CHEROKEE RETIREMENT HOME INC

Official classification

Type B

Official code

87224(a)

Regulation authority

CCR

What the official deficiency says

87224(a) Eviction Procedures. (a).The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required except as otherwise specified in paragraph (5). This requirement was not met as evidenced by: Based on interview and record review, Licensee verbally expressed notice of eviction after property damage; licensee did not provide a written notice of eviction to R1. This posed a potential health, safety, and resident rights risk to residents in care.

Official plan of correction

Licensee is not currently providing care for residents at this time and planning renovations. Licensee to read regulation 87224 and submit a signed statement of understanding to LPA by POC due date.

Deadline recorded: Jul 25, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.657(a)

Regulation authority

CCR

What the official deficiency says

1569.657 Rate increase due to change in level of resident care; notice. (a) For any rate increase due to a change in the level of care of the resident, the licensee shall provide the resident and the resident’s representative, if any, written notice of the rate…The notice shall include a detailed explanation of the additional services to be provided at the new level of care and an accompanying itemization of the charges. This requirement was not met as evidenced by: Based on interview and record review, Licensee did not ensure a proper notice for a level of care rate increase to R1 per regulatory requirements. This posed a potential health, safety, and resident rights risk to resident in care.

Official plan of correction

Licensee will read regulation 1569.657(a) and provide a written declaration of understanding to LPA by POC due date.

Deadline recorded: Jun 30, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87405(d)(2)

Regulation authority

CCR

What the official deficiency says

Administrator Qualifications and Duties. (d) The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7). If the licensee is also the administrator, all requirements for an administrator shall apply. (2) Knowledge of and ability to conform to the applicable laws, rules and regulations. This requirement was not met as evidenced by: Based on interviews and record reviews, Licensee/Administrator did not adhere to eviction regulations as specified in section 87224 Eviction Procedures. This posed a potential health and safety risk to residents in care.

Official plan of correction

Licensee and Administrator will read regulation 87224 and submit a signed declaration of understanding to LPA by POC due date.

Deadline recorded: Apr 11, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87755(b)

Regulation authority

CCR

What the official deficiency says

Inspection Authority of Licensing Agency (b) The licensee shall ensure that provisions are made...for the examination of all records relating to the operation of the facility. This requirement was not met as evidenced by: Based on record review, Administrator did not ensure requested information regarding resident whereabouts in a timely manner. This posed a potential health and safety risk to residents in care.

Official plan of correction

Licensee will read reguation 87755 and provide a written declaration of understanding to LPA by POC due date.

Deadline recorded: Apr 11, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87224(a)

Regulation authority

CCR

What the official deficiency says

Eviction Procedures. (a).The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required except as otherwise specified in paragraph (5). This requirement was not met as evidenced by: Based on interview and record review, Licensee verbally expressed a notice of eviction and did not provide a written copy to residents or their responsible persons. This posed a potential health, safety, and resident rights risk to residents in care.

Official plan of correction

Licensee to inform residents in care in writing that previous verbal eviction notice is rescinded. Proof to be sent to LPA by POC due date.

Deadline recorded: Apr 11, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

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 1 out of 6 resident files reviewed. R6 file does not contain a physician's report or other evidence of a medical assessment to comply with above section since admission in April 2024, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/17/2024 Plan of Correction Licensee to obtain updated physician's report for R6 and submit copy to LPA by POC due date. Licensee to conduct audit of all resident files to ensure updated and accurate physician reports are present. Licensee to send results of completed audit to LPA by POC due date.

Official classification

Type B

Official code

87463(c)

Regulation authority

CCR

What the official deficiency says

(c) The licensee shall arrange a meeting with the resident, the resident's representative, if any, appropriate facility staff, and a representative of the resident's home health agency, if any, when there is significant change in the resident's condition, or once every 12 months, whichever occurs first, as specified in Section 87467, Resident Participation in Decision Making. 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 5 out of 6 resident files reviewed. R1, R2, R3, R4, and R5 files did not contain updated yearly reappraisals or other evidence of compliance with the above section which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/17/2024 Plan of Correction Licensee to complete required updated re-appraisal forms for R1-R5 and send completed copies to LPA by POC due date. Licensee to conduct chart audit of all resident files to ensure accurate and updated re-appraisals. LIcensee to send completed audit form to LPA by POC due date.