PALM VALLEY CARE I

Official classification

Type B

Official code

87405(d)(2)

Regulation authority

CCR

What the official deficiency says

Administrator – Qualification and Duties: The administrator shall have the qualifications… Knowledge of and ability to conform to the applicable laws, rules and regulations This requirement is not met as evidenced by: Based on interviews and record reviews, the licensee did not comply with the regulation cited above. The licensee did not meet the terms of the federal wage settlement agreement. This poses a potential health, safety, and/or personnal rights risks to residents in care.

Official plan of correction

Corrected prior to this visit. Angelita issued the full restitution payment via mailed check to S1 on April 15, 2026 and provided the documented proof during this visit

Deadline recorded: May 1, 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 observation, the licensee did not comply with the section cited above. Hot water temparature in 2 resident bathroom faucets were measured between 127 and 133 degress Fahrenheit, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/25/2025 Plan of Correction Staff adjusted the water heater during this visit; LPAs rechecked the hot water temperature but it was too low between 85 and 86 degrees F. Administrator agreed to take the hot water temparature for 7 days to ensure consistent water temparature and will submit proof to the Department by POC due date.

Official classification

Type A

Official code

87309(a)(1)

Regulation authority

CCR

What the official deficiency says

(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. (1) Disinfectants, cleaning solutions, and poisonous substances shall be stored in areas separate from food supplies as specified in Section 87555, General Food Service Requirements. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. LPAs observed chemicals stored in a garage cabinet where food supplies are being stored. Cabinet was not locked and accessible to residents in care which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/19/2025 Plan of Correction Corrected on site: one staff immediately removed the chemicals and stored in a locked cabinet separate from the food supplies.

Official classification

Type A

Official code

87555(b)(25)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (25) Soaps, detergents, cleaning compounds or similar substances shall be stored in areas separate from food supplies. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation], the licensee did not comply with the section cited above. LPAs observed chemicals stored in a garage cabinet where food supplies are being stored, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/19/2025 Plan of Correction Corrected on site: staff on duty immediately removed the chemicals and stored them in a locked cabinet.

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 observation, the licensee did not comply with the section cited above. LPAs observed 2 dead cockroaches inside the kitchen freezer and a small live cockroach inside a sliding kitchen drawer. Administrator/licensee is unable to privide proof of pest control services at this time, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/25/2025 Plan of Correction Administrator called the pest control for service to be done today. Administrator agreed to submit the new contract to the Department by POC due date.

Official classification

Type B

Official code

87465(a)(1)

Regulation authority

CCR

What the official deficiency says

(1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents. 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. Review of resident's medication revealed that 3 medications were not in compliance with the physician's orders. Additionally, one medication was observed to be expired. This poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/19/2025 Plan of Correction Administrator will ensure all resident medications will be in compliance with physician's orders. Administrator agreed to submit new physician's orders to the Department by POC due date.

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

(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 observation, the licensee did not comply with the regulation noted above. During inspection of the kitchen, visiting LPAs observed the medication cabinet to be unlocked and medications were accessible to residents in care which poses an inmeediate health, safety, and pesonal risks to persons in care.

Official plan of correction

Per discussion, Administrator will submit a statement of understading of the regulation cited relating to proper storage of medication. Submit statement by POC due date.

Deadline recorded: May 9, 2025. 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 b: Based on interview and record review, the licensee did not comply with the regulation cited above. Upon arrival at the facility, there were no qualified staff members on duty, except for one individual who was not authorized to work at this location. This poses an immediate health, safety and personal risks to persons in care.

Official plan of correction

Per discussion, the Licensee will ensure qualified staff are present at the facility at all times. Per discussion, the Adminsitrator agreed to submit a statement of understanding of the regulation cited relating to personnel requirments. Submit statement by POC due date.

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