CHHINA'S SENIOR GUEST HOUSE

Official classification

Type B

Official code

87463(a)

Regulation authority

CCR

What the official deficiency says

(a) The pre-admission appraisal, as specified in Section 87457, Pre-Admission Appraisal, shall be updated, in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition, as defined in Section 87101, Definitions, and to keep the appraisal accurate. For the purposes of this section, the updated pre-admission appraisal shall be referred to as the reappraisal. 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 two (2) out of six (6) client records which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/21/2026 Plan of Correction Licensee agrees to review the regulation and send a signed Memorandum of Understanding to LPA via email by 8/21/26.

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 two (2) out of six (6) resident records which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/21/2026 Plan of Correction Licensee agrees to review the regulation and send a signed Memorandum of Understanding to LPA via email by 8/21/26.

Official classification

Type A

Official code

87309(c)

Regulation authority

CCR

What the official deficiency says

(c) Except as specified in subsection (d), the licensee shall implement reasonable interventions in order to ensure that nutritional supplements, vitamins, alcohol, cigarettes and other potentially toxic substances, such as certain plants, gardening supplies, and auto supplies, are stored so as not to pose a hazard to residents. 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 5 out of 5 persons which poses an immediate safety risk to persons in care.

Official plan of correction

POC Due Date: 07/09/2025 Plan of Correction LPAs observed medications out on the table, and the cabinet with medications in the dining area (lock broken) and also a broken toilet in the back yard along with sharp garden tools. Garden tools were removed during visit along with mediations that were on the table put into a locked box.

Official classification

Type B

Official code

87456(a)(2)

Regulation authority

CCR

What the official deficiency says

(a) Prior to accepting a resident for care and in order to evaluate his/her suitability, the facility shall, as specified in this article 8: (2) Perform a pre-admission appraisal. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and a record review, the licensee did not comply with the section cited above in 5 out of 5 persons (R1-R5) which poses a potential safety and personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/04/2024 Plan of Correction Licensee will complete all pre appraisals for the 5 residents and have them signed and dated.POC due to CCL by 09/04/2024

Official classification

Type B

Official code

87507(c)

Regulation authority

CCR

What the official deficiency says

(c) Admission agreements shall be signed and dated, acknowledging the contents of the document, by the resident or the resident's representative, if any, and the licensee or the licensee's designated representative no later than seven days following admission. Attachments to the agreement may be utilized as long as they are also signed and dated as prescribed above. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation & record review the licensee did not comply with the section cited above in 1 out of 5 residents (R1) which poses a personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/04/2024 Plan of Correction Licensee will complete the admission agreement for R1 and have it completed and signed by POC date of 09/04/2024

Official classification

Type B

Official code

87468.1(a)(1)

Regulation authority

CCR

What the official deficiency says

Residents in all residential care facilities for the elderly shall have all of the following personal rights: To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement is not met as evidenced by: Based on prior LPA interviews and outside witness interviews. the licensee did not ensure resident was able to make their own decision on medical provider for 1 out of 5 [R1] persons in care this poses a potential health and safety risk to residents in care.

Official plan of correction

Licensee and staff will have personal rights training by an outside source POC due to CCL by 09/06/2024. Licensee will submit sign in sheet & tranining documents by 09/06/2024

Deadline recorded: Sep 6, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(2)

Regulation authority

CCR

What the official deficiency says

Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement is not met as evidenced by: Based on prior LPA observations and outside witness interviews. the licensee did not ensure medications were inaccessible to 5 out of 5 [R1-R5] persons in care this poses an immediate health and safety risk to residents in care.

Official plan of correction

Licensee did not have any medicaitons out on todays visit. Licensee and staff will have medication training and how to properly store medications by an outside source POC due to CCL by 09/06/2024. Licensee will submit sign in sheet & tranining documents by 09/06/2024

Deadline recorded: Sep 6, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87608

Regulation authority

CCR

What the official deficiency says

B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails. This requirement is not met as evidenced by: Based on prior LPA observation, the licensee did not comply with the section cited above in 1 out of 5 (R1) residents did not have a hospice care plan that specified a full bed rail was needed or an approval from the Department which posed a potential personal rights risk to persons in care.

