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Official classification

Type B

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. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, 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: Deficient Practice Statement Based on medication audit, the licensee did not comply with the section cited above as R1's medication count was 41 pills remaining when it should have been 40 pills remaining according to the start date which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/07/2025 Plan of Correction Licensee is to submit a statement of compliance to ensure all medications are counted/ audited at arrival. POC is due July 7, 2025.

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: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above as LPA and AGPA observed the sliding wood door in the kitchen to be disrepaired which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/07/2025 Plan of Correction Licensee is to repair the broken sliding wood door, if wished to not repair it, Licensee is to discard the door and install locks on the knife drawer. POC is due July 7, 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: Deficient Practice Statement Based on LPA and AGPA's observation, the licensee did not comply with the section cited above as insects was observed in the knife drawer along with on chairs in the dining room which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/07/2025 Plan of Correction Licensee is to submit proof to Licensing of pest control services conducted at the facility. Services must include but not limited to cockroaches and rodents. POC is due July 7, 2025.

Official classification

Type A

Official code

87405(d)(2)

Regulation authority

CCR

What the official deficiency says

87405- Administrator - Qualifications and Duties(d)(2)- Knowledge of and ability to conform to the applicable laws, rules and regulations….. This requirement is not met as evidenced by; Based on the records reviewed and interviews, it has been determined that the administrator did not report an incident regarding association of an individual who has been convicted of a crime for which registration as a Registered Sex Offender (RSO) is required, is residing at the facility or has presence/contact that pose immediate a risk to the health and safety of the client(s) in care.

Official plan of correction

Administrator agreed to submit a self-certification of understanding the regulation ,87405 (d)(2) and will make sure to report any reportable incidents to CCLD as required and submit proof to CCLD by POC date-02/07/24. Additionaly, administrator shall complete training regarding to report such incidents for minimum 4 hours and will submit proof to department by 03/06/24.

Deadline recorded: Feb 7, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87356(a)(1)

Regulation authority

CCR

What the official deficiency says

87356-Criminal Record Exemption (a) The Department shall notify a licensee to act immediately to terminate the employment of, remove from the facility licensee shall comply with the notice.... (1)Any person who has been convicted of, or is awaiting trial for, a sex offense against a minor; this requirement is not met as evidenced by; Based on evidence obtained during the course of this investigation, the Department has Substantiated that an individual who has been convicted of a crime for which registration as a Registered Sex Offender (RSO) is required, is residing at the facility or has presence/contact that pose immediate a risk to the health and safety of the client(s) in care .

Official plan of correction

Licensee/Administrator shall ensure that No individual who has been convicted of a crime for which registration as a Registered Sex Offender (RSO) is required, is residing at the facility or has presence/contact with clients/ residents in any manner. Civil Penalties shall be assessed if POC requirements are not met.

Deadline recorded: Jan 26, 2024. A deadline is not proof that correction was completed.