BLESSED HOMECARE

Official classification

Type B

Official code

87465(h)(4)

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: (4) All centrally stored medications shall be labeled and maintained in compliance with state and federal laws. No persons other than the dispensing pharmacist shall alter a prescription label. This requirement is not met as evidenced by: Based on observation facility was writing on prescription labels. This poses a potential health and safety risk to residents in care.

Official plan of correction

Licensee is to write a statement of understanding of this regulation and agrees that going forward willl not write on new prescription labels.

Deadline recorded: Sep 9, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

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: Based on observation and interview, medications are being pre-poured more than 24 hours in advance. LPAs interviews indicated that medication is pre-poured for five (5) days in advance. This poses a potential health and safety risk to residents in care.

Official plan of correction

Licensee agrees to cease pre-pouring medications immediately. Licensee shall submit a statement of understanding of this regulation.

Deadline recorded: Sep 9, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.185(b)(1)(F)

Regulation authority

HSC

What the official deficiency says

§1569.185 Fees for license or applications; use of revenues; collected; denial or forfeiture (b) (1) In addition to fees set forth in subdivision (a), the department shall charge all of the following fees: (F) A late fee that represents an additional 50 percent of the established current annual fee when a licensee fails to pay the current annual licensing fee on or before the due date as indicated by postmark on the payment. This requirement is not met as evidenced by: Deficient Practice Statement Based on file review, the licensee did not comply with the section cited above as LPA observed outstanding balance of $1,237 due to unpaid fee plus late fee assessed, which poses a potential health and safety risk for residents in care.

Official plan of correction

POC Due Date: 01/22/2025 Plan of Correction Licensee is to pay off the outstanding fee and submit proof of payment to LPA by POC due date.

Official classification

Type B

Official code

87468(c)(2)(A)

Regulation authority

CCR

What the official deficiency says

(c) Licensees shall prominently post personal rights, nondiscrimination notice, and complaint information in areas accessible to residents, representatives, and the public. (2) Information on the appropriate reporting agency in case of a complaint or emergency, including procedures for filing confidential complaints, shall be posted as follows: (A) Licensees may use the Residential Care Facility for the Elderly (RCFE) Complaint Poster (PUB 475) or may develop their own poster as provided in this section. A poster developed by the licensee shall contain the same content as the PUB 475. The poster that is posted shall be 20” x 26” in size and be posted in the main entryway of the facility. PUB 475 may be accessed, downloaded, and printed from the www.ccld.ca.gov website. This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above in 1 out of 1 posters which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee will post the Residential Care Facility for the Elderly (RCFE) Complaint Poster (PUB 475) in a common area. Picture of the poster posted to be sent into CCL by 11/13/24 Failure to provide POC by due date may result to civil penalty of $100 per day until received.

Deadline recorded: Nov 13, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87465(e)

Regulation authority

CCR

What the official deficiency says

(e) For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician on a prescription blank, maintained in the resident's file, and a label on the medication. Both the physician's order and the label shall contain at least all of the following information. This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above in 1 out of 1 residents, PRN orders for Probiotics and Stomach Relief were not present in R1s file which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee will obtain PRN prescriptions for R1s Probiotic and Stomach Relief with correct dosage. Licensee will come up with a plan on how to ensure PRN prescriptions are documented on medication list. Failure to provide POC by due date may result to civil penalty of $100 per day until received.

Deadline recorded: Nov 13, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87203

Regulation authority

CCR

What the official deficiency says

87203 Fire Safety All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above as LPAs observed facility fire door to be propped open with a door stopper and the fire extinguisher in hallway and entry way was last serviced on 06/24/20 and 01/25/23 which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee immediately closed fire door and stated that the facility will keep it closed. Licensee will send proof of service for both fire extinguishers to LPA. Failure to provide POC by due date may result to civil penalty of $100 per day until received.

Deadline recorded: Oct 31, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(h)(1)(C)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (1) Medications shall be centrally stored under the following circumstances: (C) Because of potential dangers related to the medication itself, or due to physical arrangements in the facility and the condition or the habits of other persons in the facility, the medications are determined by either a physician, the administrator, or Department to be a safety hazard to others. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in 1out of 1 counts, R1s PRN medication was not centrally stored in R1s room which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/11/2024 Plan of Correction The PRN medication was moved from the room immediately. Licensee is to submit to LPA Ratajczak a statement of understanding that if a resident is able to centrally store their own medication a locked box is needed for their room.

Official classification

Type B

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 record review, the licensee did not comply with the section cited above in 2 out of 2 counts, staff files does not have annual trainings which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/24/2024 Plan of Correction Licensee will submit to LPA Ratajczak a statement of understanding that trainings need to be done annually.

Official classification

Type B

Official code

87465(e)

Regulation authority

HSC

What the official deficiency says

(e) For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician on a prescription blank, maintained in the resident's file, and a label on the medication. Both the physician's order and the label shall contain at least all of the following information. 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 1 out of 1 counts, PRN orders for Naproxen sodium and D3 were not present in R1s file which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/24/2024 Plan of Correction Licensee will submit to LPA Ratajczak a statement of understanding that PRNs for all Residents needs doctor orders. Licensee will also obtain PRN prescriptions for R1s Naproxen sodium and D3.

Official classification

Type B

Official code

87411(c)(1)

Regulation authority

HSC

What the official deficiency says

(c) All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69 (1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross. 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 1 out of 1 staff does not have first aid training which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/24/2024 Plan of Correction Licensee will submit LPA Ratajczak documentation showing S1 has complete their first aid training by POC due date