR

What the official deficiency says

(b) The medical assessment shall include, but not be limited to: (1) A physical examination of the resident indicating the physician's primary diagnosis and secondary diagnosis, if any and results of an examination for communicable tuberculosis, other contagious/infectious or contagious diseases or other medical conditions which would preclude care of the person by the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on a record review, the licensee did not comply with the section cited above in that R1 is missing a TB test clearance on file, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/31/2023 Plan of Correction The licensee shall obtain a TB test clearance and retain a copy in R1s file by 5/31/23. Send proof of TB test clearance once obtained as correction to the Department.

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 interviews and record reviews, the licensee did not comply with the section cited above in that the facility is not conducting emergency disaster or fire drills and/or there is no documentation of drills being conducted, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/31/2023 Plan of Correction The facility shall begin conducting emergecy disaster drills per requirements (on all shifts) and documenting these drills as proof available for review. Send proof of first drill along with paln for ongoing drills per title 22 regulations.

Official classification

Type B

Official code

87608(a)

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: 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 that R3 is using half bedrails as postural supports but there are no physician orders on file, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/31/2023 Plan of Correction The licensee shall obtain MD orders for R3 for 1/2 bedrails as postural supports and retain a copy in the residents file. Send proof of correction.

Official classification

Type B

Official code

87705(c)

Regulation authority

CCR

What the official deficiency says

(c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: This requirement is not met as evidenced by: Deficient Practice Statement Based on observations the licensee did not comply with the section cited above in that there were a number of items either missing or not safe guarded as required for residents with dementia (knives accessible, stove range accessible, out-dated MD report, exits not alarmed, etc.), which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/31/2023 Plan of Correction The licensee shall review 87705 and enusre the facility is taking all required precautions for residents with dementia. Send proof of identified issues that have been fixed (including noted items listed above).

Official classification

Type A

Official code

87207(a)

Regulation authority

CCR

What the official deficiency says

All facilities shall maintain a fire clearance approval by the city , county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal... This requirement is not met as evidenced by: Deficient Practice Statement Based on observations, the licensee did not comply with the section cited above in that the handle on the fire door for the hall leading to resident bedrooms the handle is reversed so that the lock is outside, inaccessible to residents. There is also a wedge next to the fire door for proping the door open which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/18/2023 Plan of Correction The licensee shall remove the handle that locks residents in the hall and replace it with a handle that does not have a lock and shall no longer utilze the wedge that props the door open. ***Cleared during visit***