KNOLLS WEST ASSISTED LIVING

Official classification

Type B

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 observation, record review, the licensee did not comply with the section cited above by not ensuring that staff#3 (S3) has an updated CPR training which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/11/2026 Plan of Correction Licensee will submit the updated CPR certificate on plan of correction (POC) due date.

Official classification

Type B

Official code

87465(6)

Regulation authority

CCR

What the official deficiency says

Title 22, Division 6 Chapter 8 Article 08 87465 Incidental Medical and Dental Care (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 evidence by: Based on LPAs observations, record review the facility did not comply with the section cited above by not ensuring that the medication records were accurately maintained by staff when compared to medication given, which posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

The Licensee shall retrain staff on medication management training conducted by a medical professional. Training documentation shall include the name of the trainer, names of staff with signatures, that attended the training.

Deadline recorded: Apr 20, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87412(d)

Regulation authority

CCR

What the official deficiency says

(d) The licensee shall maintain documentation that an administrator has met the certification requirements specified in Section 87406, Administrator Certification Requirements or the recertification requirements in Section 87407, Administrator Recertification Requirements. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview and record review, the administrator did not comply with the section cited above in having a current and valid administrator certification which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/07/2023 Plan of Correction Administrator stated that she will complete the course to obtain a current and valid administrator certificate. Administrator stated that she will submit copy via email to LPAl by POC due date.

Official classification

Type A

Official code

87355(e)

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: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview and record review, the administrator did not comply with the section cited above in employing (4) staff without an approved criminal record clearance which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/01/2023 Plan of Correction Administrator stated that she will remove the (4) staff from the schedule. Administrator stated that she will request criminal record clearance for the (4) staff and submit proof to LPA via email by POC due date.

Official classification

Type B

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, interview and record review, the Administrator did not comply with the section cited above in requesting a transfer of a criminal record clearance for (2) staff which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/07/2023 Plan of Correction Administrator stated that she will remove the (2) staff from the schedule. Administrator stated that she will submit proof via email to LPA by POC due date for the request transfer of a criminal record clearance for the (2) staff and associate them to the facility.