NEW HOPE RESIDENTIAL ELDER CARE III

Official classification

Type B

Official code

87470(c)(1)(D)

Regulation authority

CCR

What the official deficiency says

(c) An Infection Control Plan shall be developed by the licensee and shall be included in the Plan of Operation required by Section 87208. (1) The Infection Control Plan shall include all of the following: (D) The licensee shall review the use of infection control procedures in the facility at least annually, if local government public health determines an epidemic outbreak has occurred, or if the review is requested by the local licensing agency. 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 which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/28/2026 Plan of Correction Per caregiver,the license will update the plan and submit proof to LPA by POC date via email.

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 observation, record review, the licensee did not comply with the section cited above by not having a current insurance update or available which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/28/2026 Plan of Correction Per caregiver,the license will update/ renew and submit proof to LPA by POC date via email .

Official classification

Type B

Official code

87305(a)

Regulation authority

CCR

What the official deficiency says

(a) Prior to construction or alterations, all facilities shall obtain a building permit. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation record review, the licensee did not comply with the section cited above by having an additional bed in room 5 prior to fire clearance which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/28/2026 Plan of Correction Per caregiver, the license will update/ renew and submit picture proof to LPA by POC date via email .

Official classification

Type B

Official code

87307(a)

Regulation authority

CCR

What the official deficiency says

(a) Living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents, staff, and others who may reside in the facility. The following provisions shall apply: 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 by having 3 twin staff bed in staff room which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/28/2026 Plan of Correction Per caregiver, the license will remove the beds in staff room submit proof to LPA by POC date via email .

Official classification

Type A

Official code

87411(f)

Regulation authority

CCR

What the official deficiency says

(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure. A report shall be made of each screening, signed by the examining physician. The report shall indicate whether the person is physically qualified to perform the duties to be assigned, and whether he/she has any health condition that would create a hazard to him/herself, other staff members or residents. A signed statement shall be obtained from each volunteer affirming that he/she is in good health.Personnel with evidence of physical illness or emotional instability that poses a significant threat to the well-being of residents shall be relieved of their duties. 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 by not having staff 2have completed TB negative results in file which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/10/2026 Plan of Correction Per caregiver,the license will not allow staff 2 to work and have S2 complete TB test and submit results proof to LPA by POC date via email .

Official classification

Type B

Official code

87470(c)(1)(D)

Regulation authority

CCR

What the official deficiency says

(c) An Infection Control Plan shall be developed by the licensee and shall be included in the Plan of Operation required by Section 87208. (1) The Infection Control Plan shall include all of the following: (D) The licensee shall review the use of infection control procedures in the facility at least annually, if local government public health determines an epidemic outbreak has occurred, or if the review is requested by the local licensing agency. 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: Plan of Correction

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 [(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: Plan of Correction

Official classification

Type B

Official code

87465(a)(8)(A)

Regulation authority

CCR

What the official deficiency says

(8) If a facility has no medical unit on the grounds, a complete first aid kit shall be maintained and be readily available in a specific location in the facility. The kit shall be a general type approved by the American Red Cross, or shall contain at least the following: (A) A current edition of a first aid manual approved by the American Red Cross, the American Medical Association or a state or federal health agency. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation 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: 08/28/2026 Plan of Correction Per caregiver,the license will purchase a manual and submit picture proof to LPA by POC date via email .

Official classification

Type B

Official code

1569.695(d)

Regulation authority

HSC

What the official deficiency says

(d) A facility shall review the plan annually and make updates as necessary, including changes in floor plans and the population served. The licensee or administrator shall sign and date documentation to indicate that the plan has been reviewed and updated as necessary. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, record review, the licensee did not comply with the section cited above by not having the plan completed or updated which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/28/2026 Plan of Correction Per caregiver,the license will update and send a copy to LPA by POC date via email .

Official classification

Type A

Official code

87458(c)(1)(A)

Regulation authority

CCR

What the official deficiency says

(c) The medical assessment shall include, but not be limited to: (1) A physical examination of the resident indicating the licensed medical professional's diagnosis or diagnoses and results of an examination for all of the following: (A) Communicable tuberculosis. 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 by R1 not having a completed TB results on file. Which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/10/2026 Plan of Correction Per caregiver,the license will have R1 conduct TB test and submit proof to LPA by POC date via email .

