EVA'S CARE HOME

Official classification

Type B

Official code

1569.683(a)(1)

Regulation authority

CCR

What the official deficiency says

§1569.683 Eviction notices; reasons for eviction contents; service. a) In addition to complying with other applicable regulations, a licensee of a residential care facility for the elderly who sends a notice of eviction to a resident 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. In addition, the notice to quit shall include all of the following: (1) The effective date of the eviction.This requirement is not met as evidenced by: Based on interviews conducted and documentation reviewed, the Licensee did not ensure a 30-day eviction notice was issued to (R1), who was refusing emergency services, including there being issues with ileostomy bag, which posed a potential health and safety risk to residents in care.

Official plan of correction

Licensee/Administrator agrees to consider respite care, if appropriate, and to admit residents on a short-term basis. Licensee/Administrator agrees to read Reg 87507/Admission Agreement and submit a statement of understanding. Due by April 16, 2026. LIcensee/Administrator agree to reach out to the Department LPA or Officer of the Day with questions.

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

Official classification

Type B

Official code

1569.625

Regulation authority

HSC

What the official deficiency says

Staff training; legislative findings; contents (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 interviews and record review, the licensee did not comply with the section cited above in (1) out of (3) staff persons, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/16/2023 Plan of Correction Licensee/Administrator agrees to have staff (S1) complete the required (20) hours of annual training and provide documentation to the Department by 11/17/23.

Official classification

Type B

Official code

1569.618

Regulation authority

HSC

What the official deficiency says

§1569.618 Administration and management of residential care facilities; substituted qualifications; employee scheduling. (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 interviews and record review, the licensee did not comply with the section cited above in (2) out of (3) staff persons, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/17/2023 Plan of Correction Licensee/Administrator agree to ensure that staff (S1) and (S2) complete First Aid and CPR certification and submit documentation to the Department by 11/17/23.

Official classification

Type B

Official code

87463(c)

Regulation authority

CCR

What the official deficiency says

87463 Reappraisals (c) The licensee shall arrange a meeting with the resident, the resident’s representative, if any, appropriate facility staff, and a representative of the resident’s home health agency, if any, when there is significant change in the resident’s condition, or once every 12 months, whichever occurs first, as specified in Section 87467, Resident Participation in Decision Making. This requirement is not met as evidenced by: Based on documentation reviewed and interviews conducted, the Licensee did not ensure that an updated care plan was completed for resident (R1) at least annually, in 2020, 2021, 2022 and in 2023, including when there was a change in condition over the past 6-7 months, which poses a potential health and safety risk to residents in care.

Official plan of correction

Licensee/Administrator agree to complete and updated care plan (LIC625) for R1 and submit it to the Department by 8/24/23. Licensee/Administrator agrees to read Regulation 87463 and submit a signed statement that it is understood. Also due to Department by 8/24/23.

Deadline recorded: Aug 24, 2023. A deadline is not proof that correction was completed.