HIGHLAND SENIOR HOME CARE LLC

Official classification

Type A

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

(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 by not ensuring that water temperatures tested between 105 -120 degrees Fahrenheit, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/25/2026 Plan of Correction The Administrator will adjust the water heater, test the water temperature to ensure it measures between 105-120 degrees Fahrenheit and submit proof to LPA by Plan of Correction (POC) due date.

Official classification

Type A

Official code

87555(b)(27)

Regulation authority

CCR

What the official deficiency says

(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 and interview, the licensee did not comply with the section cited above by not ensuring that the facility is free from roaches, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/25/2026 Plan of Correction The Administrator will have the facility assessed and sprayed for roaches and send proof that the services were provided and/paid for to LPA by Plan of Correction (POC) due date.

Official classification

Type A

Official code

87465(e)

Regulation authority

CCR

What the official deficiency says

(e) For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician on a prescription blank, maintained in the resident's file, and a label on the medication. Both the physician's order and the label shall contain at least all of the following information. 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 by not ensuring the the over the counter medications (Tylenol and Immodium) had a physician's order for the resident(s), which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/25/2026 Plan of Correction The Administrator will request a physicians order for the over-the-counter medications in the medication cabinet and submit proof to LPA by Plan of Correction (POC) due date.

Official classification

Type B

Official code

87507(c)

Regulation authority

CCR

What the official deficiency says

(c) Admission agreements shall be signed and dated, acknowledging the contents of the document, by the resident or the resident's representative, if any, and the licensee or the licensee's designated representative no later than seven days following admission. Attachments to the agreement may be utilized as long as they are also signed and dated as prescribed above. 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 by not ensuring that the Admission Agreement for Resident 4 (R4) was signed by the resident or their responsible party, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/03/2026 Plan of Correction The Administrator will contactR4's responsible party, have them sign the Admission Agreement and submit proof of the signature and date to LPA by Plan of Correction (POC) due date.

Official classification

Type A

Official code

87465(c)(3)

Regulation authority

CCR

What the official deficiency says

87465(c)(3) Incidental Medical and Dental Care (c)If the resident's physician has stated in writing that the resident is unable to determine his/her..(3) A record of each dose is maintained in the resident's record. This requirement is not met as evidenced by: Based on record review, the facility did not ensure that R1, R3 and R4 had completed information on their Medication Administration Record (MAR) and/or their Centrally Stored Medications List (CSM), which posed an immediate risk to the health and safety or residents in care.

Official plan of correction

The Licensee/Administrator will review all of the residents' MAR and CSM, update them, conduct a staff training on medications and submit proof to LPA by Plan of Correction (POC) due date.

Deadline recorded: Feb 26, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87211(1)(D)

Regulation authority

CCR

What the official deficiency says

87211 (1)(D) Reporting Requirements (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days...(D) Any incident which threatens the welfare, safety or health of any resident...This requirement was not met as evidenced by: Based on interview and record review, the Licensee/Administrator and confirmed that several incidents involving R1 were not reported, which posed an immediate risk to the health and safety of resident(s) in care.

Official plan of correction

Licensee/Administrator will review Title 22 related to reporting requirements and submit signed statement to LPA by Plan of Correction (POC) due date.

Deadline recorded: Feb 26, 2026. 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) 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. 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 ensuring cleaning solutions such as bleach and Ajax were kept locked and inacceisble, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/11/2025 Plan of Correction Staff removed cleaning solutions and placed them in a lock cabinet during the visit. Administrator will train staff on hazardous or dangerous materials and provide LPA a copy of this training by the Plan of Correction due date.

Official classification

Type A

Official code

87465(a)(6)

Regulation authority

CCR

What the official deficiency says

(6) When requested by the prescribing physician or the Department, a record of dosages of medications which are centrally stored shall be maintained by the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, iinterview and record review, the licensee did not comply with the section cited above by not ensuring that once medication is administered, staff must initial each day and time that the medication is given into the MAR, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/11/2025 Plan of Correction Administrator will provide medications training for staff an provide LPA with a record of this training by the Plan of Correction due date and provide a copy of the MAR for the month of March.

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 interview and rrecord review, the licensee did not comply with the section cited above by not ensuring that when fire/earthquake drills are conducted, a log is kept of the day, time and participants, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/21/2025 Plan of Correction Administrator will conduct a Fire/Earthquake drill and submit proof to LPA by the Plan of Correction due date.

