COUNTRY ROSE ESTATE MEMORY CARE

Official classification

Type B

Official code

87203

Regulation authority

CCR

What the official deficiency says

87203 Fire Safety All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. 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 by not possessing/producing copy of a current five (5) year sprinkler certification, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/27/2025 Plan of Correction Licensee agreed to obtain a five (5) year sprinkler certification and provide proof of correction to LPA by close of business on 1/27/2025.

Official classification

Type B

Official code

87464(f)(1)

Regulation authority

CCR

What the official deficiency says

BASIC SERVICES: (f) Basic services 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). This requirement was not met, as evidenced by: Based on interviews, the Licensee did not ensure R1 was supervised. The Administrator was interviewed & corroborated the allegation; he reported R1 did leave the facility without staff knowledge & was found approximately 40 mins later. Staff interviews reported R1 appeared to have sustained a fall due to observing dirt on their clothing & a cut on their hand.

Official plan of correction

The Administrator stated an automatic door lock will be installed on the one exit gate on the property.

Deadline recorded: May 4, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.1(a)(1)

Regulation authority

CCR

What the official deficiency says

87468.1 Personal Rights of Residents in All Facilities (a) 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 is not met as evidenced by Based on interviews, the Licensee did not ensure residents in care were treated with dignity which posed a potential health, safety, and Personal Rights risk to 3 of 14 persons in care.

Official plan of correction

Administrator agreed to conduct in service training for all staff regarding Personal Rights of Residents in All facilities. Attendance sheet for this training will be submitted to the LPA by 8/26/2022.

Deadline recorded: Jul 26, 2022. 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 Records 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: This requirement was not met as evidenced by: Based on observations, interview and systems review, the licensee did not ensure S1 had a CA criminal record clearance prior to working in the licensed facility which posed an immediate safety risk to 14 of 14 clients in care.

Official plan of correction

During the visit, Licensee agreed to remove unbackground cleared employee (S1). The LPA witnessed S1 leaving the facility. Licensee agreed not to have staff return to work until S1 has received clearance from the Department.

Deadline recorded: Jun 21, 2022. A deadline is not proof that correction was completed.