REMINGTON CLUB II

Official classification

Type B

Official code

87224(d)(1)

Regulation authority

CCR

What the official deficiency says

The licensee shall set forth in the notice to quit the reasons relied upon for the eviction with specific facts to permit determination of the date, place, witnesses, and circumstances concerning those reasons. The notice to quit shall include the following information:...” This requirement was not met, as evidenced by: Based on interviews and records, Licensee did not provide the required information in an eviction notice to R1. This resulted in a personal rights risk to 1 of 75 resdients in care.

Official plan of correction

Licensee acknowledged that the eviction notice on 02/19/2026 did not contain all of the required information, and did not enforce it. Management agreed to review the Title 22 requirements regarding eviction procedures, provided during the visit, and adhere to the requirements for future evictions.

Deadline recorded: Apr 29, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.2(a)(4)

Regulation authority

CCR

What the official deficiency says

(a)In addition to the rights... personal rights: (4)To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers... This requirement was not met as evidenced by: Based on interviews and records review, the licensee did not ensure care/services were provided that met the individual needs of R1 during a transfer. This resulted in a safety risk for 1 of 75 residents in care.

Official plan of correction

Health & Wellness Director retrained staff to include utilization of required assistive devices during transfers and requesting assistance from a second caregiver when needed. Additional transfer training will be provided to staff, with proof of training sent to LPA by POC due date.

Deadline recorded: May 1, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87555(b)(23)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (23) All readily perishable foods or beverages capable of supporting rapid and progressive growth of micro-organisms which can cause food infections or food intoxications shall be stored in covered containers at appropriate temperatures. This requirement is not met as evidenced by: Deficient Practice Statement Based on direct LPA observation, the licensee did not comply with the section cited above in seven (7) refrigerated items. This posed a potential health risk to persons in care.

Official plan of correction

POC Due Date: 02/20/2026 Plan of Correction The expired and uncovered food was immediately thrown out during the visit. Licensee agreed to retrain all kitchen staff for food safety protocols. A monthly audit procedure will be put in place to maintain compliance with food storage and expirations.

Official classification

Type B

Official code

87412(a)(12)

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: (12) Hazardous health conditions documents 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 1 out of 120 staff, which posed a potential health risk to persons in care.

Official plan of correction

POC Due Date: 01/30/2026 Plan of Correction The staff member left the facility immediately until proof of negative test result is obtained. Licensee will submit proof of negative result by the POC due date.

Official classification

Type B

Official code

87412(g)(1)

Regulation authority

CCR

What the official deficiency says

Personnel Records 87412 (g)(1) The licensee shall be permitted to retain such records in a central administrative location provided that they are readily available to the licensing agency at the facility as specified in Section 87412(f). This requirement was not met as evidence by: Based on records review the facility did not comply with the section cited above in one out of the five staff records were not readily available with complete documents, which posed a potential personal rights risk to persons in care.

Official plan of correction

Facility will obtain records and place them in the staff file for S1 and send a copy to LPA by POC due date, 02/28/2025.

Deadline recorded: Feb 28, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87506(b)(16)

Regulation authority

CCR

What the official deficiency says

Resident Records 87506 (b)(16) Records of resident's cash resources as specified in Section 87217, Safeguards for Resident Cash, Personal Property, and Valuables. This requirement was not met as evidence by: Based on records review the facility did not comply with the section cited above in four out of the ten residents did not have a Personal Property/Valuables form on file, which posed a potential personal rights risk to persons in care.

Official plan of correction

Facility will send a completed copy of the SPV forms for the following residents: R2, R5, R6 and R7 and submit to LPA once they are completed by POC due date, 02/28/2025.

Deadline recorded: Feb 28, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87411(f)

Regulation authority

CCR

What the official deficiency says

(f) 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 not more than six (6) months prior to or seven (7) days after employment or licensure. A report shall be made of each screening, signed by the examining physician. The report shall indicate whether the person is physically qualified to perform the duties to be assigned, and whether he/she has any health condition that would create a hazard to him/herself, other staff members or residents. A signed statement shall be obtained from each volunteer affirming that he/she is in good health.Personnel with evidence of physical illness or emotional instability that poses a significant threat to the well-being of residents shall be relieved of their duties. This requirement is not met as evidenced by: Deficient Practice Statement Based on records reviewed and manager interview, Licensee did not maintain a report of a health screening for 2 of 5 staff sampled (S1 and S2). This posed a potential health and safety risk to residents in care.

Official plan of correction

POC Due Date: 02/28/2024 Plan of Correction Licensee agreed to arrange for S1 and S2 to each be seen by a doctor, for the purposes of completing a health screening report. Licensee agreed to E-mail LPA the LIC503 Health Screening (or an equivalent form) for both S1 and S2, with negative TB test result, by the POC due date.

Official classification

Type B

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

87303 Maintenance and Operation: “(e)(2) Faucets used by residents for personal care… shall deliver hot water. Hot water temperature 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…and not more than 120 degree F…” This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA measurement, for 5 of 5 sampled bedrooms, Licensee did not ensure controls were maintained to automatically regulate the temperature of hot water used by residents to be between 105 F and 120 F. This posed a potential safety risk to residents in care.

Official plan of correction

POC Due Date: 01/29/2024 Plan of Correction During the LPA’s site inspection, Licensee adjusted the facility’s boilers to lower the water temperature. When the same sink taps were retested, all were within the required 105 F to 120 F range. This action resolves the deficiency.

Official classification

Type B

Official code

87411(c)(1)

Regulation authority

CCR

What the official deficiency says

87411 Personnel Requirements – General: “(c) All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training… (1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross.” This requirement is not met as evidenced by: Deficient Practice Statement Based on records reviewed and manager interview, Licensee did not ensure that 2 of 2 staff sampled (S3 and S4), who routinely assist residents with activities of daily living, received appropriate training in first aid from a qualified agency. This posed a potential health and safety risk to residents in care.

Official plan of correction

POC Due Date: 02/28/2024 Plan of Correction Licensee agreed to arrange for S3 and S4 to complete first aid training from a qualified agency, and to E-mail their respective first aid training certification cards to LPA, by the POC due date.

Official classification

Type B

Official code

87206(a)

Regulation authority

CCR

What the official deficiency says

87206 (a) Advertisements and License Number In accordance with Health and Safety Code Sections 1569.68 and 1569.681, licensees shall reveal each facility license number in all public advertisements, including Internet, or correspondence… this requirement was not met as evidence by: Based on an interview and LPA observations of the Facility’s website, the facility did not provide a facility number to the community on their advertisements. This posed a potential personal rights risk to 61 of 61 (R1) residents in care.

Official plan of correction

The facility will be including their license number to their online website by POC due date, 05/31/2023. Assistant Deputy Director will inform LPA via email once their website has been adjusted to include their license number.

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