MOUNTAIN VIEW RESIDENTIAL CARE

Official classification

Type B

Official code

1569.695(c)

Regulation authority

HSC

What the official deficiency says

(c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of residents is not required during a drill. While a facility may provide an opportunity for residents to participate in a drill, it shall not require any resident participation. Documentation of the drills shall include the date, the type of emergency covered by the drill, and the names of staff participating in the drill. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, record review, the licensee did not comply with the section cited above by not providing quarterly drills as stated on the regulation stated above, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/17/2026 Plan of Correction Licensee has agreed to read over the regulation and provide training. The licensee will email LPA proof of training. In addition, lincensee will also provide LPA with fire drill roster.

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 LPAs observations, the licensee did not comply with the section cited above the hot water temperature for four (4) restrooms. Two (2) of the four (4) restroom water tested at 91.5 and 103.1 which is below regulations. The other two restrooms tested at 128.5 and 130.1 which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/10/2025 Plan of Correction Administrator agreed to immediately put a sign that states " Caution hot water " in the bathrooms. Aministrator agrees to conduct a weekly hot water temperature log. Administrator agrees to review the regulation above acknowledging review and understanding of the regulation. Train all staff and submit to LPA.

Official classification

Type A

Official code

1569.618(c)(3)

Regulation authority

HSC

What the official deficiency says

(c)The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staff to provide CPR. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPAs observation, interview, record review, the licensee did not comply with the section cited above with four (4) out of four (4) staff files did not show or staff does not have a current CPR certificate which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/10/2025 Plan of Correction Administrator agreed to have all staff CPR certified within the next seven (7) days.

Official classification

Type A

Official code

87465(c)(3)

Regulation authority

CCR

What the official deficiency says

(c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication, but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: (3) A record of each dose is maintained in the resident's record. The record shall include the date and time the PRN medication was taken, the dosage taken, and the resident's response. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPAs observation, interview, record review, the licensee did not comply with the section cited above, Licensee did not have Medication Administration Record (MAR) for Resident #2 (R2) on file which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/04/2025 Plan of Correction Administrator agrees to have the Resident's Medication Administration Record (MAR) on file with medications descriptions with date and time of dosage to be administered by Physician available for review.

Official classification

Type A

Official code

87458(a)

Regulation authority

CCR

What the official deficiency says

(a) Prior to a person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment, signed by a licensed medical professional acting within the scope of their practice and made within the last year, to be kept in the resident's record. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, record review, the licensee did not comply with the section cited above Resident #1 (R1) does not have Physician Report on file which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/04/2025 Plan of Correction Administrator agrees to have Resident's Physician Report on file at the facility by Plan of Correction (POC) date.

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 LPAs observation, the licensee did not comply with the section cited above the residents emergency exit doors from their bedroom leading to the outside to be in damaged and unsafe due to water damage. The paint on the door is chipped and peeling which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/17/2025 Plan of Correction Administrator stated that they ordered the new doors to be replaced by Plan of Correction (POC) date.

Official classification

Type A

Official code

87303(1)(f)

Regulation authority

CCR

What the official deficiency says

Maintenance and Operation: (1)(f) The facility shall be clean, safe, sanitary and in good repair and free of leaks 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 was not met as evidence by: Based on observations, the licensee failed to esnsure that the facilty is kept clean and sanitary all all times for residents, which can poses a Health, Safety, or Personal Rights risk to persons in care.

Official plan of correction

Facility Administrator/Licensee will have professionallly clean Floor surfaces in bath, restrooms and other areas in sanitary and odorless condition and email training of the staff to LPA Singh by the POC due date 5/13/2025.

Deadline recorded: May 13, 2025. 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 and Operation: (a)(f) 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 was not met as evidence by: Based on observations, the licensee failed to esnsure that the facilty is in good repair at all times, which can poses a Health, Safety, or Personal Rights risk to persons in care.

Official plan of correction

Facility Administrator/Licensee will have all repair done-doors,blinds fixed and email invoice to LPA Singh by the POC due date 05/19/2025.

Deadline recorded: May 13, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

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 was not met as evidence by: Based on observations, the licensee failed to esnsure that the facilty is keept clean and sanitary all all times for residents, which can poses a Health, Safety, or Personal Rights risk to persons in care.

Official plan of correction

Facility Administrator/Licensee will have a professional exterminator come to the facility and address the infestation of bed bugs. Facility will no longer utilize spraying method as the facility has been having a continuous problem with bed bugs and has yet to be resolved. Licensee/Administrator will look into a second treatment method completed by licensed exterminator to treat bed bugs and will email Proof of invoice to LPA Guerrero by POC date 3/19/2024.