Official classification

Type A

Official code

87309(a)(1)

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. (1) Storage areas for poisons, and firearms and other dangerous weapons shall be locked. 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 the two (2) gallons of chemicals in the shed at the backyard were locked and making it not accessible to residents in care which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/23/2024 Plan of Correction Licensee stated to train all staff on CCR 87309(a)(1) and submit proof of all staff training log to LPA Brown on Plan of Correction (POC) due date.

Official classification

Type A

Official code

87412(a)(11)

Regulation authority

CCR

What the official deficiency says

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (11) A health screening as specified in Section 87411, Personnel Requirements - General. 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 Staff #2 (S2) completed the required Health Screening Report which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/23/2024 Plan of Correction Licensee stated to submit proof of S2 Medical Appointment to complete the required Health Screening to LPA Brown on Plan of Correction (POC) due date.

Official classification

Type A

Official code

87412(a)(12)

Regulation authority

CCR

What the official deficiency says

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (12) Hazardous health conditions documents as specified in Section 87411, Personnel Requirements - General. 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 Staff #2 (S2), Staff #3 (S3) and Staff #4 (S4) completed the required Tuberculosis (TB) Test and TB Test Result maintained in their file which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/23/2024 Plan of Correction Licensee stated to submit proof of Medical Appointment of S2, S3 and S4 to complete the required TB Test to LPA Brown on POC due date.

Official classification

Type A

Official code

87411(d)

Regulation authority

CCR

What the official deficiency says

(d) All personnel shall be given on the job training or have related experience in the job assigned to them. This training and/or related experience shall provide knowledge of and skill in the following, as appropriate for the job assigned and as evidenced by safe and effective job performance: 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 providing the required job training to Staff #4 (S4) which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/23/2024 Plan of Correction Licensee stated to provide S4 the required job training and submit proof to LPA Brown on PLan of Correction (POC) due date,

Official classification

Type A

Official code

1569.625(b)(2)

Regulation authority

HSC

What the official deficiency says

(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. 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 by not ensuring that the 20 hours training requirements were provided to Staff #4 (S4) which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/23/2024 Plan of Correction Licensee stated to provide the proof of enrollment on the required 20 hours training to S4 and submit proof to LPA Brown on POC due date.

Official classification

Type A

Official code

1569.626(a)(1)

Regulation authority

HSC

What the official deficiency says

(a) All residential care facilities for the elderly shall meet the following training requirements, as described in Section 1569.625, for all direct care staff: (1) Twelve hours of dementia care training, six of which shall be completed before a staff member begins working independently with residents, and the remaining six hours of which shall be completed within the first four weeks of employment. All 12 hours shall be devoted to the care of persons with dementia. The facility may utilize various methods of instruction, including, but not limited to, preceptorship, mentoring, and other forms of observation and demonstration. The orientation time shall be exclusive of any administrative instruction. 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 ensuroing that the required 12 hours of dementia training was provided to Staff #4 (S4) which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/23/2024 Plan of Correction Licensee stated to provide proof of enrollment of S4 on the required 12 hours of dementia training to LPA Brown on POC due date.

Official classification

Type A

Official code

87465(a)(8)(A)

Regulation authority

CCR

What the official deficiency says

(8) If a facility has no medical unit on the grounds, a complete first aid kit shall be maintained and be readily available in a specific location in the facility. The kit shall be a general type approved by the American Red Cross, or shall contain at least the following: (A) A current edition of a first aid manual approved by the American Red Cross, the American Medical Association or a state or federal health agency. 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 a first aid manual approved by the American Red Cross or the Amercian Medical Association is available at the facility which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/23/2024 Plan of Correction Licensee stated to obtain a first aid manual approved my red cross or american medical association and submit proof to LPA Brown on Plan of Correction (POC) due date.

Official classification

Type A

Official code

87608(a)(5)(B)

Regulation authority

CCR

What the official deficiency says

(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: Deficient Practice Statement Based on observation, interview, and record review, the licensee did not comply with the section cited above by having full bed rail for Resident #1 (R1), Resident #2 (R2), Resident #3 (R3), Resident #4 (R4) which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/23/2024 Plan of Correction Licensee stated to remove all full bed rail for R1, R2, R3 and R4 and submit proof to LPA Brown on POC due date.

