SERENE RESIDENTIAL CARE HOME

Official classification

Type B

Official code

87705(c)(5)

Regulation authority

CCR

What the official deficiency says

Care of Persons with Dementia: Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: 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. 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. R1 and R3 did not have updated needs and service plans on file for review during this visit. This poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/25/2024 Plan of Correction licensee will submit a plan to ensure all required records are complete and available for review at anytime. Plan to be submitted to the Department by POC due date. Per report, they will submit R1 and R3's needs and serv ices plan by POC due date. Kesha.lewis@dss.ca.gov

Official classification

Type A

Official code

87705(c)(4)(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: (4) There is an adequate number of direct care staff to support each resident’s physical, social, emotional, safety and health care needs as identified in his/her current appraisal. (A) In addition to requirements specified in Section 87415, Night Supervision, a facility with fewer than 16 residents shall have at least one night staff person awake and on duty if any resident with dementia is determined through a pre-admission appraisal, reappraisal or observation to require awake night supervision. Based on LPA's conversation with licensee and staff it was confirmed that there is not always awake night staff. This poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee will submit an updated LIC 500 showing new staff and night shift by COB 09/15/2023, to LPA via email. Kesha.lewis@dss.ca.gov

Deadline recorded: Sep 12, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87202(a)

Regulation authority

CCR

What the official deficiency says

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. Based on LPA's observation there is a sick in the back door in the kitchen preventing the door from being opened. After and speaking with the licensee he states " that should have been removed in the morning " This poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

LPA informed Licensee that the fire exit cannot be block at any time. Licensee will review regulation and submit a letter to LPA Lewis on how the door will be secured in the future via email. LPA had staff remove the stick while still at the facility.

Deadline recorded: Mar 28, 2023. A deadline is not proof that correction was completed.