Official plan of correction

Licensee does not have any bed rails on beds at this time except for 1. Licensee and staff will attend a Postural Support training. Proof of training due by POC due date 09/06/2024

Deadline recorded: Sep 6, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(g)

Regulation authority

CCR

What the official deficiency says

Incidental Medical and Dental Care. A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical …care and provide for assistance in obtaining such care... The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health including... life-threatening medical crisis.... This requirement was not met as evidenced by: This is an amended version of the original report dated 2/27/2024. The Licensee did not assist with or obtain immediate care for an injury resulting in the loss of a resident's 1 [R1] limb. This posed an immediate health risk to [R1] one out of 5 residents in care. This is an amended version of the original report dated 2/27/2024.

Official plan of correction

Although the Licensee does not agree with the finding, they are willing to attend (with all staff) a CCL approved training regarding a care plan to assist or obtain immediate medical care for residents facing an imminent health risk. Proof of training will be submitted by POC due date. This is an amended version of the original report dated 2/27/2024.

Deadline recorded: Apr 5, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87464(f)(1)

Regulation authority

CCR

What the official deficiency says

Basic services shall at a minimum include Care and supervision as defined... " Care and supervision " means the facility assumes...responsibility...to provide... ongoing assistance with activities of daily living without the resident’s physical health, mental health...or welfare... endangered. Assistance includes... personal care. This requirement was not met as evidenced by: This is an amended version of the original report dated 2/27/2024. The Licensee did not provide ongoing assistance without resident’s physical health endangered. This posed an immediate health risk to [R1], 1 out of 5 residents in care. This is an amended version of the original report dated 2/27/2024.

Official plan of correction

Although the Licensee does not agree with the finding, they are willing to attend (with all staff) a CCL approved training regarding care and supervision. Proof of training will be submitted by POC due date. This is an amended version of the original report dated 2/27/2024.

Deadline recorded: Apr 5, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87625(b)(2)(3)

Regulation authority

CCR

What the official deficiency says

Managed Incontinence. The...Licensee shall be responsible for the following: Ensuring...incontinent residents are checked... time when they are known to be incontinent, including during the night. Ensuring that... residents are kept clean and dry, and...the facility remains free of odors from incontinence. requirement was not met by as evidenced by: This is an amended version of the original report dated 2/27/2024. Based on interviews conducted with outside sources and residents and facility and outside source records reviews the Licensee assist residents were checked during times known to be incontinent and kept clean and dry from incontinence. This posed a potential health risk to [R1 and R2], 2 out of 5 residents in care. This is an amended version of the original report dated 2/27/2024.

Official plan of correction

Licensee agreed to put a tracking system in place implementing a log of times and dates caregivers change briefs for residents that require incontinence care. The Licensee will provide proof of tracking logs by POC due date. This is an amended version of the original report dated 2/27/2024.

Deadline recorded: Apr 26, 2024. 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

Personal Rights of Residents... Residents in all residential care facilities for the elderly shall have all of the following personal rights: To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement was not met as evidenced by: This is an amended version of the original report dated 2/27/2024. Based on resident and outside source interviews the Licensee did not treat residents with respect and dignity. This posed a potential personal rights violation to [R2], 1 out of 5 of residents in care.

Official plan of correction

Licensee and staff will attend a CCL approved training on resident's personal rights and will provide proof of attendance by POC due date. This is an amended version of the original report dated 2/27/2024.

Deadline recorded: Apr 26, 2024. 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

Personal Rights of Residents in All Facilities. Residents in all residential care facilities for the elderly shall have all of the following personal rights: To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement was not met as evidenced by: Based on resident and outside source interviews the Licensee did not treat residents with respect and dignity. This posed a potential personal rights violation to [R2], 1 out of 5 of residents in care.

Official plan of correction

Licensee and staff will attend a CCL approved training on resident's personal rights and proof of attendance by POC due date.

Deadline recorded: Mar 27, 2024. A deadline is not proof that correction was completed.