ROSE VALLEY REDLANDS

Official classification

Type A

Official code

87355(e)(3)

Regulation authority

CCR

What the official deficiency says

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (3) Request a transfer of a criminal record clearance as specified in Section 87355(c) or 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 associating S#1 to the facility through guardian which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/26/2024 Plan of Correction Licensee has agreed to associate S#1 to facility through guardian by POC due date.

Official classification

Type B

Official code

87506(e)

Regulation authority

CCR

What the official deficiency says

87506 Resident Records(e) Original records or photographic reproductions shall be retained for a minimum of three (3) years following termination of service to the resident. This requirement is not met as evidenced by: The licensee did not comply with the section cited above by not maintaining records for resident #1 and resident #2 at the facility for 3 years after termination of services, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

The Licensee/Administrator shall submit a self-certified statement of understanding on the regulation cited and submit the statement to the Licensing Agency by POC due date.

Deadline recorded: Oct 14, 2024. 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

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: The licensee did not comply with the section cited above by not obtaining outside pest control services to ensure the facility was free of mice, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

The Licensee/Administrator shall submit to the Licensing Agency proof of pest control services contracted by 6/13/2024 and submit documentation completed services by 6/18/2024.

Deadline recorded: Jun 13, 2024. 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

(a) The facility shall be clean, safe, sanitary and in good repair at all times. This requirement is not met as evidenced by: LPA observed missing tile pieces and loose tile pieces around the kitchen sink exposing rock and gravel. LPA conducted a toured of resident’s bedrooms. LPA observed a broken glass window in resident #1 (R1’s) bedroom; which poses a potential health, safety, or personal rights risk to persons in care.

Official plan of correction

Licensee shall submit to the licensing agency proof of repairs or a self-certification that repairs have been made by POC due date.

Deadline recorded: Jan 26, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87411(f)

Regulation authority

CCR

What the official deficiency says

(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure. A report shall be made of each screening, signed by the examining physician. The report shall indicate whether the person is physically qualified to perform the duties to be assigned, and whether he/she has any health condition that would create a hazard to him/herself, other staff members or residents. A signed statement shall be obtained from each volunteer affirming that he/she is in good health. Personnel with evidence of physical illness or emotional instability that poses a significant threat to the well-being of residents shall be relieved of their duties. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA file review, the licensee did not comply with the section cited above by not maintaining verification of staff #1 complete health screening results, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/27/2023 Plan of Correction Licensee/Administrator shall submit to the licensing agency proof of staff #1 TB results by POC due date.

Official classification

Type B

Official code

1569.605

Regulation authority

HSC

What the official deficiency says

On and after July 1, 2015, all residential care facilities for the elderly, except those facilities that are an integral part of a continuing care retirement community, shall maintain liability insurance covering injury to residents and guests in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in the total annual aggregate, caused by the negligent acts or omissions to act of, or neglect by, the licensee or its employees. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA file review, the licensee did not comply with the section cited above by not maintaining verification of liability insurance on file for Licensing review, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/27/2023 Plan of Correction Licensee/Administrator shall submit to the licensing agency proof of liability insurance by POC due date.

Official classification

Type B

Official code

87457(c)

Regulation authority

CCR

What the official deficiency says

(c) Prior to admission a determination of the prospective resident's suitability for admission shall be completed and shall include an appraisal of his/her individual service needs in comparison with the admission criteria specified in Section 87455, Acceptance and Retention Limitations. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA file review, the licensee did not comply with the section cited above by Resident #1 (R1) and resident #2 (R2) preplacement appraisals were observed incomplete, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/27/2023 Plan of Correction Licensee/Administrator shall submit to the Licensing Agency proof of correction by POC due date.

Official classification

Type B

Official code

87458(b)(1)

Regulation authority

CCR

What the official deficiency says

(b) The medical assessment shall include, but not be limited to: (1) A physical examination of the resident indicating the physician's primary diagnosis and secondary diagnosis, if any and results of an examination for communicable tuberculosis, other contagious/infectious or contagious diseases or other medical conditions which would preclude care of the person by the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA file review, the licensee did not comply with the section cited above by Resident #1 (R1) did not have verfication of complete health screening results, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/27/2023 Plan of Correction Licensing/Administrator shall submit to the licensing agency proof of TB results by POC due 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 file review and observations, the licensee did not comply with the section cited above by last emergency drill was conducted in July 2019, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/27/2023 Plan of Correction Licensee/Administrator shall conduct a emergency drill with staff and submit proof of correction to the licensing agency by POC due date.

Official classification

Type A

Official code

87208(c)

Regulation authority

CCR

What the official deficiency says

Plan of Operation - A licensee who accepts or retains residents diagnosed by a physician to have dementia shall include additional information in the plan of operation as specified in Section 87705(b). This requirement was not met as evidenced by: Resident 1 has a primary diagnosis of Dementia.

Official plan of correction

Licensee shall immediately place Resident 1 to another facility more appropriate for their level of care. Licensee shall notify the Department of this placement on or before the end of the POC date.

Deadline recorded: Nov 25, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87411(C)

Regulation authority

CCR

What the official deficiency says

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 the lack of record or proof of completion of medication training could not be provided.

Official plan of correction

Administrator agreed to have a Hospice Agency come to the facility to provide medication training to staff members who work directly with residents with in the next 3 weeks. Administrator agreed to have medication training with hospice agency scheduled Administrator also agrees to move forward with in house training by January 2023.

Deadline recorded: Nov 23, 2022. A deadline is not proof that correction was completed.