Deadline recorded: Mar 19, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by leaving bleach chemicals accessible for residents in care, which poses an immediate health, safety, or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/09/2024 Plan of Correction Licensee has agreed to go ever regulation and provide traning on how to properly secure disinfectants, cleaning solutions, poisons, and other items which could pose a danger to residents in care. Licensee shall provide a sign and date training of underestaing to LPA Guerrero on POC date 3/9/2024.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

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 the facility shall be clean, safe, sanitary and in good repair. LPAs observed building #1 vent to be covered with accumilating dust. which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/11/2024 Plan of Correction Licensee has agreed to read over regulation and provide pictures proof that the bathroom has been repaired/ sanitized and cleaned. Licensee has agreed to clean air duct in building #1 and provide pictures of completion to LPA by POC date 3/11/2024.

Official classification

Type B

Official code

87303(a)(1)

Regulation authority

CCR

What the official deficiency says

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. LPAs observed two resident bathrooms to have broken tiles. In addition, LPAs observed black build-up on bathroom tile and ceiling. which poses a potential health, safety, or personal rights risk to persons in care.which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/22/2024 Plan of Correction Licensee has agreed to read over regulation and provide pictures proof that the bathroom has been repaired/ sanitized and cleaned. Licensee has agreed to provide sanitation training to LPA on POC date 4/1/2024.

Official classification

Type B

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. LPAs measured water in bathroom located in building #1 and observed water temperature to measure at 130.9 which pose a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/11/2024 Plan of Correction Licensee has agreed to adjust water temperature to meet the required temperature of 105/120 f based on regulation and provide pictures of completion to LPA Guerrero by POC date 3/11/2024.

Official classification

Type B

Official code

87303(e)(5)

Regulation authority

CCR

What the official deficiency says

(e) Water supplies and plumbing fixtures shall be maintained as follows: (5) Non-skid mats or strips shall be used in all bathtubs and showers. 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 that facility did not have skid mats in restrooms which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/11/2024 Plan of Correction Licensee has agreed to purchase skid mats for all residents restrooms and provide pictures along with recipts to LPA Guerrero upon completion by POC date 3/11/2024

Official classification

Type B

Official code

87303(i)(1)

Regulation authority

CCR

What the official deficiency says

(i) Facilities shall have signal systems which shall meet the following criteria: (1) All facilities licensed for 16 or more and all residential facilities having separate floors or buildings shall have a signal system which shall: 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 that facility has two separte buildings with no signal systems facility has a census of 22 residents. which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/29/2024 Plan of Correction Licensee has agreed to install signal systems for both buiding #1 and Building #2. Administrator will provide pictures along with recipts upon completion to LPA Guerrero on POC date 3/29/2024

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 Based on observation, the licensee did not comply with the section cited above. LPAs observed expired canned jalapenos along with diced green chili cans. Which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/22/2024 Plan of Correction Licensee has agreed to read over the regulation and provide nutrition training for all staff regarding food storage. Licensee shall provide a signed and dated document of traning to LPA Guerrero upon completion by POC date 3/22/2024

Official classification

Type B

Official code

87303(b)(1)

Regulation authority

CCR

What the official deficiency says

87303 (b) A comfortable temperature for residents shall be maintained at all times... (1) The facility shall heat rooms that residents occupy to a minimum of 68-degree F, (20 degrees C). This requirement is not met as evidenced by: Deficient Practice Statement Based on observations, the licensee did not comply with the section cited above. LPAs observation heating pilot was not lit. Which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/11/2024 Plan of Correction Licensee has agreed to fix pilot and provide pictures/recipts upon completion to LPA on POC date 3/11/2024.

Official classification

Type B

Official code

87307(a)

Regulation authority

CCR

What the official deficiency says

87307 (a) Living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents, staff, and others who may reside in the facility. The following provisions shall apply: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. By converting the entry way into an enclosed office and blocking main exterior exit door. Which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/09/2024 Plan of Correction Licensee has agreed to read over the entire regulation and remove all office items from entry way to ensure all emergency exits are clear of obstruction. Licensee will provide pictures and email all picures upon completion to LPA Guerrero by POC 3/9/2024.

Official classification

Type B

Official code

87411(c)

Regulation authority

CCR

What the official deficiency says

Personnel Requirements - General (c) All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69 This requirement was not met as evidenced by: LPA reviewed four of four staff files that did not have proof of training within the current year. This poses a potential health and safety risk to residents in care.

