JAZBA CARE STAMP MILL

Official classification

Type B

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation ,medications cabinet was found to be open, accessible to residents and one residents medications were found on kitchen counter without any staff's supervision which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/03/2025 Plan of Correction Administrator shall send a letter of understanding of this regulation and conduct staff training. All POC documents are due by 11/03/25.

Official classification

Type B

Official code

87555(a)

Regulation authority

CCR

What the official deficiency says

87555 General Food Service Requirements (a) The total daily diet shall be of the quality(...)necessary to meet the needs of the residents and shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. All food shall be selected, stored, prepared and served in a safe and healthful manner. This requirement is not met as evidenced by: Based on observation and interviews conducted, the facility had several food items that were expired and perishable items that were not in a container with a lid, which poses a potential health, safety, and personal rights violation to the residents in care.

Official plan of correction

Licensee agrees to submit a statement of understanding. Additionally, Licensee agrees to create a plan to ensure all food items are discarded when expired, as well as ensure proper food storage and submit to LPA by the POC due date of 7/5/24.

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

Official classification

Type B

Official code

87705(k)(3)

Regulation authority

CCR

What the official deficiency says

Care of Persons with Dementia- Fire and earthquake drills shall be conducted at least once every three months on each shift and shall include, at a minimum, all direct care staff. This requirement was not met based on records and interviews which found that drills were not conducted as required. This posed a potential risk to residents.

Official plan of correction

Licensee will submit a schedule of staff working at this location 6/14/24- 6/21/24 as will as emergency drill reports that those who worked participated in drills. The documentation will be submitted by the POC date of 6/21/24.

Deadline recorded: Jun 21, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87465(c)(3)

Regulation authority

CCR

What the official deficiency says

Incidental Medical and Dental Care-(c)(3) A record of each dose is maintained in the resident's record. The record shall include the date and time the PRN medication was taken, the dosage taken, and the resident's response. This requirement was not met based on records review and interviews. Interviews found a lack of understanding odf the requirement and 3 of 4 resident medication records found PRN medications dispensed without the required documentatiuon. This posed a potential risk to residents.

Official plan of correction

Licensee will institute the required documentation and submit the PRN log for each current resident, to CCL by the POC date of 6/21/24

Deadline recorded: Jun 21, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)(1)(D)

Regulation authority

CCR

What the official deficiency says

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. (D) Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident. This requirement is not met as evidenced by: Based on interviews and review of the Department's files, an incident report was not submitted for resident (R1) following a fall on 3/9/24, which posed a potential health and safety risk to residents in care.

Official plan of correction

A completed incident report was submitted on 4/8/24 to the Department. Licensee/Administrator agree to read Regulation 87211 and send a signed statement to the Departent by 5/8/24.

Deadline recorded: May 8, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

Not listed

Regulation authority

Not listed

What the official deficiency says

(b) (1) The department shall adopt regulations to require staff members of residential care facilities for the elderly who assist residents with personal activities of daily living to receive appropriate training. This training shall consist of 40 hours of training. A staff member shall complete 20 hours, including six hours specific to dementia care, as required by subdivision (a) of Section 1569.626 and four hours specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696, before working independently with residents. The remaining 20 hours shall include six hours specific to dementia care and shall be completed within the first four weeks of employment. This requirement is not met as evidenced by: Based on staff files that were reviewed and staff files that were not available, the Licensee did not ensure that all staff have completed the required initial/continuing training, which poses a potential health and safety risk to residents in care.

Official plan of correction

Licensee/Administrator agrees to provide documentation of completed staff training by 5/8/24- fax or email to the Department.

Deadline recorded: May 8, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87412(d)

Regulation authority

CCR

What the official deficiency says

87412 Personnel Records. (a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. This requirement is not met as evidenced by: Based on staff and administrator's statements, not all staff files were present and available for review and the (3) that were reviewed did not have all of the requirement documentation, which poses a potential health and safety risk to residents in care.

Official plan of correction

Licensee/Administrator agree to ensure that each staff has a complete personnel record per Regulation 87412 and all staff records are maintained on site. Signed statement that Reg 87412 has been read and understood. LPA Hood to check staff files during a future visit.

Deadline recorded: May 8, 2024. A deadline is not proof that correction was completed.