Medical and dental careType A
- 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 record review, the licensee did not comply with the section cited above by not ensuring a updated centrally stored medication was provided for all five residents, which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 11/10/2025 Plan of Correction Licensee stated to submit an updated centrally stored medication log for all (5) residents by Plan of Correction (POC) due date.
Medication handling and storageType A
- Official classification
- Type A
- Official code
- 87465(h)(5)
- Regulation authority
- CCR
What the official deficiency says
(h) The following requirements shall apply to medications which are centrally stored: (5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. 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 Resident #5 medication was kept in original container, which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 10/27/2025 Plan of Correction Licensee stated to leave medication in original container and to alert all facility staff. Deficiency will be cleared.
Medication handling and storageType A
- Official classification
- Type A
- Official code
- 87465(c)
- Regulation authority
- CCR
What the official deficiency says
(c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication, but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: 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 by not ensuring all (5) residents daily and PRN medications were documented or dispensed properly, which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 10/27/2025 Plan of Correction Licensee stated to submit staff training on Medication Administration and Documentation by Plan of Correction (POC) due date.
Health conditions and treatmentsType A
- Official classification
- Type A
- Official code
- 87606(c)
- Regulation authority
- CCR
What the official deficiency says
(c) To accept or retain a person who is bedridden, other than for a temporary illness or recovery from surgery, a licensee shall obtain and maintain an appropriate fire clearance as specified in Section 87202, Fire Clearance. 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 by having Resident #3 (R3), Resident #4 (R4), and Resident #5 (R5) labeled as beddridden without appropriate fire clearance, which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 10/27/2025 Plan of Correction Licensee stated to submit LIC200 to licensing department or updated physician report/appointment by Plan of Correction (POC) due date.
Deficiency Dismissed Type A Section Cited CCR 87606(c)
Health conditions and treatmentsType A
- Official classification
- Type A
- Official code
- 87608(a)(3)
- Regulation authority
- CCR
What the official deficiency says
(a) Based on the individual's preadmission appraisal, and subsequent changes to that appraisal, the facility shall provide assistance and care for the resident in those activities of daily living which the resident is unable to do for himself/herself. Postural supports may be used under the following conditions: (3) A written order from a physician indicating the need for the postural support shall be maintained in the resident's record. The licensing agency shall be authorized to require other additional documentation if needed to verify the order. 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 having Resident #6 (R6) with a full bed rail with no doctor order or on hospice care, which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 10/27/2025 Plan of Correction Licensee stated to remove bed rail and submit doctor order or proof of doctor request to LPA Hernandez by Plan of Correction (POC) due date.
Facility condition and maintenanceType B
- 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. 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 having water to be of white color in Resident #1 (R1) Resident #2 (R2), and Resident #5 (R5) residents restrooms. LPA observed in Resident #8 (R8) to not have any hot water as hot water faucet on bathroom sink does not turn on. Deficiency will be issued. which poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 10/31/2025 Plan of Correction Licensee stated to submit to LPA proof of water being fixed and water faucet by Plan of Correction (POC) due date.
Admission, assessment, and evictionType B
- Official classification
- Type B
- Official code
- 87458(a)
- Regulation authority
- CCR
What the official deficiency says
(a) Prior to a person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment, signed by a licensed medical professional acting within the scope of their practice and made within the last year, to be kept in the resident's record. 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 by not ensuring Resident #8 (R8) had an updated physician report, which poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 11/03/2025 Plan of Correction Licensee stated to submit proof of doctors appointment and or physician report to LPA by POC due date.
Admission, assessment, and evictionType B
- Official classification
- Type B
- Official code
- 87463(b)
- Regulation authority
- CCR
What the official deficiency says
(b) The reappraisal shall document significant changes in the resident's physical, mental, cognitive, behavioral, or functional condition, including those required to be documented as specified in Section 87466, Observation of the Resident. 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 by not ensuring reapprasials for Resident #1 (R1), Resident #2 (R2), Resident #4 (R4), Resident #7 (R7) and Resident #8 (R8) were completed as well as no needs and services plan for R1 or R8. which poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 11/03/2025 Plan of Correction Licensee stated to submit reapprasials for R1, R2, R4, R7 and R8 residents and needs and services plan for R1 and R8 to LPA by Plan of Correction (POC) due date.
Resident rightsType B
- Official classification
- Type B
- Official code
- 1569.39(b)
- Regulation authority
- HSC
What the official deficiency says
(b) A residential care facility for the elderly that accepts or retains residents with restricted health conditions, as defined by the department, shall ensure that residents receive medical care as prescribed by the resident’s physician and contained in the resident’s service plan by appropriately skilled professionals acting within their scope of practice. An appropriately skilled professional may not be required when the resident is providing self-care, as defined by the department, and there is documentation in the resident’s service plan that the resident is capable of providing self-care. 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 by not ensuring Resident #1 has a restricted health care plan, which poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 11/03/2025 Plan of Correction Licensee stated to submit restricted health care plan to R1 by POC due date.