ALTA VISTA SENIOR LIVING

Official classification

Type A

Official code

1569.618(c)(3)

Regulation authority

HSC

What the official deficiency says

(c)The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staff to provide CPR. 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 4 times which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/02/2025 Plan of Correction The Licensee agrees to provide proof of CPR certification for the (4) staff reviewed on the LIC811. If this does not apply then enroll and have the (4) staff complete the training. Proof of POC is to be submitted to the department by 5pm on the due date indicated.

Official classification

Type B

Official code

87412(a)

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: 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 4 persons which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/15/2025 Plan of Correction The Licensee agrees to review staff files according to the LIC311F, submit a list of employee files reviewed attesting that the records are in the employee personnel file. Proof of POC is to be submitted to the department by 5pm on the due date indicated.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

CCR 87303(a) Maintenance and Operation - The facility shall be clean, safe, sanitary and in good repair at all times...safety and well-being of residents, employees and visitors. This requirement is not met as evidenced by. Based on interviews and records review, the licensee failed to comply with the section cited above as bed bugs were observed by multiple residents in multiple bedrooms, which poses a potential health and personal rights risk to persons in care.

Official plan of correction

POC: The Administrator agreed to review section cited and provide a statement of understanding on how ensure that the facility will be kept free of pest to LPA Urena via email by 05/02/2025.The Licensee contracted a fumigation exterminator company, and the bug infestation was cleared.

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

Official classification

Type A

Official code

1569.618(c)(3)

Regulation authority

HSC

What the official deficiency says

(c)The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staff to provide CPR. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview and records review, the licensee did not comply with the section cited above in 6 out of 8 persons/ staff files reviewed which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/10/2024 Plan of Correction The licensee agrees to have staff enroll and complete CPR certification training. Proof of POC is to be submitted to the department by 5pm on the due date indicated.

Official classification

Type A

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 record review, the licensee did not comply with the section cited above in 1 out of 1 times which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/10/2024 Plan of Correction The Licensee agrees to conduct an emergency disaster drill and document it. Proof of POC is to be submitted to the department by 5pm on the due date indicated.

Official classification

Type B

Official code

1569.605

Regulation authority

HSC

What the official deficiency says

On and after July 1, 2015, all residential care facilities for the elderly, except those facilities that are an integral part of a continuing care retirement community, shall maintain liability insurance covering injury to residents and guests in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in the total annual aggregate, caused by the negligent acts or omissions to act of, or neglect by, the licensee or its employees. 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 1 which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/23/2024 Plan of Correction The Licensee agrees to obtain valid liability insurance. Proof is to be submitted to the department by 5pm on the due date indicated.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement is not met as evidenced by: the licensee did not ensure that the facility gate was in good repair, which posed a potential health, safety and personal rights risk to persons in care.

Official plan of correction

There is no POC due at this time, as the gate was officially repaired on 09/27/24.

Deadline recorded: Oct 23, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87307(d)(2)

Regulation authority

CCR

What the official deficiency says

87307 Personal Accommodations and Services (d) The following space and safety provisions shall apply to all facilities: (2) The premises shall be maintained in a state of good repair and shall provide a safe and healthful environment. This requirement is not met as evidenced by the licensee did not ensure that the premises was maintained in safe and healthful environment. Which posed a potential health, safety and personal rights risk to persons in care.

Official plan of correction

The licensee agrees to conduct an inservice on elopment and, safety checks. Proof of POC is to be submitted to the department by 5pm on the due date indicated.

Deadline recorded: Oct 23, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement is not met as evidenced by: the licensee did not ensure that the elevator was in good repair, which posed a potential health, safety and personal rights risk to persons in care.

Official plan of correction

There is no POC at this time, as the elevator was officially repaired on 09/13/24.

Deadline recorded: Oct 9, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87468.1(a)(3)

Regulation authority

CCR

What the official deficiency says

PERSONAL RIGHTS OF RESIDENTS IN ALL FACILITIES: (a) Residents in all RCFEs shall have all of the following personal rights: (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature... This requirement was not met, as evidenced by: Based on interviews and records, R1 was not granted the right to be free from punishment/abuse. Written staff statements corroborated the alleged incident took place. Interviews revealed S1 slapped R1 on the face after the resident spit on them.

Official plan of correction

S1 was immediately suspended on 09/29/2022 and has not returned to the facility. Separation paperwork shows S1 was terminated on 10/07/2022.

Deadline recorded: Oct 27, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87355(e)(1)

Regulation authority

CCR

What the official deficiency says

CRIMINAL RECORD CLEARANCE: (e) All individuals subject to a criminal record review pursuant to H & S ... 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 or... This requirement was not met, as evidenced by: Based on record review, the Licensee did not ensure S1 was fingerprint cleared prior to working in the facility. A review of the Department's fingerprint database revealed S1 is pending a fingerprint clearance from the Department.

Official plan of correction

S1 was immediately suspended on 09/29/2022 and has not returned to the facility. Separation paperwork shows S1 was terminated on 10/07/2022.

Deadline recorded: Oct 27, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87507(g)(3)(5)(E)

Regulation authority

CCR

What the official deficiency says

87507. Admission Agreements. (g) Admission agreements shall specify the following: (3) Payment provisions, including...: (5) Refund conditions. (E) Preadmission fees shall be refunded according to the following conditions: 2. ...paid preadmission fees that are greater than five hundred dollars ($500) shall be refunded to...resident, or the...resident's representative in the following manner: b. A refund of at least 60 percent of the preadmission fee in excess of $500 shall be provided if the resident leaves the facility for any reason during the second month of residency. This requirement was not met as evidenced by: Based on records review and interviews, facility did not issue a timely refund to resident which poses a personal rights risk to 1 out of 76 residents in care.

Official plan of correction

Adminstrator will ensure that R1 receives a full refund of all moneys due by September 20, 2021, and show proof to LPA by that date.

Deadline recorded: Sep 20, 2021. A deadline is not proof that correction was completed.