Official classification

Type B

Official code

87305(a)

Regulation authority

CCR

What the official deficiency says

Prior to construction or alterations, all facilities shall obtain a building permit. 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 altering the den at the facility to a staff room without obtaining a building permit which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/06/2024 Plan of Correction Licensee stated to obtain building permit and write a letter to CCLD to notify alteration completed at the facility and submit proof to LPA Brown on Plan of Correction (POC) due date.

Official classification

Type B

Official code

1569.696(a)

Regulation authority

HSC

What the official deficiency says

(a) All residential care facilities for the elderly shall provide training to direct care staff on postural supports, restricted conditions or health services, and hospice care as a component of the training requirements specified in Section 1569.625. The training shall include all of the following: 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 by not providing the required postural support training to Staff #4 (S4) which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/05/2024 Plan of Correction Licensee stated to provide the required postural support training to S4 and submit proof to LPA Brown on POC due date.

Official classification

Type B

Official code

1569.696(a)(1)

Regulation authority

HSC

What the official deficiency says

(a) All residential care facilities for the elderly shall provide training to direct care staff on postural supports, restricted conditions or health services, and hospice care as a component of the training requirements specified in Section 1569.625. The training shall include all of the following: (1) Four hours of training on the care, supervision, and special needs of those residents, prior to providing direct care to residents. The facility may utilize various methods of instruction, including, but not limited to, preceptorship, mentoring, and other forms of observation and demonstration. The orientation time shall be exclusive of any administrative instruction. 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 providing the required four (4) hours training to Staff #4 on the care, supervision and special needs of residentsin which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/05/2024 Plan of Correction Licensee stated to provide the required 4 hours of training to S4 and submit proof to LPA Brown on POC due date.

Official classification

Type B

Official code

87465(a)(8)(C)

Regulation authority

CCR

What the official deficiency says

(8) If a facility has no medical unit on the grounds, a complete first aid kit shall be maintained and be readily available in a specific location in the facility. The kit shall be a general type approved by the American Red Cross, or shall contain at least the following: (C) Bandages or roller bandages. 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 the facility have a complete first aid kit as evidenced of missing bandages or roller bandages which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/05/2024 Plan of Correction Licensee stated to purchase or obtain bandages or roller bandages and submit proof to LPA Brown on POC due date.

Official classification

Type A

Official code

87705(c)(4)(A)

Regulation authority

CCR

What the official deficiency says

87705 Care of Persons with Dementia (4) There is an adequate number of direct care staff to support each resident’s physical, social, emotional, safety and health care needs as identified in his/her current appraisal. (A) In addition to requirements specified in Section 87415, Night Supervision, a facility with fewer than 16 residents shall have at least one night staff person awake and on duty if any resident with dementia is determined through a pre-admission appraisal, reappraisal or observation to require awake night supervision. 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 having a staff scheduled to work the night shift as required for a facility with dementia residents which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/23/2024 Plan of Correction Licensee stated to submit an updated Personnel Report (LIC500) and Staff Schedule indicating Night Shift coverage to LPA Brown on Plan of Correction (POC) due date.

Official classification

Type A

Official code

87465(h)(5)

Regulation authority

CCR

What the official deficiency says

87465. Incidental Medical and Dental Care.(h)The following requirements shall apply to medications which are centrally stored: (5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. This requirement is not met as evidenced by observation, the licensee did not comply with the section cited above by storing resident's medications in containers that are not the original prescription bottles from the pharmacy which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

The licensee has agreed to read regulation 87465 entirely and send LPA self-certify letter that the regulation was read and understood. The license has agreed to train all staff on medication safety. The licensee has agreed to send LPA documentation that a medication safety class has been scheduled. The licensee has agreed to send LPA documentation that each staff member has attended the medication training, this includes staff dates and signatures as evidence of attendance.

Deadline recorded: Aug 12, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87307(a)

Regulation authority

CCR

What the official deficiency says

87307. Personal Accommodations and Services.(a) Living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents, staff, and others who may reside in the facility... This requirement is not met as evidenced by observation, the licensee did not comply with the section cited above by allowing a staff member to reside and sleep in a residents bedroom closet which poses an potential health, safety or personal rights risk to persons in care.

Official plan of correction

The licensee has agreed to read regulation 87307 entirely and send LPA self-certify letter that the regulation was read and understood. The licensee has agreed to vacate the staff and their belongings out of the residents bedroom closet. The licensee has agreed to send LPA pictures to show that the staff member has moved out of the residents bedroom closet.

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