LEGACY LANE SENIOR LIVING II

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement is not met as evidenced by: Based on observations, the care home did not ensure the premises was clean and sanitary in multiple areas of the care home, which poses a potential health, safety, and personal rights risk to the residents in care.

Official plan of correction

Facility will address all concerns observed during visit. LPA will conduct a future visit to clear deficiency. A civil penalty in the amount of $250 was assessed for today's date due to repeat violation.

Deadline recorded: Jul 27, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87466

Regulation authority

CCR

What the official deficiency says

87466 Observation of the Resident - The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs. When changes such as unusual weight gains or losses or deterioration of mental ability or a physical health condition are observed, the licensee shall ensure that such changes are documented and brought to the attention of the resident's physician and the resident's responsible person, if any. This requirement is not met as evidenced by: Based on interviews conducted and records reviewed, the care home did not ensure to observe changes in R1 and provide appropriate assistance for unmet needs, which poses an immediate health, safety, and personal rights risk to the residents in care.

Official plan of correction

Care home will complete training for all staff regarding observing residents for changes in condition and providing assistance for unmet needs. Care home will provide an estimated date for completion of training to LPA by POC due date of July 16, 2026. Care home will also provide LPA materials involved with staff training by POC due date. An immediate civil penalty in the amount of $500 is assessed for today's date due to a violation that resulted in the injury or illness of a resident in care.

Deadline recorded: Jul 16, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(a)(4)

Regulation authority

CCR

What the official deficiency says

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility (...) by compliance with the following: (4) The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Based on interviews conducted, observations, medication count, and records reviewed, the care home did not ensure to assist residents with self-administered medications as needed, which poses an immediate health, safety, and personal rights risk to the residents in care.

Official plan of correction

Care home will complete training for all staff regarding medication administration. Care home will provide an estimated date for completion of training to LPA by POC due date of July 16, 2026. Care home will also provide LPA materials involved with staff training by POC due date.

Deadline recorded: Jul 16, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87486.1(a)(1)

Regulation authority

CCR

What the official deficiency says

87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement is not met as evidenced by: Based on interviews conducted, the care home did not ensure that residents were accorded dignity in their personal relationships with staff, which poses an immediate health, safety, and personal rights risk to the residents in care.

Official plan of correction

Care home will complete training for all staff regarding how to treat residents with dignity. Care home will provide an estimated date for completion of training to LPA by POC due date of July 16, 2026. Care home will also provide LPA materials involved with staff training by POC due date.

Deadline recorded: Jul 16, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87468.2(a)(4)

Regulation authority

CCR

What the official deficiency says

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (4) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement is not met as evidenced by: Based on interviews conducted and records reviewed, the care home did not ensure to provide care, supervision, and services to meet the needs of the residents in care, which poses an immediate health, safety, and personal rights risk to the residents in care.

Official plan of correction

Care home will complete training for all staff regarding how to provide care and supervision to the residents. Care home will provide an estimated date for completion of training to LPA by POC due date of July 16, 2026. Care home will also provide LPA materials involved with staff training by POC due date.

Deadline recorded: Jul 16, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87411(a)

Regulation authority

CCR

What the official deficiency says

87411 Personnel Requirements - General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. (...) This requirement is not met as evidenced by: Based on interviews conducted and records reviewed, the care home did not ensure personnel were competent to provide services necessary to meet the residents' needs, which poses an immediate health, safety, and personal rights violation to the residents in care.

Official plan of correction

Care home will complete training for all staff regarding personnel expectations when providing care. Care home will provide an estimated date for completion of training to LPA by POC due date of July 16, 2026. Care home will also provide LPA materials involved with staff training by POC due date. A civil penalty in the amount of $250 was assessed for today's date due to repeat violation.

Deadline recorded: Jul 16, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87224(d)

Regulation authority

CCR

What the official deficiency says

87224 Eviction Procedures (d) The licensee shall set forth in the notice to quit the reasons relied upon for the eviction with specific facts to permit determination of the date, place, witnesses, and circumstances concerning those reasons. (1) The notice to quit shall include the following information: (...) (C) A statement informing residents of their right to file a complaint with the licensing agency, as specified in Section 87468, subsection (a)(4), including the name, address and telephone number of the licensing office with whom the licensee normally conducts business, and the State Long Term Care Ombudsman office. (...) This requirement is not met as evidenced by: Based on observations and records reviewed, the facility did not ensure to comply with Title 22 eviction procedures when drafting 30-Day Notice of Termination of Residency that was issued to R1, which poses a potential health, safety, and personal rights risk to the residents in care.

