ELITE MANOR RESIDENTIAL CARE

Official classification

Type A

Official code

87309(a)(b)

Regulation authority

CCR

What the official deficiency says

The licensee shall ensure that disinfectants, cleaning solutions, poisonous substances....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: LPA observed three (3) toxins were unlocked in the kitchen under the sink cabinet (lock was broken), bathroom#1 two (2) toxins unlocked again (same as Annual on 4/20/2026) under the sink cabinet, bathroom#2 two (2) toxins (photos taken) unlocked in cabinet below sink.

Official plan of correction

LPA observed staff locking all toxins at time of visit. Licensee will have a contractor come out to the facility to install another lock in the kitchen cabinet under the sink by 5/15/2026. Licensee will have comprehensive training on locking toxins with material and sign in sheet by POC

Deadline recorded: May 6, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible....medication. This requirement is not met as evidenced by: LPA observed Resident#4 six (6) medications (photos taken of each medication) was unlocked in kitchen cabinet by oven the same place as the Annual on 4/20/2026, Resident#2 in Room #2 had three (3) medications unlocked sitting on the dresser (photos taken by LPA)

Official plan of correction

LPA observed staff lock medication at time of visit. Licensee will have a licensed professional train all staff on medication storage and administration by 5/19/2026

Deadline recorded: May 6, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87468.1(a)(6)

Regulation authority

CCR

What the official deficiency says

(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights:(6)To leave or depart the facility at any time and to not be locked into any room, building, or on facility premises by day or night. This requirement is not met as evidenced by: LPA during visit had interviews with the Administrator, two Staff, Resident#4 was in the living room in a gerry chair as a restraint with no exception.

Official plan of correction

LPA observed resident#4 released from the gerry chair at time of visit. Licensee will have PCP write a order for use of gerry chair as restraint and submit a letter of exception to Licensing agency by 5/15/2026. All staff will have a training on personal rights with material and sign in sheet by 5/15/2026

Deadline recorded: May 6, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87305(a)(b)

Regulation authority

CCR

What the official deficiency says

(a) Prior to construction or alterations, all facilities shall obtain a building permit.(b) The licensing agency may require the facility to acquire a local building inspection where the agency determines that a suspected hazard to health and safety exists.This requirement is not met as evidenced by: LPA observed three structures (LPA took photos) with staff personal belongings stored and beds not on the facility sketch and does not have approval from Licensingand has no fire clearance.

Official plan of correction

Licensee will have the city zoning department and city fire department visit facility to inspect added structures and submit clearance letters by POC date.

Deadline recorded: Jun 2, 2026. A deadline is not proof that correction was completed.

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 in two (3) count out of toxins left out one (1) ajax one (1) cleaner (in the cabinet in the front bathroom), & one (1) cleaner (staff unlocked bathroom by kitchen) which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/21/2026 Plan of Correction Caregivers will have a training on locking toxins with material and sign in sheet by POC date. Licensee will add a digital keypad lock on staff bathroom by the kitchen by 4/28/2026

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement is not met as evidenced by: Deficient Practice Statement Based on observationof the LPA finding medication in the kitchen unlocked in a cabinet by the stove, the licensee did not comply with the section cited above in (one) 1 count out of four (4) different medication which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/27/2026 Plan of Correction Staff locked all medication at time of visit observed by LPA. Licensee will have all staff trained on storing over the counter medication in a locked cabinet with sign in sheet and material by POC date.

Official classification

Type B

Official code

87412(a)(11)

Regulation authority

CCR

What the official deficiency says

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (11) A health screening as specified in Section 87411, Personnel Requirements - General. 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 in count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/04/2026 Plan of Correction Licensee will have staff#2 & Staff#3 go to the doctor and have a documented health screening by POC date.

Official classification

Type B

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, LPA observed cleaning stored in an unlocked cabinet under the kitchen sink. The licensee did not comply with the section cited above in [5] out of [5] objects which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/10/2024 Plan of Correction Administrator will remove the items so that they are inaccessible to residents and will install a lock on the cabinet door. Administrator will provide additional training on the above regulation and will submit proof of training by POC date.

Official classification

Type B

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, medications were observed to be stored in pill cups. The licensee did not comply with the section cited above in [5] out of [5] persons) which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/10/2024 Plan of Correction Medications were immediately destroyed and Administrator will schedule additional training on medication storage and dispensing. Administrator will provide proof of training by POC date.

Official classification

Type A

Official code

87506(a)

Regulation authority

CCR

What the official deficiency says

(a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. This requirement was not met as evidenced by: Based on observation and interview, the licensee did not comply with the section cited above by failing to maintain a current record for 2 out of 5 residents at the facility.

Official plan of correction

Licensee will obtain files for each resident and ensure a file is completed and obtained for any future residents prior to admission. Licensee to provide proof of correction to CCLD by close of business on 6/5/2023.

Deadline recorded: Jun 5, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87355(e)(2)

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: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c) This requirement was not met as evidenced by: Based on record review and interview, the licensee did not comply with the section cited above by failing to associate 2 out of 5 staff employed at the facility.

Official plan of correction

Licensee agreed to associate the 2 staff and provide proof of correction to CCLD by close of business on 6/5/2023.

Deadline recorded: Jun 5, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87465(e)

Regulation authority

CCR

What the official deficiency says

(e) For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician, on a prescription blank, maintained in the residents file, and a label on the medication... This requirement was not met as evidenced by: Based on observation and interview, the licensee did not comply with the section cited above by having a bottle of unidentified medication in R1's medication container.

Official plan of correction

Licensee agreed to obtain new medication with proper label and provide staff training on proper dispensing and disposing of medication. Licensee to provide proof of correction to CCLD by close of business on 6/9/2023.

Deadline recorded: Jun 9, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87465(a)(4)

Regulation authority

CCR

What the official deficiency says

(a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following: (4) The licensee shall assist residents with self-administered medications as needed.

Deadline recorded: Jun 9, 2023. A deadline is not proof that correction was completed.