GELZHEN GUEST HOME LLC

Official classification

Type A

Official code

87202(a)(2)

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: (2) Bedridden persons 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 that there was a resident deemed to be bedridden currently receiving care and supervision without the proper notification to Licensing and proper bedridden fire clearance in order to accept and retain such a resident which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/04/2025 Plan of Correction The facility designated Administrator stated that a proper bedridden fire clearance request will be completed and submitted into CCL for review by this LPA. A statement of correction, along with updated bedridden fire clearance request, will be completed and submitted into CCL by the due date.

Official classification

Type A

Official code

1569.625(b)(1)

Regulation authority

HSC

What the official deficiency says

(1) The department shall adopt regulations to require staff members of residential care facilities for the elderly who assist residents with personal activities of daily living to receive appropriate training. This training shall consist of 40 hours of training. A staff member shall complete 20 hours, including six hours specific to dementia care, as required by subdivision (a) of Section 1569.626 and four hours specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696, before working independently with residents. The remaining 20 hours shall include six hours specific to dementia care and shall be completed within the first four weeks of employment. The training coursework may utilize various methods of instruction, including, but not limited to, lectures, instructional videos, and interactive online courses. The additional 16 hours shall be hands-on 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 [1] out of [5] personnel records did not contain the required initial/annual training hours which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/04/2025 Plan of Correction The facility designated Administrator stated that all facility personnel providing care and supervision to the residents will be trained to meet the required number of hours for initial and annual training at all times. A statement of correction, along with proof of updated training, will be completed and submitted into CCL by the due date. Proof of training will detail the topics trained with length of training, name of trainer, and all attendees.

Official classification

Type A

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 contain the required courses and hours of annual training which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/21/2024 Plan of Correction The facility designated Administrator stated that all facility personnel providing care and supervision to the residents will undergo the proper courses of training and obtain the adequate number of hours. A statement of correction, along with copies of the number of courses and number of hours of training, will be completed and submitted into CCL by the due date for review by this LPA.

Official classification

Type A

Official code

87705(c)(5)(A)

Regulation authority

CCR

What the official deficiency says

(c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (5) Each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, both of which shall include a reassessment of the resident's dementia care needs. (A) When any medical assessment, appraisal, or observation indicates that the resident's dementia care needs have changed, corresponding changes shall be made in the care and supervision provided to that resident. 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 [1] out of [5] facility resident files did not contain an updated annual medical assessment to address any possible changes to their care needs related to dementia which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/15/2024 Plan of Correction The facility designated Administrator stated that all residents diagnosed with dementia will be scheduled with their responsible licensed medical professionals to undergo a medical assessment and update the LIC 602. A statement of correction, along with copies of the updated LIC 602s, will be completed and submitted into CCL by the due date for review by this LPA.

Official classification

Type A

Official code

87303(a)(1)

Regulation authority

CCR

What the official deficiency says

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. (1) Floor surfaces in bath, laundry and kitchen areas shall be maintained in a clean, sanitary, and odorless condition. 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 there was a hole in the facility resident restroom floor that was covered by a brick which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/15/2024 Plan of Correction The facility designated Administrator stated that a plan will be conducted to hire licensed professionals to fix the hole and replace the flooring as required. A statement of correction, along with copies of the receipt for the hired professionals completed work, will be completed and submitted into CCL by the due date for review by this LPA.

Official classification

Type A

Official code

87411(c)(1)

Regulation authority

CCR

What the official deficiency says

(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 record review, the licensee did not comply with the section cited above in [2] out of [4] personnel files were missing required documentation of current certified First Aid training which poses/posed an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/16/2023 Plan of Correction The facility designated Administrator stated that a statement of correction, along with copies of the updated missing first aid certification, will be completed and submitted into CCL by the due date.

Official classification

Type A

Official code

1569.69(a)

Regulation authority

HSC

What the official deficiency says

(a) Each residential care facility for the elderly licensed under this chapter shall ensure that each employee of the facility who assists residents with the self-administration of medications meets all of the following training requirements: 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 [3] out of [4] personnel files were missing required medication training and verification which poses/posed an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/16/2023 Plan of Correction The facility designated Administrator stated that a statement of correction, along with copies of the updated medication training and verification forms and documents, will be completed and submitted into CCL by the due date.

Official classification

Type A

Official code

87458(a)

Regulation authority

CCR

What the official deficiency says

(a) Prior to a person's acceptance as a resident, the licensee shall obtain and keep on file, documentation of a medical assessment, signed by a physician, made within the last year. The licensee shall be permitted to use the form LIC 602 (Rev. 9/89), Physician's Report, to obtain the medical assessment. 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 [4] personnel files were missing required documentation of a medical assessment, signed by a physician, made within the last year which poses/posed an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/16/2023 Plan of Correction The facility designated Administrator stated that a statement of correction, along with copies of the updated missing medical assessment forms and documents, will be completed and submitted into CCL by the due date.

