MERCY HOME 3

Official classification

Type B

Official code

1569.618(c)(3)

Regulation authority

HSC

What the official deficiency says

(c)The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staff to provide CPR. 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 having two staff with expire CPR which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/28/2026 Plan of Correction The Licensee stated staff will be renewing their CRP/1st Aid training and will provided a copy to LPA Rico.

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 [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/28/2026 Plan of Correction The Licensee stated they will conduct an emergency drill for all staff and provided a copy to LPA Rico.

Official classification

Type B

Official code

87355(e)(3)

Regulation authority

CCR

What the official deficiency says

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (3) Request a transfer of a criminal record clearance as specified in Section 87355(c) or This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview and record revie], the licensee did not comply with the section cited above by not ensuring that Staff #2 (S2) criminal backgrpund clearance was transferred to the facility proior to employment which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/07/2025 Plan of Correction Licensee stated to transfer S2 criminal background clearance to the facility and submit proof to LPA Brown by the Plan of Correction (POC) due date.

Official classification

Type B

Official code

87507(c)

Regulation authority

CCR

What the official deficiency says

(c) Admission agreements shall be signed and dated, acknowledging the contents of the document, by the resident or the resident's representative, if any, and the licensee or the licensee's designated representative no later than seven days following admission. Attachments to the agreement may be utilized as long as they are also signed and dated as prescribed above. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview and record review, the licensee did not comply with the section cited above by not ensuring that Resident #2 (R2) Admission Agreement was signed and dated by the Licensee/Facility Representative which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/07/2025 Plan of Correction Licensee signed R2 Admission Agreement during the visit. POC cleared.

Official classification

Type A

Official code

87608(a)(5)(B)

Regulation authority

CCR

What the official deficiency says

87608 Postural Supports (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...(5) Under no circumstances shall postural supports include tying, depriving, or limiting the use of a resident's hands or feet. (B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails. This requirement is not met as evidenced by: Based on observation, interview, record review, the licensee did not comply with the section cited above by having a full bed rail for Resident #3 (R3) and R3's not on hospice and no exception was submitted and approved to CCLD which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee stated to remove R3's full bed rail and submit proof to LPA Brown on Plan of Correction (POC) due date.

Deadline recorded: Jul 23, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87608(a)(3)

Regulation authority

CCR

What the official deficiency says

87608 Postural Supports (a) Based on the individuals preadmission appraisal....(3) A written order from a physician indicating the need for the postural support shall be maintained in the residents record. The licensing agency... This requirement is not met as evidenced by: Based on observation, interview and record review, the licensee did not comply with the section cited above by having Resident #2 (R2) and Resident #4 (R4), with half bed rails with no written order from their physician indicating the need for the postural support for mobility which poses a potential health, safety and personal rights risks to resident in care.

Official plan of correction

The Licensee stated to submit written order from R2 and R4 physician indicating the need for the postural support for mobility and submit proof to LPA Brown on plan of correction (POC) due date.

Deadline recorded: Aug 5, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87705(j)

Regulation authority

CCR

What the official deficiency says

87705 Care of Persons with Dementia (j) The licensee shall have an auditory device or other staff alert feature to monitor exits, if exiting presents a hazard to any resident. This requirement is not met as evidenced by: Deficient Practice Statement This requirement is not met as evidenced based on interview and observation, the licensee did not comply with the section cited above evidenced by not having an auditory devices on the facility exits on the front entry door, the backdoor sliding door, and in Resident R1’s bedroom which poses a potential health, safety, or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/15/2024 Plan of Correction The licensee has agreed to read regulation 87705 entirely and send LPA a statement of understanding that the regulation was read and understood. The licensee has agreed to install auditory devices on all facility exits. POC is due by 1/15/2024.