HOME SWEET HOME FOR THE ELDERLY

Official classification

Type A

Official code

87202(a)

Regulation authority

CCR

What the official deficiency says

(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: 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] facility resident records was deemed to be bedridden at this time. This facility does not have a bedridden fire clearance at this time which poses an immediate 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 designated Administrator stated that the proper paperwork will be updated and completed. These updated forms will be submitted into CCL requesting the change to the plan of operation, addressing bedridden care and supervision, along with a statement of correction by the due date. In addition, a request will also be made with a bedridden fire clearance completed and submitted into CCL by the due date.

Official classification

Type A

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

(e) Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving and grooming 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 (41 degrees C) and not more than 120 degree F (49 degrees 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 that the hot water being dispensed from the facility restrooms were measured at only 98.8 degrees below the allowed range of 105-120 degrees which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/17/2025 Plan of Correction The facility designated Administrator stated that the hot water heater will be increased to deliver hot water within the allowed range of 105-120 degrees at all times. A statement of correction, along with (7) days worth of hot water measurements, will be completed and submitted into CCL by the due date.

Official classification

Type A

Official code

87204(a)

Regulation authority

CCR

What the official deficiency says

(a) A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including specification of the maximum number of persons who may receive services at any one time. An exception may be made in the case of catastrophic emergency when the licensing agency may make temporary exceptions to the approved capacity. 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 that [4] out of [5] facility residents were deemed to be nonambulatory when this facility was only licensed and fire cleared to be able to accept and retain up to (2) non ambulatory residents which poses an immediate 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 designated Administrator stated that a plan of operation will be updated and completed to request the additional number of non ambulatory residents accepted and retained at this facility. A statement of correction, along with updated Plan of Operation, will be completed and submitted into CCL by the due date.

Official classification

Type B

Official code

87303(c)

Regulation authority

CCR

What the official deficiency says

(c) All window screens shall be clean and maintained in good repair. 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 that several window screens were in need of repair/replacement since they had holes, tears, or rips in them which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/17/2025 Plan of Correction The facility designated Administrator stated that a review of all window screens will be conducted. Any window screens found to have any holes, rips, or tears in them will be repaired/replaced as necessary. A statement of correction, along with a receipt for services rendered for the repairs/replacements, will be completed and submitted into CCL by the due date.

Official classification

Type B

Official code

1569.625(b)(2)

Regulation authority

HSC

What the official deficiency says

(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. 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 [2] out of [3] facility personnel files did not have updated annual training with corresponding required hours which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/15/2023 Plan of Correction This facility designated Administrator stated that all facility personnel will receive and undergo the required hours of annual training since they were providing care and supervision to the residents in care. A statement of correction, along with copies of verified training subjects and hours, will be completed and submitted into CCL by the due date.

Official classification

Type A

Official code

87411(a)

Regulation authority

CCR

What the official deficiency says

87411(a)- Personnel Requirements - General-Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs.-This requirement is not met by interviews conducted and records review R-1 AWOL'd from the facility. The LIC 602 states the resident was not allowed to leave the facility unassisted. This presents an immediate health and safety risk to the resident in care.

Official plan of correction

The facility shall conduct an in-service training with staff to go over what and how staff shall ensure that residents do not AWOL. Administrator shall send the in-service training materials, plan on how staff will ensure residents do not AWOL and a signature sheet of all staff who attended. The Administrator will email the date of the in-service training to LPA by 05/19/23 to meet the 24 hour POC requirement.

Deadline recorded: May 19, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.1

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. R1 was blocked in the room by a couch. Although it was to prevent a confrontation and used as a last resort. It was a rights violation.

Official plan of correction

The facility administrator will ensure that all staff receive in-service training regarding the personal rights of the clients and proof of this training will be submitted to CCL by the POC due date.

Deadline recorded: May 26, 2023. A deadline is not proof that correction was completed.