ANGELIC HANDS ASSISTED LIVING

Official classification

Type A

Official code

80088(e)(1)

Regulation authority

CCR

What the official deficiency says

80088 Furniture, Fixtures, Equipment, and Supplies (e) Faucets used by clients for personal care such as shaving and grooming shall deliver hot water. (1) Hot water temperature controls shall be maintained to automatically regulate temperature of hot water delivered to plumbing fixtures used by clients to attain a hot water temperature of not less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C). This requirement is not met as evidenced by: Based on observation and interview, licensee did not meet this requirement evidenced by the hot water temperature measuring at 132.4 degrees, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee agreed to adjust the water temperature and record the reading for ten(10) days and send proof to LPA by POC due date

Deadline recorded: Feb 13, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

85066(b)

Regulation authority

CCR

What the official deficiency says

85066 Personnel Records (b) A dated employee time schedule shall be developed at least monthly, shall be displayed conveniently for employee reference and shall contain the following information for each employee: (1) Name. (2) Job title. (3) Hours of work. (4) Days off. This requirement is not met as evidenced by: Based on observation and interview, the licensee did have a personnel roster which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee agreed to send proof of personnel roster by POC due date.

Deadline recorded: Feb 19, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87506(a)

Regulation authority

CCR

What the official deficiency says

87506 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: Based on observation and interview, the licensee did have a record of one resident, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee agreed to send copies of resident's current records to LPA by POC due date.

Deadline recorded: Feb 19, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87204(a)

Regulation authority

CCR

What the official deficiency says

(a) A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including specification of the maximum number of persons who may receive services at any one time. An exception may be made in the case of catastrophic emergency when the licensing agency may make temporary exceptions to the approved capacity. 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 three (3) out of four (4) residents are under the age of 60, exceeding the departments limitation of accepting a resident under the age of 60 in a resident care facility for the elderly (RCFE) which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/20/2024 Plan of Correction Discussion of POC will be determined at a later date. Conversation of the Plan of Correction will be notated on an LIC812.

Official classification

Type B

Official code

87208(7)(a)

Regulation authority

CCR

What the official deficiency says

This requirement is not met as evidenced by: (7) Sketches, showing dimensions, of the following: (A) " Building(s) to be occupied, including a floor plan that describes the capacities of the buildings for the uses intended and a designation of the rooms to be used... " Deficient Practice Statement Based on observation, interview, and record review, the licensee did not comply with the section cited above due to staff residing in a common area (nook) that was not established in the facility sketch provided to CCL which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/20/2024 Plan of Correction Submission of an updated plan of operation with an updated to facility sketch will be sent to CCL or the removal of staff belongings if Licensee chooses not to have live-in staff afterall.

Official classification

Type A

Official code

87507(g)(5)(E)(2)(b)

Regulation authority

CCR

What the official deficiency says

Admission Agreements: (g)...shall..:(5) Refund...(E) Preadmission fees shall be refunded...: 2...fees that are greater than ...($500) shall be refunded...:a. A refund of at least 80 percent...iin excess of $500...resident leaves the facility for any reason during the first month of residency. The Licensee did not comply with the above regulation with at least one resident. R2resided at the facility for less than one month before passing away. Family removed items from facility and was not provided any refund of preadmission fees. This was an immediate personal rights violation of R2.

Official plan of correction

Licensee agrees to provide a refund of $800 to R2's family, as well as review Title 22 Regulations section 87507 in regards to Admissions Agreements, Licensee to provide LPA Colvin with proof of refund to R2's family and may self-certify that they have thuroughly read the regulation section. Due by 10/14/22

Deadline recorded: Oct 14, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87507(g)(3)(B)(1)

Regulation authority

CCR

What the official deficiency says

Admission Agreements: (g)...shall specify the following: (3) Payment provisions, including the following: (B) Rate for additional items and services, including: 1. A...description of and the corresponding fee schedule for all additional items and services not included in the fees for basic services... The Licensee did not comply with the above regulation with at least one resident. LPA Colvin observed that R1's agreement had written in additional services (hairbuts, transportation), without listing cost of these additional services. This was a potential personal rights violation of R1.

Official plan of correction

Licensee agrees to provide LPA Colvin and R1 with a detailed breakdown of costs for each additional fee charged to R1, per what is listed in the Admissions Agreement, as well as how frequently these services are/where provided and charged. Due by Plan of Correction date of 10/28/22.

Deadline recorded: Oct 28, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87208(a)(2)

Regulation authority

CCR

What the official deficiency says

Plan of Operation: (a) Each facility shall have and maintain a current, written definitive plan of operation...Any significant changes in the plan of operation...shall be submitted to the licensing agency for approval. The plan and related materials shall contain the following: (2)...Admission Agreement... The Licensee did not comply with the above regulation with at least one resident. LPA Colvin observed that the Admissions Agreement for R1 was entirely different than the Admissions Agreement Licensing has on file from the application for licensure. This is a potential personal rights violation of R1.

Official plan of correction

Licensee agrees to immediately cease using the Admissions Agreement used for R1, as LPA Colvin observed multiple Title 22 violations in the document. Licensee to either return to initial approved agreement, or create a new Admissions Agreement and submit to LPA Colvin for review prior to use. Licensee to additionally review all current resident files and deermine if any residents have a signed Admissions Agreement other than what was previously approved during facility's application for a license. Licensee to inform LPA Colvin of findings of audit. Due by Plan of Correction date of 10/28/22.

Deadline recorded: Oct 28, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)(1)(A)

Regulation authority

CCR

What the official deficiency says

Reporting Requirements: (a) Each licensee shall furnish to the licensing agency such reports... including...: (1) A written report shall be submitted...within seven days of the occurrence of any of the events...(A)Death of any resident from any cause regardless of where the death occurred... The Licensee did not comply with the above regulation with at least one resident. LPA Colvin observed that R2 passed away in September 2022, but Licensing never received a Death Report from the facility.

Official plan of correction

Licensee agrees to provide LPA Colvin with a Death Report for R2. Due by Plan of Correction date of 10/28/22

Deadline recorded: Oct 28, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87506(d)

Regulation authority

CCR

What the official deficiency says

Resident Records: (d) All resident records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours.... This requirement was not met as evidenced by: Based on observation and interview, the Licensee did not comply with the above regulation with one resident file. LPA Colvin was unable to access records for R2 during the inspection. This is a potential personal rights violation.

Official plan of correction

Licensee agrees to provide LPA Colvin with a complete copy of R2's file by Plan of Correction date of 10/28/22. This may be subitted via email, fax, postal mail, or drop off at the Spruce Street Office in Riverside.

Deadline recorded: Oct 28, 2022. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87506(d)

Regulation authority

CCR

What the official deficiency says

Resident Records: (d) All resident records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours.... This requirement was not met as evidenced by: Based on observation and interview, the Licensee did not comply with the above regulation with one resident file. LPA Colvin was unable to access records for R1 during the inspection. This is an immediate safety risk to residents.

Official plan of correction

Licensee agrees to provide LPA Colvin with a complete copy of R1's file by Plan of Correction date of 8/30/22. This may be subitted via email, fax, postal mail, or drop off at the Spruce Street Office in Riverside.

Deadline recorded: Aug 30, 2022. A deadline is not proof that correction was completed.