SHEARWATER RESIDENCE

Official classification

Type A

Official code

87217(f)

Regulation authority

CCR

What the official deficiency says

87217- Safeguards for Resident Cash, Personal Property, and Valuables (f) No licensee or employee of a facility shall make expenditures from residents' cash resources for any basic service specified in this Chapter, or for any basic services identified in a contract/admission agreement between the resident and facility....this requirement was not as evidenced by; Based on the documentation and video surveillance obtained, staff, S1 falsely used resident, R1’s bank card to make unauthorized personal purchases, which poses a immediate health and safety risks to residents in care.

Official plan of correction

Licensee/Administrator shall send a letter of understanding of this Regulation and shall conduct all staff training. All POC documents are due by 3/31/26.

Deadline recorded: Mar 31, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87555(b)(8)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (8) All food shall be of good quality. Commercial foods shall be approved by appropriate federal, state and local authorities. Food in damaged containers shall not be accepted, used or retained. This requirement is not met as evidenced by: Deficient Practice Statement During visit, LPA observed food supply with multiple expired items, and food items without date or label, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/10/2026 Plan of Correction Administrator shall submit a letter of understanding and shall do staff training regarding this regulation and ensure that facility shall not any expired food items and food shall be labeled and dated per requiement. All POC documents are due by 02/10/2026.

Official classification

Type B

Official code

87463(a)(3)

Regulation authority

CCR

What the official deficiency says

(a) The pre-admission appraisal shall be updated, in writing as frequently as necessary to note significant changes and to keep the appraisal accurate. The reappraisals shall document changes in the resident's physical, medical, mental, and social condition. Significant changes shall include but not be limited to: (3) Any illness, injury, trauma, or change in the health care needs of the resident that results in a circumstance or condition specified in Sections 87455(c) or 87615, Prohibited Health Conditions. This requirement is not met as evidenced by: Deficient Practice Statement Based on staff's interviews and record review, the licensee did not comply with the section cited above as reappraisal was not completed to addrress resident, R2 ,Change in helath condition for stage 3 pressure injury as indicated in LIC602 ,dated-09/25/23 which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/19/2024 Plan of Correction Facility will complete reappraisal to addrress resident, R2 ,Change in helath condition for stage 3 pressure injury as indicated in LIC602 ,dated-09/25/23 and will notify department by POC Date-03/19/24 with proof of documents.

Official classification

Type B

Official code

87615(a)(1)

Regulation authority

CCR

What the official deficiency says

(a) Persons who require health services for or have a health condition including, but not limited to, those specified below shall not be admitted or retained in a residential care facility for the elderly: (1) Stage 3 and 4 pressure sores (dermal ulcers). This requirement is not met as evidenced by: Deficient Practice Statement Based on staff's interviews and record review, it has been found that facility retain resident, R2 with pressure injury, stage 3 which is a Prohibited Health Condition for RCFE and did not have Approved Exception to provide care and services which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/19/2024 Plan of Correction Licensee/administrator shall send letter of understanding of this regulation and shall apply for Exception Request to retain resident with stage 3 wound/pressure injury as required . All POC documents are due by 03/19/24.

Official classification

Type B

Official code

87705(c)(4)

Regulation authority

CCR

What the official deficiency says

87705- Care of Persons with Dementia (c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (4) There is an adequate number of direct care staff to support each resident’s physical, social, emotional, safety and health care needs as identified in his/her current appraisal. This requirement is not met as evidenced by: Based on interviews conducted and record review, facility staff did not provide care and supervision to R1 resulting in R1 leaving the facility unassisted which posed an immediate health and safety risk to residents in care.

Official plan of correction

Current Licensee/Administrator conducted staff training on keeping a closer watch on any residents that may have a tendency for wondering behaviour and document any changes in condition. Documentation of training has been provided to department during today's visit.

Deadline recorded: Oct 19, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.1(a)(1)

Regulation authority

CCR

What the official deficiency says

Personal Rights of Residents in All Facilities. Residents in all residential care facilities for the elderly shall have all of the following personal rights: To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement was not met as evidenced by a former caregiver admitting they raised their voice to residents this poses an immediate hazard to residents.

Official plan of correction

By 04/08/2022, the Licensee shall submit in writing staff will have personal rights training and how they shall ensure staff treat residents with dignity.

Deadline recorded: Apr 8, 2022. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87468.1(a)(2)

Regulation authority

CCR

What the official deficiency says

(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights:… (2) To be accorded safe, healthful and comfortable accommodations… This requirement was not met as evidenced by statements that found staff at the facility were not consistently following public health guidance for mask wearing. This posed an immediate risk to residents in care.

Official plan of correction

The facility has since enfrced stricy adherence to masking requirements. Licensee will submit a plan for monitoring and enforcement of masking compliance on all shifts. The plan will be submitted by the POC date of 1/19/22.

Deadline recorded: Jan 19, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.655(b)

Regulation authority

HSC

What the official deficiency says

Increase in fee rates for elderly residents. (b) No licensee shall charge nonrecurring lump-sum assessments. .. " nonrecurring lump-sum assessments " mean rate increases due to unavoidable and unexpected costs that financially obligate the licensee...This requirement was not met based on recrds and statements that some residents were charged fees for Covid-19 staffing that were a an unexpected and unavoidable cost to the licensee. Residents were not reassessed for level of care and residents did not receive 60 days notice. This violated residents personal rights.

Official plan of correction

Licensee will submit a statement of understanding of requireents for rate increases to residents as well as a plan to reimburse fees charged to those residents charged for Covid-19 contracted staffing. Plans to be submitted to CCL by the POC date of 1/19/22

Deadline recorded: Jan 19, 2022. A deadline is not proof that correction was completed.