BUENA VISTA ASSISTED LIVING

Official classification

Type B

Official code

80061(b)(1)(E)

Regulation authority

CCR

What the official deficiency says

80061 Reporting Requirements (b) ...during the operation of the facility... a report shall be made to the licensing agency...(1) Events reported shall include the following(E) Any unusual incident or client absence which threatens the physical or emotional health or safety of any client. Requirement was not being met as evidenced by: Licensee did not report SIRs to the Department for the power outage that occured on 1-8-25 at 12:30 PM

Official plan of correction

Licensee will conduct staff training on the reporting requirements and provide proof of training and training material to LPA by the plan of correction date.

Deadline recorded: Jan 23, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87355(b)

Regulation authority

CCR

What the official deficiency says

87355 Criminal Record Clearance (b) Prior to the Department issuing a license, the applicant, administrator and any adults other than a client, residing in the facility shall have a criminal record clearance or exemption. Based on observation, interview and record review This is a requirement is not met as evidenced by: 1 out of 1 times the licensee failed to have staff obtain proper fingerprint clearance before at the facility. This poses an immediate health, safety and personal rights risk to persons in care.

Official plan of correction

The licensee agrees to have S1 obtain fingerprint clearance and associated S1 to the facility. POC is to be submitted to the department by 5pm on the due date indicated.

Deadline recorded: Jun 21, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87211(a)(1)(D)

Regulation authority

CCR

What the official deficiency says

Reporting Requirements: (a) Each licensee shall furnish…reports as the Department may require, including, but not limited to, the following: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case.: (D) Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview and record review, the licensee did not comply with the section cited above in at least one outbreak of COVID-19, which posed an immediate health and safety risk to persons in care. LPA Colvin learned that while the Administrator left a message for Community Care Licensing on a voicemail regarding the COVID-19 positive cases, no additional follow-up to ensure the report went through was made, including a written incident report.

Official plan of correction

POC Due Date: 07/27/2022 Plan of Correction Licensee to submit Statement of Understnading regarding the requirements for reporting COVID-19 cases, as well as submit the requested COVID-19 positive case summary (provided by LPA Colvin) for each case from the last outbreak. Statement of Understanding and Positive Case SUmmaries due by Plan of Correction date of 7/26/22.

Official classification

Type B

Official code

1569.185(a)

Regulation authority

HSC

What the official deficiency says

Fees for license or applications; use of revenues; collected; denial or forfeiture: (e) The failure of an applicant for licensure or a licensee to pay all applicable and accrued fees and civil penalties shall constitute grounds for denial or forfeiture of a license. This requirement was not met by: 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 one year of Licensing Fees (2022) which poses a potential safety risk to persons in care. LPA Colvin observed that the Licensee has not yet paid the annual fees for 2022, which are now past due in the amount of $1,238.00.

Official plan of correction

POC Due Date: 08/09/2022 Plan of Correction Licensee agrees to pay all fees due to Licensing and provide LPA Colvin with a self-certification of fees paid by the Plan of Correction date of 7/26/22.