Official plan of correction

Facility will ensure to comply with Title 22 regulations and the Health and Safety code when drafting eviction notices in the future. Facility will rescind 30-Day Notice of Termination of Residency issued to R1. Facility will provide proof of 30-Day Notice of Termination of Residency issued to R1 being rescinded to LPA by POC due date of July 1, 2026.

Deadline recorded: Jul 1, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(h)(2)

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: (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: Based on observations, the care home did not ensure to keep medications inaccessible to the residents in care when resident had a vial of Xylocaine accessible in their bedroom and medications were accessible in staff bedroom, which poses an immediate health, safety, and personal rights risk to the residents in care.

Official plan of correction

Facility will ensure that all centrally stored medications are kept in a safe and locked place. LPA will conduct a future visit to clear deficiency. A civil penalty in the amount of $250 was assessed for today's date due to repeat violation.

Deadline recorded: Jun 17, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement is not met as evidenced by: Based on observations, the care home did not ensure the premises was clean and in good repair regarding multiple observed items addressed in report, which poses a potential health, safety, and personal rights risk to the residents in care.

Official plan of correction

Facility will create a system for cleaning the care home, addressing biowaste, and addressing repairs. Facility will address all concerns observed during visit. LPA will conduct a future visit to clear deficiency.

Deadline recorded: Jun 29, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(h)(2)

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: (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: Based on LPA's observations and records reviewed, the facility did not ensure that residents' medications were kept in a safe and locked place, which poses an immediate health, safety, and personal rights risk to the residents in care.

Official plan of correction

Facility will ensure that all centrally stored medications are kept in a safe and locked place. LPA will conduct a future visit to clear deficiency. A civil penalty in the amount of $250 was assessed for today's date due to repeat violation.

Deadline recorded: May 8, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.625(b)(1)

Regulation authority

CCR

What the official deficiency says

§1569.625 Staff training; legislative findings; contents (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. The training coursework may utilize various methods of instruction, including, but not limited to, lectures, instructional videos, and interactive online courses. The additional 16 hours shall be hands-on training. This requirement is not met as evidenced by: Based on LPA's observations and records reviewed, the facility did not ensure that staff on site received training in accordance with the Health and Safety code, which poses a potential health, safety, and personal rights risk to the residents in care.

Official plan of correction

Facility will complete required training for all staff in accordance with Health and Safety code and ensure documentation of training is maintained at the care home at all times. LPA will conduct a future visit to clear deficiency.

Deadline recorded: Jun 6, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87507(h)(4)

Regulation authority

CCR

What the official deficiency says

87507 Admission Agreements (h) The admission agreement shall not contain the following: (4) Any provision that violates the rights of any residents including but not limited to those specified in Section 87468 and in Health and Safety Code section 1569 et seq. This requirement is not met as evidenced by: Based on records reviewed, the facility did not ensure that admission agreements for the residents did not violate rights indicated in Health and Safety Code section §1569.652(c), which poses a potential health, safety, and personal rights risk to the residents in care.

Official plan of correction

Facility will update Admissions Agreement Addendums for all residents and ensure that there is nothing included that violates any rights specified in Section 87468 and in Health and Safety Code section 1569 et seq. Facility will submit updated Admissions Agreement Addendums to LPA by POC due date of May 11, 2026.

Deadline recorded: May 11, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87411(a)

Regulation authority

CCR

What the official deficiency says

87411 Personnel Requirements - General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. (...) The licensing agency may require any facility to provide additional staff whenever it determines through documentation that the needs of the particular residents, the extent of services provided, or the physical arrangements of the facility require such additional staff for the provision of adequate services. This requirement is not met as evidenced by: Based on observations, interviews conducted, and records reviewed, the facility did not ensure to provide sufficient staffing to meet the needs of the residents in care, which poses a potential health, safety, and personal rights risk to the residents in care.

Official plan of correction

Facility will update the staff roster and provide updated staff roster to LPA by POC due date of May 7, 2026. Facility will maintain a staff schedule as a comprehensive record of personnel on-site. Facility will ensure that staff present reflect both the roster and staff schedule at all times.