Official plan of correction

Licensee shall provide training as indicated in section 87411(c)(3) to all care staff. Proof of training and summary of training covered shall be submitted to CCL no later than end of POC date.

Deadline recorded: Sep 30, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87507(f)

Regulation authority

CCR

What the official deficiency says

Admission Agreements... (f) The licensee shall comply with all applicable terms and conditions set forth in the admission agreement, including all modifications and attachments. This requirement is not met as evidence by: Based on observation, interviews and record review, the licensee did not ensure to follow Admission Agreement; by cashing rent/and PNI funds on a resident who was evicted, which poses an immediate Health, Safety, or Personal Rights risk to persons in care.

Official plan of correction

Administrator has agreed to return total owed amount to Resident #1 (R1). Administrator will be contacting Resident #1 (R1) ROG payee and provide payment. Administrator will provide payment status to assigned LPA and provide proof of submitted payment. by POC date 9/15/2023.

Deadline recorded: Sep 15, 2023. 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 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 evidence by: Based on observation, interviews and record review, the licensee did not ensure Maintance and Operation was maintained, which poses an immediate Health, Safety, or Personal Rights risk to persons in care.

Official plan of correction

POC Administrator will review entire regulation and will provide invoices,permits, and provide all facility corrective documentation to assigned LPA by POC date 9/29/2023

Deadline recorded: Sep 29, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87224

Regulation authority

CCR

What the official deficiency says

Eviction Procedures A licensee of a licensed residential care facility for the elderly shall, prior to transferring a resident of the facility to another facility or to an independent living arrangement as a result of the forfeiture of a license.... (2) Provide each resident or the resident’s responsible person with a written notice no later than 60 days before the intended eviction. The notice shall include all of the following.... Based on observation, interviews and record review, the licensee did not ensure to follow evicion procedures which poses an immediate Health, Safety, or Personal Rights risk to persons in care.

Official plan of correction

Administrator will read over regulation and provide a same day written statement that indicates the acknowledgement and review of the regulation. Regulation shall be reviewed and signed by all facility Management associated to the facility. Administrator will send the acknowledgement to LPA via email on 6/1/23.

Deadline recorded: Jun 1, 2023. 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 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 was not met as evidence by: Based on observations, the licensee failed to esnsure that the facilty is keept clean and sanitary all all times for residents, which can poses a Health, Safety, or Personal Rights risk to persons in care.

Official plan of correction

Licensee will have a professional exterminator come to the facility and address the infestation of bed bugs. Proof of exterminator visit and plan to be sent to LPA Guerrero by 4/7/23.

Deadline recorded: Apr 7, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.311

Regulation authority

HSC

What the official deficiency says

Every residential care facility for the elderly shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections. 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 having carbon monoxide detector in building 2 which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/28/2022 Plan of Correction Licensee stated that they will purchase a carbon monoxide detectors today and install it at building 2. Licensee will send proof of purchase/installation to LPA Brown by POC due date.

Official classification

Type B

Official code

87303

Regulation authority

CCR

What the official deficiency says

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 and interview, the licensee did not comply with the section cited above by not having the window screens and window blinds in good repair which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/07/2022 Plan of Correction Licensee stated that they will install new window screens and new window blinds at the facility and submit proof to LPA Brown by POC due date.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provisionof 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 and interview, the licensee did not comply with the section cited above by not having the concrete floor located between building 1 and building 2 walkway in good repair and leveled which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/21/2022 Plan of Correction LIcensee stated that they will complete the concrete floor repair to level it and repair the floor cracks and holes between building 1 and building 2 walkway and submit proof of repair to LPA Brown by POC due date.

Official classification

Type B

Official code

130

Regulation authority

HSC

What the official deficiency says

Licensee has provided all staff who are working with Covid-19 positive resident with fit-testing for N95 respirators. This practce has a health and safety impact that includes, but is not limited to, personal rights, buildings and grounds, and responsibility for providing care and supervision. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, record review, , the licensee did not comply with the section cited above by not providing staff with N95 Fit test which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/21/2022 Plan of Correction Licensee stated that all staff will be provided N95 Fit test and they will submit proof of completion to LPA Brown by POC due date.

Official classification

Type B

Official code

121125

Regulation authority

HSC

What the official deficiency says

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 by not not having routine symptom screening and temperature check initiated at the entry for all staff and visitors which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/28/2022 Plan of Correction Licensee stated that they will have routine symptom screening and temperature check initiated at the entry for all staff and visitors today and submit proof of completion to LPA Brown by POC due date.