MOUNTAIN VIEW COTTAGES-VI

Official classification

Type B

Official code

87555(b)(26)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and interview, the licensee did not comply with the section cited above by not maintaining a sufficient amount of food for non-perishable and perishable food items per regulations which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/30/2026 Plan of Correction Licensee agrees to purchased a sufficient amount of food for the number of residents in care. Licensee agrees to review the regulation cited above. Licensee will submit a statement of understanding and a receipt showing the purchase and pictures by POC due date.

Official classification

Type B

Official code

87465(b)

Regulation authority

CCR

What the official deficiency says

(b) If the resident's physician has stated in writing that the resident is able to determine and communicate his/her need for a prescription or nonprescription PRN medication, facility staff shall be permitted to assist the resident with self-administration of his/her PRN medication. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview and record review, the licensee did not comply with the section cited above in 1 out of 3 resident in care by not maintaining an refilling the resident nebulizer medication for the albuterol prescription which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/06/2026 Plan of Correction Licensee order the residents medication during the visit. Licensee agrees to review the regulation, conduct a training and maintain a log for refills weekly. Licensee stated she will email the LPA by POC due date.

Official classification

Type B

Official code

87506(b)(16)

Regulation authority

CCR

What the official deficiency says

(b) Each resident's record shall contain at least the following information: (16) Records of resident's cash resources as specified in Section 87217, Safeguards for Resident Cash, Personal Property, and Valuables. 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 2 out of 2 residents in care by not having the residents P & I funds able to audit and verify that the ledger match the available funds. The Licensee stated that a staff maintains the petty cash on their person daily which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/13/2026 Plan of Correction Licensee agrees to purchase and maintain a safe for the Administrator and the Licensee to have access to at all times. Licensee agrees to review the regulation and submit a statement of understanding by POC due to LPA.

Official classification

Type B

Official code

87468.1(a)(1)

Regulation authority

CCR

What the official deficiency says

87468.1 Personal Rights of Residents in All Facilities -- (a) Residents in all RCFE shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement was not met as evidenced by: Based on interviews with staff, wtiness, and residents, S1 was observed to speak loudly at residents and claim that they are the authority in this home to be followed.

Official plan of correction

Licensee provide S1 with training or information on resident personal rights and corrective action. Licensee shall submit POC to the Department no later than the end of the POC date.

Deadline recorded: Aug 11, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

80087(a)

Regulation authority

CCR

What the official deficiency says

BUILDINGS AND GROUNDS: The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. This requirement was not met as evidenced by: LPA and staff observed debris (wooden pallets, side/end table, plastic containers and bags, mattress) were observed on the facility.

Official plan of correction

Licensee shall arrange for the debris to be picked up by a sanitation crew no later than the end of day of 5/7/22. Proof shall be provided to the Department no later than 5/7/22.

Deadline recorded: May 7, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

MAINTENANCE/OPERATION: The facility shall be clean, safe, sanitary, in good repair at all times. Maintenance shall include provision of maintenance services, procedures for the safety and well-being of residents, employees, visitors. This requirement was not met as evidenced by: LPA and staff observed the dining/common arear screen door off track. LPA snd staff were not able to close and/or open the screen door without the door going off track.

Official plan of correction

Licensee shall arrange for a properly aligned and adjusted dining/common area screen door no later than the end of day of 5/26/22. Proof shall be provided to the Department no later than 5/26/22.

Deadline recorded: May 26, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87219(h)(2)

Regulation authority

CCR

What the official deficiency says

PLANNED ACTIVITIES: Facilities shall provide sufficient space to accommodate both indoor and outdoor activities...(2) Outdoor activity areas...easily accessible to residents...Gardens or yards shall be sufficient in size, comfortable, appropriately equipped for outdoor use. This requirement was not met as evidenced by: LPA and staff observed outdoor seating that does not have shade.

Official plan of correction

Licensee shall provide appropriate shaded outdoor area for resident use no later than the end of day of 5/7/22. Proof shall be provided to the Department no later than 5/7/22.

Deadline recorded: May 7, 2022. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

1569.38

Regulation authority

HSC

What the official deficiency says

POSTING OF LICENSING REPORTS; DISCLOSURE TO NEW RESIDENTS: Requires the licensee of a residential care facility for the elderly to provide written notification to the residents, resident's responsible party (if any) and to the local Long-Term Care Ombudsman within 10 days..: The Department of Social Services commences proceedings to suspend or revoke the license of the facility. This occurs when the accusation is served to the respondent. This requirement was not met as evidenced by: LPA observed that the facility failed to posta ccusations. Licensee verified that they have not provided written notification as required by H & S Code 1569.38(b) to the residents/resident's responsible party and Ombudsman.

Official plan of correction

Licensee shall post accusations: 8219211401, 8219211401B, 8219211401C and 8219211401D in a conspicuous place and provide written notification to the residents/resident's responsible party and Ombudsman. The facility was issued a civil penalty of $100 a day which is imposed until the facility complies with a maximum of $5000.

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