MAJINTIN VILLE

Official classification

Type B

Official code

1569.605

Regulation authority

HSC

What the official deficiency says

On and after July 1, 2015, all residential care facilities for the elderly, except those facilities that are an integral part of a continuing care retirement community, shall maintain liability insurance covering injury to residents and guests in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in the total annual aggregate, caused by the negligent acts or omissions to act of, or neglect by, the licensee or its employees. This requirement is not met as evidenced by: Deficient Practice Statement Based on records review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/02/2025 Plan of Correction Licensee agreed to send proof of insurance to the Department by 5-2-2025 5:00 PM.

Official classification

Type A

Official code

87202(a)(2)

Regulation authority

CCR

What the official deficiency says

(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: (2) Bedridden persons This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in 1 of 3 residents, which poses an immediate health and safety risk to persons in care. LPA Colvin observed that R1 is bedridden, according to their Physician's Report. Physician's Report additionally indicates that it is a permanent condition.

Official plan of correction

POC Due Date: 04/20/2024 Plan of Correction Licensee agrees to immedaitely notify the local Fire Department of the presence of a bedridden resident. Licensee additionally states that they will have the resident's physician either submit a statement that R1 is not bedridden, or they will redo the Physician's Report to reflect this. Copy to be submitted to LPA Colvin by Plan of Correction date of 4/20/24.

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. 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 1 area of the facility (cabinet under kitchen sink), which poses an immediate health and safety risk to persons in care. LPA Colvin observed numerous cleaning chemicals in the cabinet under the kitchen sink, which was unlocked and accessible.

Official plan of correction

POC Due Date: 04/20/2024 Plan of Correction Licensee agrees to immediately secure chemicals and to conduct walk-through of the facility to ensure no other unlocked chemicals. Licensee may self-certify once complete.

Official classification

Type B

Official code

87457(c)

Regulation authority

CCR

What the official deficiency says

(c) 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 is not met as evidenced by: Deficient Practice Statement Based onrecord review, the licensee did not comply with the section cited above in 1 of 3 residents, which posed a potential health, safety or personal rights risk to persons in care. LPA Colvin observed that R2 did not have a completed Pre-Admission Appraisal in their file.

Official plan of correction

POC Due Date: 05/03/2024 Plan of Correction Licensee agrees to complete a Pre-Admission Appraisal for R2 and provide a copy to LPA Colvin by the Plan of Correction date of 5/3/24.

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 interview, the licensee did not comply with the section cited above in4 of 4 quarterly disaster drills, which poses a potentia safety risk to persons in care. LPA Colvin confirmed with Licensee/Administrator that there are no documented Emergency Disaster Drills for the facility.

Official plan of correction

POC Due Date: 05/03/2024 Plan of Correction Licensee agrees to complete a Disaster Drill with staff and residents and maintain a record of the drill in a file at the facility. Licensee will create a tentative schedule for quarterly diaster drills. Proof of disaster drill and tentative schedule for future drills to be provided to LPA Colvin by Plan of Correction date of 5/3/24.

Official classification

Type B

Official code

87507(a)

Regulation authority

CCR

What the official deficiency says

Admission Agreements: (a) The licensee shall complete an individual written admission agreement, as defined in Section 87101(a), with each resident or the resident's representative, if any. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in 1 of 3 residents, which poses a potential personal rights risk to persons in care. LPA Colvin observed that R3's Admissions Agreement is primarily blank, with important information (such as facility information, rate for charges, and services provided) left blank

Official plan of correction

POC Due Date: 05/03/2024 Plan of Correction Licensee agrees to complete a new Admissions Agreement with R3/R3's family to ensure that they are aware and agreeing to the complete information needed to be present in the agreement. Licensee to provide a copy of the new Admissions Agreement to LPA Colvin by Plan of Correction date of 5/3/24.

Official classification

Type B

Official code

87506(a)

Regulation authority

CCR

What the official deficiency says

Resident Records: (a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in2 of 3 residents, which poses a potential personal rights risk to persons in care. LPA Colvin observed that R2 & R3 do not have a completed Needs & Services Plan in their file.

Official plan of correction

POC Due Date: 05/03/2024 Plan of Correction Licensee agrees to complete a Needs & Services Plan for R2 & R3 and provide a copy to LPA Colvin by Plan of Correction date of 5/3/24.

Official classification

Type B

Official code

87156(a)

Regulation authority

CCR

What the official deficiency says

Licensing Fees: (a) An applicant or licensee shall be charged fees as specified in Health and Safety Code section 1569.185. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above with outstanding Licensing Fees due to the Department, which poses a potential health, safety or personal rights risk to persons in care. LPA Colvin observed that the facility has outstanding Licensing Fees in the amount of $989.

Official plan of correction

POC Due Date: 05/03/2024 Plan of Correction Licensee agrees to pay the outstanding Licensing fees. Licensee may self-certify to LPA Colvin once complete. Due by Plan of Correction date of 5/3/24.

Official classification

Type B

Official code

87465(a)(4)

Regulation authority

CCR

What the official deficiency says

Incidental Medical and Dental Care: (a) A plan for incidental medical..shall be developed by each facility. The plan shall encourage routine medical ..provide for assistance in obtaining such care..(4) The licensee shall assist residents with self-administered medications as needed. This requirement was not being met as evidenced by: Based on interview, LPA discovered that staff were not assisting with R1 with receiving their medications nor in administrating them. This is a potential health and safety risk to residents in care.

Official plan of correction

Licensee to develop a plan to provide R1 with their medications, as well as conduct in-service training for staff on the cited regulation. Proof of such is to be provided to LPA by POC date.

Deadline recorded: May 24, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.2(a)(8)

Regulation authority

CCR

What the official deficiency says

Additional Personal Rights of Residents in Privately Operated Facilities: (a) In addition ..for the elderly shall have all of the following personal rights:(8) To be free from neglect, .. or sexual abuse. This requirement was not being met as evidenced by: Based on staff interview, LPA found that R1 was not being afforded baths by staff. This is a potential personal rights risk to residents in care.

Official plan of correction

Licensee agrees to conduct in-service training on the cited regulation (Personal Rights) and provide proof of training to LPA by POC date.

Deadline recorded: May 24, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87207

Regulation authority

CCR

What the official deficiency says

False Claims: No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility. This requirement was not met by: Based on observations and record review, the Licensee did not comply with the above regulation with staff training certificates. LPA Colvin observed the facility to be in possession of blank signed training records. This is an immediate safety risk to residents.

Official plan of correction

Licensee agrees to discard the certificates in question and ensure that all training documents for staff are legitimate and verifiable. No further Plan of Correction required.

Deadline recorded: Sep 1, 2021. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)(1)

Regulation authority

CCR

What the official deficiency says

Reporting Requirements: (a) Each licensee shall furnish...such reports... including,...:(1) A written report shall be submitted to the licensing agency...within seven days of the occurrence of any of the events... This requirement was not met by: Based on record review, the Licensee did not comply with the above regulation. LPA Colvin observed that no incident reports have been submitted to Licensing since July 2020. This is a potential safety risk for all residents in care.

Official plan of correction

Licensee to submit to LPA Colvin any incident reports from August 2020 to current date, to ensure that they are reviewed and logged. Licensee agrees to submit reports for all reportable incidents (according to Title 22 Regulations) to Licensing in timely manner. Plan of Correction date is 9/7/21.

Deadline recorded: Sep 7, 2021. A deadline is not proof that correction was completed.