Deadline recorded: May 7, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement is not met as evidenced by: Based on observations, interviews conducted, and records reviewed, the facility did not ensure that premises was free from pests, including multiple bedrooms for residents, which poses a potential health, safety, and personal rights risk to residents in care.

Official plan of correction

Facility will contract for regular pest control services to address pest infestation, including, but not limited to, spiders and roaches . Facility will provide a copy of the contract for pest control services to LPA by POC due date of May 5 , 2026.

Deadline recorded: May 5, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87555(b)(7)

Regulation authority

CCR

What the official deficiency says

87555 General Food Service Requirements (b) The following food service requirements shall apply: (7) Modified diets prescribed by a resident's physician as a medical necessity shall be provided. This requirement is not met as evidenced by: Based on observations, interviews conducted, and records reviewed, the facility did not ensure that R1 was provided food belonging to their medically prescribed modified diet, which poses a potential health, safety, and personal rights risk to residents in care.

Official plan of correction

Facility will immediately post all residents special diets for staff and begin providing meals to residents that abide by their modified diets. Facility will provide a training to staff regarding special diets and provide proof of training to LPA by POC due date of May 5, 2026.

Deadline recorded: May 5, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(h)(2)

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: (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: Based on interviews conducted and observations, the facility did not ensure that residents' medications were kept in a safe and locked place, which poses an immediate health, safety, and personal rights risk to the residents in care.

Official plan of correction

Facility will ensure that all centrally stored medications are kept in a safe and locked place. LPA will conduct a future visit to clear deficiency.

Deadline recorded: Apr 23, 2026. A deadline is not proof that correction was completed.

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: Based on interviews conducted and observations, the facility did not ensure that residents' medications were kept in a safe and locked place, which poses an immediate health, safety, and personal rights risk to the residents in care.

Official plan of correction

Facility will ensure that all centrally stored medications are kept in their originally received container. Facility will complete a statement of understanding regarding regulation 87465 and submit statement to LPA by POC due date of April 23, 2026.

Deadline recorded: Apr 23, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(h)(6)

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: (6) The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained for at least one year (...). This requirement is not met as evidenced by: Based on LPA's observations and records reviewed, the facility did not ensure to maintain a record of centrally stored medications for each resident for at least one (1) year, which poses an immediate health, safety, and personal rights risk to the residents in care.

Official plan of correction

Facility will create a record of all residents' current medications in accordance with Title 22 and maintain documentation of records for at least one (1) year. Facility will provide a copy of all residents' centrally stored medication records to LPA by POC due date of April 23, 2026.

Deadline recorded: Apr 23, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87628(a)

Regulation authority

CCR

What the official deficiency says

87628 Diabetes (a) The licensee shall be permitted to accept or retain a resident who has diabetes if the resident is able to perform his/her own glucose testing with blood or urine specimens, and is able to administer his/her own medication including medication administered orally or through injection, or has it administered by an appropriately skilled professional. This requirement is not met as evidenced by: Based on LPA's observations, interviews conducted, and records reviewed, the facility did not ensure resident admitted was assessed to be able to perform their own glucose testing, which poses a potential health, safety, and personal rights risk to the residents in care.

Official plan of correction

Facility will either obtain an updated medical assessment to determine resident's capability to perform their own glucose testing or acquire services from skilled professional to provide assistance to resident by POC due date. LPA will conduct a future visit to clear deficiency.

Deadline recorded: May 22, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87506(a)

Regulation authority

CCR

What the official deficiency says

87506 Resident Records (a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. This requirement is not met as evidenced by: Based on LPA's observations and records reviewed, the facility did not ensure to make complete and current records available to licensing agency staff to review, which poses an immediate health, safety, and/or personal rights violation to the residents in care.

Official plan of correction

Facility will ensure that a separate, complete, and current record is maintained for each resident in the facility at all times and ensure records are readily available to licensing agency staff. LPA will return at a later date to clear POC.

Deadline recorded: Apr 22, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87411(d)

Regulation authority

CCR

What the official deficiency says

87411 Personnel Requirements - General (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: (4) Knowledge required to safely assist with prescribed medications which are self-administered. This requirement is not met as evidenced by: Based on LPA's observations, interviews conducted, and records reviewed, the facility did not ensure that staff assisting residents with self-administered medication had medication training at the facility, which poses an immediate health, safety, and/or personal rights violation to the residents in care.

