SENIORS DIGNITY HOME AND CARE

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: Based on observation, the licensee did not comply with the section cited above in 1 out of 1 knives drawer were unlockable in the kitchen area which posed a potential safety risk to persons in care.

Official plan of correction

Former citation: The facility agreed to have the drawer fixed and send LPA a photo of the lockable drawer by POC due date, 12/11/2025. 08/12/25: POC is deemed cleared during todays visit.

Deadline recorded: Aug 13, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

Hot water temperture controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C). This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above in 1 out of three bathrooms (in the visitor area) did not have water temperatire regulated within the allotted ranges which posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Former citation: The facility agreed to reduce the hot water temperature and submit a photo of the regulated water temperature by POC due date, 12/11/25. 08/12/25: POC is deemed cleared during todays visit.

Deadline recorded: Aug 13, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(c)

Regulation authority

CCR

What the official deficiency says

87211(c) Personal Rights: Any suspected physical abuse that does not result in serious bodily injury of an elder or dependent adult shall be reported to the local ombudsman, the corresponding licensing agency, and the local law enforcement agency within twenty-four (24) hours as required by Welfare and Institutions Code Section 15630(b)(1) … This requirement was not met as evidence by: Based on interviews and records review, facility did not report the physical altercation incident to either local law enforcement or to LTCO which posed a potential safety and personal rights risk to residents in care.

Official plan of correction

Licensee will be submitting an SOC341 to the LTCO by POC due date, 07/17/2026.

Deadline recorded: Jul 17, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

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 1 out of 1 knives drawer were unlockable in the kitchen area which posed a potential safety risk to persons in care.

Official plan of correction

POC Due Date: 12/11/2025 Plan of Correction The facility agreed to have the drawer fixed and send LPA a photo of the lockable drawer by POC due date, 12/11/2025.

Official classification

Type B

Official code

87463(h)

Regulation authority

CCR

What the official deficiency says

(h) The licensee shall request that all residents receive an annual routine visit with a licensed medical professional once every twelve months, either in person or by video appointment. 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 1 out of 5 residents did not have an uodated routine visit wuth their PCP for an updated LIC602 which posed a potential health risk to persons in care.

Official plan of correction

POC Due Date: 12/18/2025 Plan of Correction The facility agreed to request for the residents LIC602 to be updated and submit to LPA when completed by POCdue date, 12/18/2025.

Official classification

Type B

Official code

87411(f)

Regulation authority

CCR

What the official deficiency says

All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician... 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 1 out of 4 staff did not have their health screening form which has their TB information which posed a potential health risk to persons in care.

Official plan of correction

POC Due Date: 12/18/2025 Plan of Correction Licensee agreed to fill out the health screening form and have the staff include their TB information and submit to LPA by POC due date, 12/11/2025.

Official classification

Type B

Official code

87303(e)

Regulation authority

CCR

What the official deficiency says

Hot water temperture controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C). 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 1 out of three bathrooms (in the visitor area) did not have water temperatire regulated within the allotted ranges which posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/11/2025 Plan of Correction The facility agreed to reduce the hot water temperature and submit a photo of the regulated water temperature by POC due date, 12/11/25.

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 and keep on file, documentation of a medical assessment, signed by a physician, made within the last year. The licensee shall be permitted to use the form LIC 602 (Rev. 9/89), Physician's Report, to obtain the medical assessment. 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 out of 6 residents [R1, R2, R3, and R4] did not have an updated Physician's Report (LIC602) on file which posed a potential health risk to persons in care.

Official plan of correction

POC Due Date: 11/15/2024 Plan of Correction The Licensee agreed to obtain a copy of the residents Physician's Report (LIC602) by POC due date of 11/15/2024.

Official classification

Type B

Official code

87458(b)(1)

Regulation authority

CCR

What the official deficiency says

(b) The medical assessment shall include, but not be limited to: (1) A physical examination of the resident indicating the physician's primary diagnosis and secondary diagnosis, if any and results of an examination for communicable tuberculosis, other contagious/infectious or contagious diseases or other medical conditions which would preclude care of the person 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 in 1 out of 6 [R2] resident's did not have a copy of their TB diagnosis in their file which posed a potential health risk to persons in care.

Official plan of correction

POC Due Date: 11/15/2024 Plan of Correction Licensee agreed to obtain a copy of the TB diagnosis on the resident's LIC602 and place on file by POC due date, 11/15/2024.

Official classification

Type B

Official code

1569.695(c)

Regulation authority

HSC

What the official deficiency says

(c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of residents is not required during a drill. While a facility may provide an opportunity for residents to participate in a drill, it shall not require any resident participation. Documentation of the drills shall include the date, the type of emergency covered by the drill, and the names of staff participating in the drill. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA observation of record review, the licensee did not comply with the section cited above in none of the quarterly fire drills for 2024 were completed which posed a potential safety risk to persons in care.

Official plan of correction

POC Due Date: 10/31/2024 Plan of Correction Facility agreed to conduct a drill for the current month by POC due date, 10/31/2024. Licensee also agreed to submit a drill in December 2024 as their last quarterly drill for the year and continue quarterly drills the following year.

Official classification

Type B

Official code

87465(d)

Regulation authority

CCR

What the official deficiency says

(d) If the resident is unable to determine his/her own need for a prescription or nonprescription PRN medication, and is unable to 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 observation and record review, the licensee did not comply with the section cited above in 1 out of 6 residents did not match the medications with the date filled which posed a potential health risk to 1 (R1) persons in care.

Official plan of correction

POC Due Date: 11/30/2023 Plan of Correction Licensee will make an internal form for the date the pharmacy filled the prescription, the date the licensee received the medication, and the date the licensee dispensed the medication to the resident. Licensee will send a copy of the form with the information filled-out to LPA by POC due date, 11/30/23.

Official classification

Type B

Official code

87468.1(a)(1)

Regulation authority

CCR

What the official deficiency says

Personal Rights of Residents in All Facilities. Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement was not met, as evidenced by: Based on interviews, the licensee did not ensure that 1 of 6 residents was accorded dignity in their personal relationship with staff. This posed a potential personal rights risk to persons in care.

Official plan of correction

Licensee expressed that he and staff are culturally loud, so he will post signs in the facility directing staff to keep their voices at a low level when interacting with residents.. Licensee offered to have personal rights training provided for all staff. Proof of training will be provided to Community Care Licensing by the POC due date of 3/16/2023.

Deadline recorded: Mar 16, 2023. A deadline is not proof that correction was completed.