BRIONES FAMILY HOMECARE

Official classification

Type A

Official code

87465(d)(3)

Regulation authority

CCR

What the official deficiency says

(d) If the resident is unable to determine his/her own need for a prescription or nonprescription PRN medication, and is unable to communicate his/her symptoms clearly, facility staff designated by the licensee, shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: (3) The date and time the PRN medication was taken, the dosage taken, and the resident's response shall be documented and maintained in the resident's facility record. 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 client MARs which neglected to document the effect of the PRN on the residents response or the reason satisfying its " as needed " basis. which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/10/2025 Plan of Correction Complete PRN, send a copy to LPA.

Official classification

Type A

Official code

87405(d)(2)

Regulation authority

CCR

What the official deficiency says

87405 (d) (2) Administrator Qualifications and Duties - The administration shall have the qualifications specified...ability to conform to the applicable laws, rules, and regulations. 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 accepting and retaining residents with restricted contions (catheter, contractures, and total care) without applying for an exception, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/10/2025 Plan of Correction Licensee will apply for exceptions, (catheter, contractures, and total care), by the POC Date, send to the LPA.

Official classification

Type B

Official code

87208(a)

Regulation authority

CCR

What the official deficiency says

(a) The licensee shall have and maintain a current, written definitive plan of operation for the facility. The licensee shall operate the facility in accordance with the terms specified in the plan of operation and may be cited for not doing so pursuant to Health and Safety Code section 1569.49. The plan and related materials shall be on file in the facility and shall be submitted to the licensing agency with the license application. Any significant changes in the plan of operation which would affect the services to residents shall be submitted to the licensing agency for approval. The plan and related materials shall contain the following: 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 LIC 602 forms which were not filled out on an annual basis as detailed in the Plan of Operation, which posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/23/2025 Plan of Correction Submit a 602 for the residents, when they get those appointments, to the LPA.

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 4 out of 5 resident needs and appraisals (LIC 625) were not completed annually or as needed which posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/23/2025 Plan of Correction The licensee will send the LPA updated needs and services for the clients who havent had one in the last year.

Official classification

Type A

Official code

87202

Regulation authority

CCR

What the official deficiency says

87202 Fire Clearance (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. Fire extinguisher was observed by House manager and LPA to have tagged dates of 05/24/2021.

Official plan of correction

The Licensee agrees to purchase a new fire extinguisher or service the current fire extinguishers. The Licensee will send a copy of the purchase receipt or a picture of new service tag for the fire extinguishers by POC date via email to CCL.

Deadline recorded: Jul 26, 2022. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87616(a)(b)

Regulation authority

CCR

What the official deficiency says

87616 Exceptions for Health Conditions (a) As specified in Section 87209, Program Flexibility, the licensee may submit a written exception request if he/she agrees that the resident has a prohibited and/or restrictive health condition but believes that the intent of the law can be met through alternative means. (b) Written requests shall include, but are not limited to, the following: (1) Documentation of the resident's current health condition including updated medical reports, other documentation of the current health, prognosis, and expected duration of condition. (2) The licensee's plan for ensuring that the resident's health related needs can be met by the facility.(3) Plan for minimizing the impact on other residents. R1 is being provided with home health services after graduating from hospice on 3/3/2022.

Official plan of correction

Licensee agrees to submit a request for an exception to retain (R1) who has a prohibited health condition. Licensee shall review the regulation on prohibited health condition and submit a statement of understanding of this regulation. The plan should be submitted by POC date.

Deadline recorded: Apr 30, 2022. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87411(f)

Regulation authority

CCR

What the official deficiency says

General. Good physical health of personnel shall be verified by a health screening, including a T.B. test, performed and signed by a physician not more than six months prior to or seven days after employment. LPA observed staff did not have a health screening and TB test results in S1's file.

Official plan of correction

Administrator to provide a health screening/TB results for staff (S1) by POC date 4/20/2022

Deadline recorded: Apr 20, 2022. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87612(a)

Regulation authority

CCR

What the official deficiency says

87612 Restricted Health Conditions (a)The licensee may provide care for residents who have any of the following restricted health conditions, or who require any of the following health services: (2) Catheter care as specified in Section 87623. (4) Contractures as specified in Section 87626. (7) Incontinence of bowel and/or bladder as specified in Section 87625. This requirement is not met as evidenced by records review the facility does not have records of home health services to address the needs of R1. This poses an immediate risk to residents in care.

Official plan of correction

Administrator will provide the department with an order from the Primary care physician of R1 to confirm discharging from Hospice and starting home health services. This information shall be submitted by POC date 4/20/2022. The facility will also request an exemption for R1 by POC date 4/20/2022

Deadline recorded: Apr 20, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.695(c)

Regulation authority

HSC

What the official deficiency says

Drills 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: Based on observation the licensee did not comply with the section cited above in 1569.65(c). LPA observed Administrator was unable to provide a copy of facility fire drill, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator agreed to conduct a fire drill and submit proof to CCLD by POC date.

Deadline recorded: Apr 20, 2022. A deadline is not proof that correction was completed.