Facility condition and maintenanceType A
- Official classification
- Type A
- 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 observation,, the licensee did not comply with the section cited above by not ensuring that the cabinet lock where the chemicals are stored is not broken which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 05/20/2026 Plan of Correction Licensee will submit pictures of the cabinet door lock is fixed on plan of correction (POC) due date.
Facility condition and maintenanceType A
- 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 the client bathroom hot water faucet delivers water temperature taht is within the required range. which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 05/20/2026 Plan of Correction Licensee will submit picture of the hot water faucet temperature that is within the regulation on plan of correction (POC) due date. .
Fire safety and emergency preparednessType B
- Official classification
- Type B
- Official code
- 87202(a)
- Regulation authority
- CCR
What the official deficiency says
(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: 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 the fire extiguishers have the certification to determined if it is operable which poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 05/26/2026 Plan of Correction Licensee will submit proof of certification of the fire extiguishers on plan of correction (POC) due date.
Basic services and supervisionType B
- Official classification
- Type B
- Official code
- 87219(a)
- Regulation authority
- CCR
What the official deficiency says
(a) Residents shall be encouraged to maintain and develop their quality of life through participation in a variety of planned activities. The activities made available shall include: 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 ensuring that the facility has an activity calendar for the resident to participate to encouraged to maintain and develop their quality of life. which poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 05/26/2026 Plan of Correction Licensee will submit a copy of the facility activity calendar on plan of correction (POC) due date.
Medical and dental careType B
- Official classification
- Type B
- 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, interview, record review, the licensee did not comply with the section cited above by not ensuring that resident #1 (R1) and #2 (R2) medications are properly logged in the medication administration record which poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 05/26/2026 Plan of Correction LIcensee to submit medication training by a licensed professional signed by all staff and the person that conducted the training by plan of correction (POC) due date.
Admission, assessment, and evictionType B
- Official classification
- Type B
- Official code
- 87458(c)(1)
- Regulation authority
- CCR
What the official deficiency says
(c) The medical assessment shall include, but not be limited to: (1) A physical examination of the resident indicating the licensed medical professional's diagnosis or diagnoses and results of an examination for all of the following: 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 ensuring that resident #1 (R1) and #2 (R2) have an updated physician's report which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 05/29/2026 Plan of Correction Licensee will submit an updated physicians report or proof of doctor's appointment to perform the medical assesment on plan of correction (POC) due date.
Fire safety and emergency preparednessType B
- 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 record review, the licensee did not comply with the section cited above that the facility has an updated disaster drill available for review which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 05/26/2026 Plan of Correction Licensee will submit an updated disaster drill signed by all staff on plan of correction (POC) due date.