ANGELS IN GRACE

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, the licensee did not comply with the section cited above in that noon and PM doses for R1's medications were removed from the bubble packs and stored in plastic containers which poses a potential health risk to 1 of 2 residents in care.

Official plan of correction

POC Due Date: 12/19/2025 Plan of Correction Administrator will provide in-service training on medication storage and administration to staff. Administrator will provide training sign in sheet to the Department by POC due date of 12/19/2025.

Official classification

Type A

Official code

87355(e)(1)

Regulation authority

CCR

What the official deficiency says

87355 Criminal Record Clearance (e) all individuals subject to a criminal record review persuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing, or volunteering in a licensed facility (1) obtain a California clearance or a criminal record exemption as required by the Department. This requirement has not been met as evidenced by: Based on observation, interviews and record review, S1 did not obtain a criminal background clearance prior to working at the facility. This poses an immediate health and safety risk to 5 of 5 residents in care. A civil penalty of $100 was assessed.

Official plan of correction

LPA verified that S1 left the facility prior concluding the visit. Administrator will submit a letter to the Department stating that S1 will not return to the facility until receiving a cleared background check by POC due date.

Deadline recorded: Dec 29, 2022. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87202(a)(2)

Regulation authority

CCR

What the official deficiency says

87202 Fire Clearance (a) All facilities... Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal. (2) Bedridden persons This requirements has not been met as evidenced by: Based on observation and record review, the facility does not have a fire clearance for bedridden residents. This poses an immediate safety risk to 2 of 5 residents in care. A civil penalty of $500 was assessed.

Official plan of correction

Administrator will submit a updated fire clearance request, an LIC200 and an updated facility sketch to the Department by POC due date.

Deadline recorded: Dec 29, 2022. A deadline is not proof that correction was completed.