Official classification

Type A

Official code

87224(a)(2)

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 forfeiture of a license...(2) Provide each resident or the This standard was not met as evidenced by: Based on interviews, observation and record review, the licensee did not ensure that the licensee followed eviction 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 indicating the acknowledgement and review of the regulation. Administrator will send a copy of this signed statement to LPA by Plan of Correction due date.

Deadline recorded: Dec 18, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87705(f)(2)

Regulation authority

CCR

What the official deficiency says

87705(f)(2) Care of Persons with Dementia (f) The following shall be stored inaccessible to residents with dementia: (2) Over-the-counter medicatioh, nutritional supplements or vitamins, alcohol, cigarettes, and toxic substances such as certain plants, gardening supplies, cleaning supplies and disinfectants. This requirement is not met as evidenced by: based on observation, interview and records review, the Licensee did not comply with the section cited above by not ensuring the one (1) gallon of bleach and two (2) spray bottles of cleaning solution were locked and inaccessible to residents, which poses an immediate health, safety and personal rights risk to residents in care.

Official plan of correction

Licensee immediately lock the one (1) gallon of bleach and two (2) spray bottles of cleaning solution during the visit. Licensee stated to train all staff on CCR 87705(f)(2) and submit proof of staff training log to LPA Small on Plan of Correction (POC) due date.

Deadline recorded: Sep 17, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87355(e)(2)

Regulation authority

CCR

What the official deficiency says

87355(e)(2) Criminial Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569. 17(b) shall prior to working...(2) Request a transfer of a criminal record clearance as specified in Section 87355(c). This requirement is not met as evidenced by: based on observation, interview and record review, the Licensee did not comply with the section cited above by not transferring S3's criminal records background clearance to the facilty prior to employment on 08/2024 which poses a potential health, safety and personal rights risk to residents in care.

Official plan of correction

Licensee stated to transfer S3's criminal record cllearance to the facility and submit proof to LPA Small on POC due date.

Deadline recorded: Sep 27, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

1569.311

Regulation authority

HSC

What the official deficiency says

Health and Safety Code 1569.311 Carbon monoxide detectors required, inspection. Every residential care facility for the elderly shall have one or more carbon monoxide detectors in the facility that meet the standards...This requirement is not met as evidenced by: Based on observations and interview, the Licnesee did not comply with the section cited above by not ensuring that the carbon monoxide detector at the facility is in good working condition which poses an immedicate health, safety and personal rights risk to residents in care.

Official plan of correction

Licensee stated to obtain/purchase an operable carbon monoxide detector and submit proof to LPA Small on Plan of Correction (POC) due date.

Deadline recorded: Sep 17, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87465(e)

Regulation authority

CCR

What the official deficiency says

(e) For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician on a prescription blank, maintained in the resident's file, and a label on the medication. Both the physician's order and the label shall contain at least all of the following information. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA observation, staff interview, resident record review, the licensee did not comply with the section cited above as Resident 1 (R1) was observed with nonprescription medication without a physician's order, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/26/2024 Plan of Correction Licensee shall maintain a physician's order for R1's prescription and nonprescription PRN medication. Licensee shall submit proof of correction to the Department no later than end of POC date.

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 LPA observation and staff interview, the licensee did not comply with the section cited above as Licensee did not have documentation of conducted disaster drills which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/26/2024 Plan of Correction Licensee shall maintain a documentation of the disaster drills as stated in regulation. Proof of correction shall be submitted to the Department no later than end of POC date.

Official classification

Type B

Official code

87608(a)(5)(A)

Regulation authority

CCR

What the official deficiency says

(A) A bed rail that extends from the head half the length of the bed and used only for assistance with mobility shall be allowed. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA observations and resident records review, the licensee did not comply with the section cited above as Resident 2 (R2) bed was observed with full bed rails, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/26/2024 Plan of Correction Licensee shall remove full bed rails from R2's bed. Proof of compliance shall be submitted to the Department no later than end of POC date.

Official classification

Type B

Official code

87633(f)(1)

Regulation authority

CCR

What the official deficiency says

(1) The record of each training session shall specify the names and credentials of the trainer, the persons in attendance, the subject matter covered, and the date and duration of the training session. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA observation and record review, the licensee did not comply with the section cited above in that neither staff nor hospice records show training received by facility staff regarding the needs of residents receiving hospice services, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/31/2024 Plan of Correction Licensee shall provide training regarding the needs of residents receiving hospice services. Proof of compliance shall be submitted to the Department no later than end of POC date.