VMB ULTIMATE CARE

Official classification

Type B

Official code

87207

Regulation authority

CCR

What the official deficiency says

87207 No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility. This requirement has not been met as evidenced by: Based on interviews and records review, the Licensee did not comply with the section cited above in that S1 stated that only 2 of 6 residents were receiving hospice services, when it was actually 6 of 6 residents. This poses a potential person rights risk to 5 of 5 residents in care.

Official plan of correction

House Manager will submit a written letter to the Department stating that S1 will be truthful when interacting with representatives from the Department and the LIC9098 Self Certification of Deficiencies Cleared to the Department by POC due date of 9/25/2025. LPA provided House Manager with LIC9098 Self Certification of Deficiencies Cleared.

Deadline recorded: Sep 25, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87407(k)(1)

Regulation authority

CCR

What the official deficiency says

87407 (k) Whenever a certified administrator assumes… responsibility for administering a residential care facility for the elderly, he or she shall provide written notice, within thirty (30) days, to: (1) The local licensing office… This requirement has not been met as evidenced by: Based on interview and record review, the Licensee did not comply with the section cited above in that a written notice of S2 acting at the facility’s administrator was not submitted to the Department. This poses a potential safety risk to 5 of 5 residents in care.

Official plan of correction

House Manager will submit the LIC308, copy of S2's Administrator Certificate, and a written request to change the Administrator to S2 to the Department by POC due date of 9/25/2025. LPA provided House Manager with LIC308 and Change of Administrator Checklist.

Deadline recorded: Sep 25, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87632(a)

Regulation authority

CCR

What the official deficiency says

87632 (a) In order accept or retain terminally ill residents… the licensee shall have obtained a facility hospice care waiver from the Department… This requirement has not been met as evidenced by: Based on interview and record review, the Licensee did not comply with the section cited above in that the facility was caring for 6 hospice residents without requesting an hospice waiver for 6 residents. This posed a potential health risk to 6 of 6 residents in care.

Official plan of correction

House Manager submitted a hospice waiver request for 6 residents after 7/23/2025, which the Department has received and is currently reviewing. DEFICIENCY CLEARED

Deadline recorded: Sep 18, 2025. 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

87355 Criminal Record Clearance (e) All individuals subject to a criminal record review… shall prior to working, residing or volunteering in a licensed facility: (2) Obtain a California clearance or a criminal record exemption as required by the Department… This requirement has not been met as evidenced by: Deficient Practice Statement Based on observation and interview, the licensee did not comply with the section cited above in that T1 and T2 were residing and/or present at the facility without a valid fingerprint clearance. This poses an immediate safety risk to 6 of 6 residents in care.

Official plan of correction

POC Due Date: 06/18/2025 Plan of Correction LPA observed T1 and T2 leave the facility during the visit. Manager will be giving T1 a written 30-day eviction notice and will come up with an agreement with T1 to ensure that T1 does not return to the facility without being fingerprint cleared and associated during the 30-day notice period. Manager stated that she will send a copy of the eviction notice to the Department by POC due date of 6/18/2025.

Official classification

Type B

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

87465 Incidental Medical and Dental Care (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 has not been met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in that resident medications are stored in an unsecured cabinet and refrigerator located in the facility kitchen. This poses a potential safety risk to 6 of 6 residents in care.

Official plan of correction

POC Due Date: 07/17/2025 Plan of Correction Manager stated that she will lock the medication cabinet and will obtain a locked container to safely store medication in the fridge. Manager will reach out to the pharmacy to train all staff on proper medication storage and provide proof of training to the Department by POC due date of 7/17/2025.

Official classification

Type B

Official code

87458(a)

Regulation authority

CCR

What the official deficiency says

87458 Medical Assessment (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 has not been met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in that the medical assessments for R1, R2, and R3 were incomplete. This poses a potential health risk to 6 of 6 residents in care.

Official plan of correction

POC Due Date: 07/17/2025 Plan of Correction Manager will reach out to residents' families for them to obtain completed medical assessments. Manager will provide LPA with written notice that the medical assessments for R1, R2 and R3 are complete and stored in the residents' files by POC due date of 7/17/2025.

Official classification

Type A

Official code

87464(f)(1)

Regulation authority

CCR

What the official deficiency says

87464(f)(1) - Elopement resulting in serious bodily injury. Basic Sercices shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). " Care and supervision " means the facility assumes responsibility for, or provides ...., ongoing assistance with activities of daily living without which the resident’s physical health, mental health, safety, or welfare would be endangered. This requirement was not met as evidenced by: Interviews and record reviews showing staff left R1 unassisted on 7/23/21, resulting in elopement with serious bodily injury and hospitalization. This posed an immediate safety risk to one of six residents in care. Immediate CP of $500 assessed today

Official plan of correction

Licensee agreed to conduct training by an outside source on elopements/absent without leave (AWOL), supervision for residents in care. This training will be scheduled by 2/3/2023 and trainings will be completed by POC date of 2/21/2023.

Deadline recorded: Feb 21, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)(D)

Regulation authority

CCR

What the official deficiency says

87211(a)(D) Reporting Requirements - Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident. This requirement was not met, as evidenced by: Interviews and records review showing licensee did not report the elopement of R1 to local licensing as required. This posed an potential safety risk to one of six residents in care.

Official plan of correction

Licensee agreed to conduct training by an outside source on reporting requirements. This training will be scheduled by 2/3/2023 and trainings will be completed by POC date of 2/21/2023.

Deadline recorded: Feb 21, 2023. A deadline is not proof that correction was completed.