Official classification

Type B

Official code

87412(c)

Regulation authority

CCR

What the official deficiency says

(c) Licensees shall maintain in the personnel records verification of required staff training and orientation. 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 [3] out of [4] personnel files were missing required training and orientation verification which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/16/2023 Plan of Correction The facility designated Administrator stated that a statement of correction, along with copies of the updated missing training forms and documents, will be completed and submitted into CCL by the due date.

Official classification

Type B

Official code

87506(a)

Regulation authority

CCR

What the official deficiency says

(a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. 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 [5] resident files were missing required forms and documents which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/16/2023 Plan of Correction The facility designated Administrator stated that a statement of correction, along with copies of the updated missing forms and documents, will be completed and submitted into CCL by the due date.

Official classification

Type B

Official code

87625(b)(3)

Regulation authority

CCR

What the official deficiency says

(b) In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for the following: (3) Ensuring that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence. 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 resident bedrooms and restrooms had strong odors of urine and feces which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/16/2023 Plan of Correction The facility designated Administrator stated that a statement of correction will be completed, along with proof of staff training (for no less than one hour in duration), on the topic of resident incontinence care and the facility's responsibility to keep residents clean and dry. In addition, staff will be further trained to maintain the facility free of odors from incontinence and be submitted into CCL by the due date.

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 residential care facilities for the elderly shall have all of the following personal rights: (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents' money or interfering with daily living functions such as eating, sleeping, or elimination. This facility was found to be deficient as evidenced by the violation of the resident's rights by facility staff while assisting and performing ADLs. This posed an immediate threat to the Health, Safety, and Personal Rights of the residents in care.

Official plan of correction

Facility representative stated that staffing will be sufficient and competent at all times for adequate care and supervision unto all facility residents. A statement of correction, along with facility wide training for all staff providing care and supervision to the residents will be conducted. This training will be for no less than (2) hours in duration on the topic of resident rights, resident dignity/respect, and proper transfer techniques. Proof of training will be submitted to include name of trainer, length of training with topics covered, and list of attendees by the due date of 11/28/2022.

Deadline recorded: Nov 28, 2022. A deadline is not proof that correction was completed.

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 2 out of 2 bathroom faucets delivering hot water which measured at 122.1 degrees which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/04/2022 Plan of Correction Facility designated Administrator will turn down the hot water heater and measure the hot water for the next 24 hours and complete a log. A statement of correction, along with a copy of this log, will be submitted into CCL for review by this LPA by the due date of 08/04/2022.

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above since a cleaning agent was present in a bathroom cabinet under the sink and not properly locked at this time which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/04/2022 Plan of Correction Facility designated Administrator will remove the cleaning agent or properly lock the cabinet at all times if any cleaning supplies are kept underneath there. A statement of correction will be submitted into CCL for review by this LPA by the due date of 08/04/2022.

Official classification

Type A

Official code

87555(b)(26)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above since there was not a sufficient supply of 2-day perishable and 7-day nonperishable food quantities being maintained at all times which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/04/2022 Plan of Correction Facility designated Administrator will replenish the facility food supply for adequate 2-day perishable and 7-day nonperishable food quantities at all times. A statement of correction, along with a copy of newly purchased food supplies receipt, will be submitted into CCL for review by this LPA by the due date of 08/04/2022.

Official classification

Type A

Official code

87465(a)(6)

Regulation authority

CCR

What the official deficiency says

(6) Facility staff, except those authorized by law, shall not administer injections, but staff designated by the licensee may assist persons with self-administration as needed. Assistance with self-administered medications shall be limited to the following: This requirement is not met as evidenced by: Deficient Practice Statement Based on interviews, the licensee did not comply with the section cited above since facility personnel were conducting injections for the residents who were unable to perform them unassisted and facility personnel were not licensed medical professionals at this time which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/04/2022 Plan of Correction Facility designated Administrator will review and update all Needs/Appraisal Care Plans for the residents requiring injections and unable to perform them unassisted at this time. New resident care plans will need to reflect any, and all facility personnel who are authorized by law, who will be present to perform injections as needed for all residents. A statement of correction, along with a copy of these updated care plans, will be submitted into CCL for review by this LPA by the due date of 08/04/2022.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

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: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above since there were (4) storage units on site that were being used to store old, unused mattresses and furniture which were being considered to be thrown out. In addition, a large load of scrap wood and other discarded items were being collected under a tarp in the backyard area which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/10/2022 Plan of Correction Facility designated Administrator will remove all unwanted mattresses and furniture, as well as, the pile of scrap wood. A statement of correction, along with pictures of the empty sheds and cleared backyard area, will be submitted into CCL for review by this LPA by the due date of 08/010/2022.