CASA VERDUGO

Official classification

Type B

Official code

87506(a)

Regulation authority

CCR

What the official deficiency says

87506(a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility... This requirement is not met as evidenced by: Based on interviews and record review, the licensee did not comply with the section cited above in that 2 of 5 resident records (R1 & R2) were incomplete which poses a potential health risk to 2 of 5 residents in care.

Official plan of correction

Licensee will fill out and obtain copies of required documents for R1 and R2 and maintain those records at the facility. Licensee will notify LPA via email when the records are complete by POC due date of 5/2/2025.

Deadline recorded: May 2, 2025. A deadline is not proof that correction was completed.

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 pursuant 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 is not met as evidenced by: Deficient Practice Statement Based on interview and record review, the licensee did not comply with the section cited above in that S1 was working at the facility for at least 5 calendar days and did not have a criminal background clearance, which poses an immediate safety risk to 5 of 5 residents in care.

Official plan of correction

POC Due Date: 01/27/2025 Plan of Correction LPAs observed S1 leave the facility during the visit. Administrator will submit the LIC501, LIC503, LIC508, and valid identification to the Department to process S1's criminal background clearance and will obtain documentation of S1's completed criminal background clearance before S1 is able to be present in or work at the facility. Administrator stated that she will review staff records to verify that staff have valid fingerprint clearance and association.

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 LPA observation, the licensee did not comply with the section cited above in that 5 of 5 residents had medications stored in multi-day pill boxes which poses a potential health risk to 5 of 5 residents in care.

Official plan of correction

POC Due Date: 02/26/2025 Plan of Correction Administrator will look into options with residents' pharmacies to package medications together into bubble packs. Administrator will ask hospice agencies to provide medication training to Administrator and staff and provide the Department with a sign in sheet for the medication training by POC due date of 2/26/2025.

Official classification

Type B

Official code

87705(c)(5)

Regulation authority

CCR

What the official deficiency says

87705 (c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (5) Each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, both of which shall include a reassessment of the resident’s dementia care needs. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not ensure that residents with a diagnosis of dementia, specifically R1 and R2, had a medical assessment that was conducted annually. This poses a potential health risk of 2 of 6 residents in care.

Official plan of correction

POC Due Date: 01/16/2025 Plan of Correction Administrator will contact R1 and R2's responsible parties to obtain medical appointments for both residents to be reassessed and obtain new LIC602s. Administrator will submit copies of the new LIC602s for R1 and R2 to the Department by POC due date of 1/16/2025.

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

87309(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 LPA observation, the licensee did not comply with the section cited above in regards to unsecured cleaning products and chemcials which were stored in a resident bathroom, unlocked garage, and under the sink in the kitchen. This poses an immediate health and safety risk to 4 of 4 persons in care.

Official plan of correction

POC Due Date: 01/19/2024 Plan of Correction Administrator removed the hazardous and toxic items and locked them in a cabinet in the garage during the visit. Cleared during the visit.

Official classification

Type B

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 is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in 4 of 4 resident records (R1-R4) were incomplete which poses a potential health and safety risk to 4 of 4 persons in care.

Official plan of correction

POC Due Date: 02/16/2024 Plan of Correction Administrator will review and complete any missing documents for R1-R4 files. Administrator will submit a signed LIC9098 to the Department by POC due date of 2/16/2024.

Official classification

Type B

Official code

87412(a)

Regulation authority

CCR

What the official deficiency says

87412 (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: 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 for 3 out of 5 staff records (S1-S3) were incomplete. This poses a potential safety risk to 4 of 4 persons in care.

Official plan of correction

POC Due Date: 02/16/2024 Plan of Correction Administrator will review and complete any missing documents for S1-S3 files. Administrator will submit a signed LIC9098 to the Department by POC due date of 2/16/2024.

Official classification

Type B

Official code

87211(a)(1)

Regulation authority

CCR

What the official deficiency says

87211 Reporting Requirements (a)(1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence... This requirement has not been met as evidenced by: Based on interviews and records review, the Administrator did not submit death reports to the Department for the deaths of R1-R14. This poses a potential safety risk to 4 of 4 residents in care.

Official plan of correction

Administrator stated she will take an online training regarding reporting requirements and submit proof of completion to the Department by POC due date of 10/31/2023.

Deadline recorded: Oct 31, 2023. A deadline is not proof that correction was completed.