ALLARA SENIOR LIVING

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, the licensee did not comply with the section cited above by not ensuring all knives, and other dangerous items such as scissor were secured and locked away in the residents dining area which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/07/2026 Plan of Correction The Director of Health and Wellness immediately secured the items. The Executed Director agrees to conduct a training with all staff regarding the regulation cited above and submit a statement of understanding and training log of all staff being trained by POC due date.

Official classification

Type A

Official code

87465(h)(4)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (4) All centrally stored medications shall be labeled and maintained in compliance with state and federal laws. No persons other than the dispensing pharmacist shall alter a prescription label. 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 by not ensuring that all resident medication are logged into the computer data and is being dispensed. The second concern is all residents medication is dispensed according to the doctor prescription and documentation for any reasons medication is missed. LPA observed medication still in the bubble pack and dispensed on the previous date and the day after which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/07/2026 Plan of Correction The Director of Health and Wellness and Executive Director agree to conduct a training on common medication errors and proper logging and documents with all staff and submit a training log with a statement of understanding of the regulation cited to LPA by POC due date.

Official classification

Type A

Official code

15630(b)(1)

Regulation authority

HSC

What the official deficiency says

Welfare and Institutions Code section 15630(b)(1) Any mandated reporter who, in his or her professional capacity, or within the scope of his or her employment, has observed... of an incident that reasonably ...physical abuse, as defined in ...or neglect, or is told by an elder or dependent adult that he or she physical abuse, ...report the known or suspected...within two working days. Based on interviews, the facility staff did not comply with the section cited above by not ensuring the staff adhere to the mandating reporting requirement which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator agreed to conduct an in-serve on reporting requirement with staff and the Health and safety code for abuse 15630.

Deadline recorded: Apr 22, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.2(a)(4)

Regulation authority

CCR

What the official deficiency says

87468.2 (a) (4) Additional Personal Rights of Residents in Privately Operated Facilities:(a)(a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (4) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement is not met as evidenced by: Based on interviews conducted and record review, while facility staff assisted R1, staff lost balance and caused R1 to sustain injuries. This violation posed a potential health and safety risk to residents in care.

Official plan of correction

The licensee shall conduct in-service training to all staff in regard to the residents’ personal rights. Proof will be submitted to the Department by POC due date

Deadline recorded: Jun 7, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.73(c)(2)

Regulation authority

CCR

What the official deficiency says

1569.73(c)A facility that has obtained a hospice waiver.. department...call emergency response services at the time of a life-threatening emergency... (2) The resident has.. advance directive, ...Section 4605 of the Probate Code, requesting to forego resuscitative measures.this was not met by.. Licensee did not comply with the section cited above by not ensuring staff were aware of residents in care DNR orders for R1 which resulted in staff taking resuscitation measure which poses a potential health, safety and personal rights risk to residents in care.

Official plan of correction

Facility will certify on LIC 9098 that Administrator and staff have reviewed and understand regulation section1569.73 (c)(2). Also, implement other measure to notify staff who has a DNR.

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

Official classification

Type B

Official code

87468.2(a)(19)

Regulation authority

CCR

What the official deficiency says

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have.. (19) To have prompt access to review all of their records and to purchase photocopies of their records. Photocopied records shall be provided within two (2) business days and at a cost that does not exceed... This requirement is not met as evidenced by: Based on interview and records review, the Licensee did not comply with the section cited above by not providing Resident #1 (R1) records to R1 representative as required as evidenced of the facility provided R1's records to R1's Representative on 06/21/2024 which poses a potential health, safety and personal rights risk to residents in care.

Official plan of correction

Licensee stated to train all staff on CCR 87468.2(a)(19) and submit proof of all staff training log to LPA Brown on Plan of Correction (POC) due date.

Deadline recorded: Jul 8, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

80069(1)(a)

Regulation authority

CCR

What the official deficiency says

80069 Client Medical Assessment The assessment shall be performed by a licensed physician or designee, who is also a licensed professional, and the assessment shall not be more than one year old when obtained. This requirement is not met as evidenced by: Based on a review of records, Administrator did not ensure 3 resident's files contained current (annual) Physician's Peports within the regulated timeframe which poses a potential Health, Safety, and/or personal rights risk to persons in care.

Official plan of correction

Administrator agrees to work with the residents, their families and primary care physicians to obtain a current medical assessment. Administrator agrees to submit verification that the Physician's Reports were completed to the Community Care Licensing Office within the following 14 business days.

Deadline recorded: Dec 15, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

80078(a)

Regulation authority

CCR

What the official deficiency says

80078 Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the client's needs. This requirement is not met as evidenced by: Based on interviews and record reviews, the Administrator failed to ensure the resident had assistance/supervision before leaving the facility on 10/26/23. Additionally, not ensuring the unit was secure to prevent R1 from departing facility; which posed an immediate Health, Safety and Personal Rights risk to persons in care.

Official plan of correction

During the visit, Vortex staff was dispatched to fix the door before the end of the day. Staff. Caregivers/Staff has been increase from 2 caregivers to 3 caregivers to provide additonal support for the memory care unit on going. Administrator agrees complete a statement of understanding by way of a LIC9098 and submit this LIC9098 to the Community Care Licensing Office by 10/30/23

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