Official plan of correction

Facility will ensure that staff assisting residents with self-administered medications receive medication training and documentation for training is maintained at the facility at all times. Facility will provide proof of medication training for staff assisting residents with self-administered medications to LPA by POC due date of April 22, 2026.

Deadline recorded: Apr 22, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87405(a)

Regulation authority

CCR

What the official deficiency says

87405 Administrator - Qualifications and Duties (a) All facilities shall have a qualified and currently certified administrator. The licensee and the administrator may be one and the same person. The administrator shall have sufficient freedom from other responsibilities and shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility as specified in this section. When the administrator is not in the facility, there shall be coverage by a designated substitute who shall have qualifications adequate to be responsible and accountable for management and administration of the facility as specified in this section. The Department may require that the administrator devote additional hours in the facility to fulfill his/her responsibilities when the need for such additional hours is substantiated by written documentation. This requirement is not met as evidenced by: Based on LPA's observations and records reviewed, the facility did not ensure to have an assigned certified administrator at the facility, which poses a potential health, safety, and/or personal rights risk to the residents in care.

Official plan of correction

Facility will hire a certified administrator and send proof of employment to LPA by POC due date of May 4, 2026.

Deadline recorded: May 4, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

(e) Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degrees C) and not more than 120 degree F (49 degrees C). This requirement is not met as evidenced by: Deficient Practice Statement Based on LPAs' observations, the facility did not insure that hot water was not less than 105 degrees F and not more than 120 degrees F when hot water was measured at 155 degrees F, which poses an immediate health, safety, or personal rights violation to the residents in care.

Official plan of correction

POC Due Date: 12/18/2025 Plan of Correction Facility will fix water temperature to be not less then 105 degrees F and not more then 120 degrees F. LPA will return at a later date to check hot water.

Official classification

Type B

Official code

87465(a)(8)

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: This requirement is not met as evidenced by: Deficient Practice Statement Based on LPAs' observations, the facility did not insure to have a complete first aid kit maintained on the premises, which poses a potential health, safety, or personal rights violation to the residents in care.

Official plan of correction

POC Due Date: 12/28/2025 Plan of Correction Facility will obtain first aid kit. LPA will return back on a later date to observe if facility obtained first aid kit.

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 LPAs' observations and records reviewed, the facility did not insure to document quarterly drill logs in accordance with the Health and Safety code, which poses a potential health, safety, or personal rights violation to the residents in care.

Official plan of correction

POC Due Date: 12/28/2025 Plan of Correction Facility will insure to document quarterly drill logs in accordance with Health and Safety Code. Facility will submit corrected quarterly drill log to LPA by POC due date.

Official classification

Type B

Official code

87468.1(a)(1)

Regulation authority

CCR

What the official deficiency says

87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement is not met as evidenced by: Based on interviews conducted and records reviewed, the facility did not ensure that residents were treated with dignity and respect in their relationships with other residents, which poses a potential health, safety, and personal rights risk to residents in care.

Official plan of correction

Facility will update house policies for all residents to include personal rights violations. Facility will have all residents sign house policies to include in their admission agreements. Facility will submit updated and signed house policies to LPA by POC due date.

Deadline recorded: Nov 21, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87555(b)(27)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (27) All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's observations, the facility did not ensure that the kitchen area was free from insects, which poses a potential health, safety, and personal rights risk to residents in care.

Official plan of correction

POC Due Date: 07/31/2025 Plan of Correction Facility will contract for regular pest control services to address pest infestation, including, but not limited to, roaches and flies. Facility will provide proof of service regarding first treatment for flies and roaches by POC due date of 7/31/2025.

Official classification

Type B

Official code

87555(b)(27)

Regulation authority

CCR

What the official deficiency says

87555 General Food Service Requirements (b) The following food service requirements shall apply: (27) All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects. This requirement is not met as evidenced by: Based on observations and interviews conducted, the facility did not ensure that the kitchen area was free from insects, which poses a potential health, safety, and personal rights risk to residents in care.

Official plan of correction

Facility will contract for regular pest control services to address pest infestation, including, but not limited to, roaches and flies. Facility will provide proof of service regarding first treatment for flies and roaches by POC due date of 6/13/2025.

Deadline recorded: Jun 13, 2025. A deadline is not proof that correction was completed.