PICO DE LORO

Official classification

Type A

Official code

87468.2(a)(27)

Regulation authority

CCR

What the official deficiency says

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (a) In addition…residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (27) To keep, have access to, and use their own personal possessions, including … to…be allowed to spend their own money, unless limited by statute or regulation. This requirement was not met as evidenced by: Based on interview and record review the licensee used R1’s personal and incidental funds to pay to pay rent owed by R1 against R1’s wishes. This poses an immediate health safety or personal rights risk to residents in care.

Official plan of correction

The licensee agreed to pay R1 the money owed and send proof by the POC due date. The licensee stated new procedure for accounting for resident personal incidental funds and board and care.

Deadline recorded: Oct 3, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87303(e)(6)

Regulation authority

CCR

What the official deficiency says

(e) Water supplies and plumbing fixtures shall be maintained as follows: (6) Toilet, handwashing and bathing facilities shall be maintained in operating condition. Additional equipment shall be provided in facilities accommodating physically handicapped and/or nonambulatory residents, based on the residents' needs. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA Delgado's observation and interview, the licensee did not comply with the section cited above in which common bathroom next to Room #14 had a broken shower handle and sink faucet had a broken hot water knob which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/09/2024 Plan of Correction Licensee will repair items addressed and email photos or invoice to LPA by POC due date.

Official classification

Type B

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 LPA Delgado's observation and interview, the licensee did not comply with the section cited above in shampoo bottles, body spray, body wash was sitting on top of the common bathroom sink unattended which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/09/2024 Plan of Correction Licensee will do In-service training with staff and email sheet to LPA by POC due date.

Official classification

Type B

Official code

87555(b)(23)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (23) All readily perishable foods or beverages capable of supporting rapid and progressive growth of micro-organisms which can cause food infections or food intoxications shall be stored in covered containers at appropriate temperatures. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA Delgado's observation and interview, the licensee did not comply with the section cited above in hamburger meat was left out on sink counter, cooked food was left on counter, foods inside refrigerators was not in stored in containers which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/09/2024 Plan of Correction Licensee will conduct an In-service training with staff and submit a plan by email to LPA by POC due date.

Official classification

Type B

Official code

1569.695(a)(2)

Regulation authority

HSC

What the official deficiency says

(a)In addition to any other requirement of this chapter, a residential care facility for the elderly shall have an emergency and disaster plan that shall include, but not be limited to, all of the following: (2) Plans for the facility to be self-reliant for a period of not less than 72 hours immediately following any emergency or disaster, including, but not limited to, a short-term or long-term power failure. If the facility plans to shelter in place and one or more utilities, including water, sewer, gas, or electricity, is not available, the facility shall have a plan and supplies available to provide alternative resources during an outage. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA Delgado's observation and interview, the licensee did not comply with the section cited above in emergency food could not be differentiate from regular food supply for residents which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/09/2024 Plan of Correction Licensee will have separate emergency food and water and email photos and receipts if applicable to LPA by POC due date.

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 LPA Delgado's observation, interview and record review, the licensee did not comply with the section cited above in drill documentation was requested and unable to be provided was which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/09/2024 Plan of Correction Licensee will submit plan of conducting drills and drill documentation that will be used and email to LPA by POC due date.

Official classification

Type B

Official code

87203

Regulation authority

HSC

What the official deficiency says

All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshall for the protection of life and properly against fire and panic. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA Delgado's observation, interview and record review, the licensee did not comply with the section cited above in interior structural changes have been made to include bedroom for future residents and another space for live-in caregiver accomodations, twin beds for staff inside the medication area which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/09/2024 Plan of Correction Licensee will submit LIC200 to Regional office with changes, revised facility sketch and address items identified and email LPA by POC due date.

Official classification

Type B

Official code

87457(c)

Regulation authority

CCR

What the official deficiency says

87457 Pre-Admission Appraisal – General (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...with the admission ...This requirement has not been met as evidenced by: Based on record review, the licensee did not comply with the section cited above completeing R1's preadmission appraisal prior to the resident being admitted to the facility which posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

The licensee agreed to send a self certified statement stating that the licensee has read and reviewed the section cited here. This shall be sent to the LPA by the POC due date.

Deadline recorded: May 24, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.655(a)

Regulation authority

HSC

What the official deficiency says

Increase in fee rates for elderly residents...: (a)If a licensee of a residential care facility for the elderly increases the rates... the licensee shall provide no less than 60 days' prior written notice to the residents... This requirement was not bet as evidenced by: Based on interviews, Licensee failed to give R1's Power of Attorny a 60-day written notice regarding the fee increase and only gave the POA a verbal notice. This poses a potential risk to residents in care.

Official plan of correction

Licensee will review Health and Safety Code 1569.655 and send a statement of understanding to CCL by POC date.

Deadline recorded: Mar 29, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87468.1(a)(6)

Regulation authority

CCR

What the official deficiency says

Personal Rights of Residents in all residential care facilities for the elderly shall have all of the following personal rights: (6) To leave or depart the facility at any time and to not be locked into any room, building, or on facility premises by day or night. This does not prohibit a licensee from establishing house rules, such as locking doors at night to protect residents, or barring windows against intruders with permission from the Department. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA Delgado's observation and interview, LPA observed the front door to have a deadbolt lock and the dining area door had to be unlocked by key that was utilized by the Supervisor. The licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/30/2022 Plan of Correction Per the licensee, the deadbolt lock will be removed from the Front door, the door knobs for the front door and dining room will be replaced with door knobs that will not be locked from the inside at any day or time.

Official classification

Type A

Official code

87468.2(a)(20)

Regulation authority

CCR

What the official deficiency says

Additional Personal Rights of Residents in ...Facilities: (a) In addition to the rights listed ... residents...shall have all of the following personal rights: (20) To be protected from involuntary transfers, discharges, and evictions.... This requirement was not met ass evidenced by: Based on interviews conducted, the Licensee did not comply with the above regulation with one resident. The Licensee refused to readmit R1 after hospital discharge due to R1 being positive for COVID-19. R1 was subsequently transferred to SNF. This was an immedaite personal rights violation of R1.

Official plan of correction

Licensee agrees to submit Statement of Understanding regarding Licenee's responsiblity for providing care and superivision to residents, and expectation that residents will be re-admitted to the facility after discharge from the hospital, except for under specific circumstances. If the Licensee is unsure of if the situation calls for denial of readmittance to the facility, the Licensee agrees to consult with Licensing to ensure residents' rights are preserved and to prevent undue harm. Licensee to provide LPA Colvin with Statement of Understanding by the Plan of Correction date of 12/21/21.

Deadline recorded: Dec 21, 2021. A deadline is not proof that correction was completed.