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Official classification

Type A

Official code

87355(e)(1)

Regulation authority

CCR

What the official deficiency says

87355(e)(1) Criminal Record Clearance. Prior to working, residing or volunteering in a licensed facility, all individuals subject to a criminal record review shall obtain a clearance or criminal record exemption. This requirement is not met as evidenced by: Deficient Practice Statement Based on a record review of all 5 staff files,, the licensee did not comply with the section cited above as observed by LPA Campell in 1 out of 5 staff files reviewed which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/22/2024 Plan of Correction Effective Immediately, but no later than 11/15/2024; the licensee shall remove S1 from the facility and have the employee fingerprinted prior to returning to work. A Civil penalty is being issued in the amount of $500 because S1 has been working since 2023 and has not been fingerprinted. Licensee shall send proof of completion to be sent to CCLD by POC date at renee.campbell@dss.ca.gov

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 LPA record review, the licensee did not comply with the section cited above in the facility did not conduct a drill at least quarterly for each shift which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/07/2024 Plan of Correction Licensee agrees to submit a plan to licensing stating 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. Plan of Correction Date is 2/27/2024 and licensee agrees to email to LPA Wallace. Immediate civil penalty of $500.00 was issued on 2/6/2024. ruth.wallace@dss.ca.gov

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 TB test results in her file.

Official plan of correction

Administrator to provide a health screening/TB results for S1 to LPA within 24 hours.

Deadline recorded: Feb 25, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

80068.3(a)

Regulation authority

CCR

What the official deficiency says

Modifications to Needs and Services Plan. The licensee shall ensure that each client's written Needs and Services Plan is updated as often as necessary to assure its accuracy, but at least annually. These modifications shall be maintained in the client's file. -LPA observed four of five does not have a Needs/Services plan on file that has been updated annually.

Official plan of correction

The Administrator shall ensure that all clients in care receive an annual Needs/Services Plan or IPP by the POC date indicated. Administrator to ensure that it is maintained in the client's file at all times. Proof of correction to be sent to CCLD by POC date.

Deadline recorded: Mar 10, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(c)(2)

Regulation authority

CCR

What the official deficiency says

87465(c)(2) Incidental Medical and Dental Care-designated by the licensee shall Once ordered by the physician the medication is given according to the physician's directions This requirement was not met as evidenced by missing medication for R1 which poses an immediate health and safety issues for R1.

Official plan of correction

Licensee/administrator shall hold an in-service medication training with all staff. The training materials used and sign in sheet of staff attendance shall be sent to CCL by 2/18/22

Deadline recorded: Feb 18, 2022. A deadline is not proof that correction was completed.