GLORIOUS HOMES #1

Official classification

Type A

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, the licensee did not comply with the section cited above in unlocked medication observed in the resident room (over the counter medication), refrigerator (injections), and kitchen drawer (Rx pills and OTC meds) which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/17/2026 Plan of Correction Licensee to buy a refrigerator with a lock for injections. Licensee to send picture to LPA. All other medicaitons were immediately locked in centrally stored cabinet in kitchen.

Official classification

Type B

Official code

87463(a)

Regulation authority

CCR

What the official deficiency says

(a) The pre-admission appraisal, as specified in Section 87457, Pre-Admission Appraisal, shall be updated, in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition, as defined in Section 87101, Definitions, and to keep the appraisal accurate. For the purposes of this section, the updated pre-admission appraisal shall be referred to as the reappraisal. 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 4 out of 4 resident files which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/30/2026 Plan of Correction Licensee to email LPA updated LIC625s for all 4 residents

Official classification

Type A

Official code

87465(h)(5)

Regulation authority

CCR

What the official deficiency says

(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: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above facility is pre-pouring resident's medications in containers seven days in advance. which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/22/2025 Plan of Correction Licensee agrees to cease pre-pouring medications immediately. Licensee to write a statement of understanding of this regulation to LPA by POC due date.

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: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above facility smoke and fire alarms were inoperable and a resident bed is blocking an exit door, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/22/2025 Plan of Correction Licensee needs to follow all recommendations by Sac Metro Fire given on 05/21/2025 and send corrections to LPA by POC due date 05/23/2025

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

(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: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in resident common bathroom was observed to have rust in the shower and toilet; the cabinet under the sink has a broken door; no paper towels in bathroom; resident shower needs a deep clean. Facility overall needs a deep cleaning including common areas and kitchen. The exterior of the facility multiple fence planks were missing from street facing fence which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/04/2025 Plan of Correction The licensee shall submit a plan to the department on how the facility will address and correct the items listed above by POC date. Once items have been corrected, the licensee shall notify the department with proof of correction.

Official classification

Type B

Official code

87303(a)(1)

Regulation authority

CCR

What the official deficiency says

(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. (1) Floor surfaces in bath, laundry and kitchen areas shall be maintained in a clean, sanitary, and odorless condition. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above LPA and LPM observed facility flooring throughout the facility to be sticky and in need of cleaning which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/04/2025 Plan of Correction The licensee shall submit a plan to the department on how the facility will address and correct the items listed above by POC date. Once items have been corrected, the licensee shall notify the department with proof of correction.

Official classification

Type B

Official code

87303(c)

Regulation authority

CCR

What the official deficiency says

(c) All window screens shall be clean and maintained in good repair. 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 multiple screens of facility windows were found to be missing or in disrepair which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/04/2025 Plan of Correction Licensee shall repair and/ or replace all missing and damnaged screens throughout the facility and sibmit proof to LPA by POC due date.

Official classification

Type B

Official code

87307(c)

Regulation authority

CCR

What the official deficiency says

(c) Individual privacy shall be provided in all toilet, bath and shower areas. 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 bathroom door knob missing in resident common bathroom which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/04/2025 Plan of Correction Licensee is to install a door knob on the bathroom door and submit proof of door knob to LPA by POC due date.

Official classification

Type B

Official code

87465(a)(6)

Regulation authority

CCR

What the official deficiency says

(6) When requested by the prescribing physician or the Department, a record of dosages of medications which are centrally stored shall be maintained by the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above in facility is not documenting residents medications on centrally stored medication record which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/04/2025 Plan of Correction Licensee shall utilizes the centrally stored medication records for residents. Licensee will send LPA a copy of all residents current medications by POC due date.

Official classification

Type B

Official code

87506(a)

Regulation authority

CCR

What the official deficiency says

(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: Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above in R1 and R2 is missing needs and service plan, ID form, pre-appraisal and personal rights and R3 is missing needs and service plan which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/04/2025 Plan of Correction Licensee will complete resident records and send LPA a copy of completed records by POC due date.

Official classification

Type A

Official code

87217(j)(2)

Regulation authority

CCR

What the official deficiency says

87217 Safeguards for Resident Cash, Personal Property, and Valuables (j) Upon the death of a resident, all cash resources, personal property, and valuables of that resident shall immediately be safeguarded. (2) The executor or the administrator of the estate shall be notified by the licensee, and the cash resources, personal property, and valuables surrendered to said party. This requirement is not met as evidenced by: Based on interview and file review the facility sign and cash the checks after R1 had passed. This poses an immediate health and safety risk to residents in care.

Official plan of correction

Licensee is come up with a plan on how they will pay the payee back within the next 30 days. Licensee is to pay back payee service and submit proof to LPA once completed. Additionally Licensee is submit a statement of understating of this regulation.

Deadline recorded: May 22, 2025. A deadline is not proof that correction was completed.