MILLBRAE ASSISTED LIVING HOME

Official classification

Type B

Official code

87411(c)(1)

Regulation authority

CCR

What the official deficiency says

PERSONNEL REQUIREMENTS- GENL 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 first aid training cannot be verified for 4 out of 6 staff files reviewed. Licensee failed to ensure that care staff maintain valid first aid training, which poses a potential health or safety risk to clients in care. No current first aid training for staff #2, #4, #5, #6.

Official plan of correction

Proof of current first aid training for S2, S4, S5, S6 will be sent to CCLD BY DUE DATE.

Deadline recorded: Dec 26, 2025. A deadline is not proof that correction was completed.

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 client records review, the licensee did not comply with the section cited above in 5 out of 7 files reviewed, which poses a potential health, safety or personal rights risk to persons in care. - Appraisals for clients #1, #2, #3, #6, #7 are dated more than 12 months ago.

Official plan of correction

POC Due Date: 12/17/2025 Plan of Correction Signed appraisals will be completed for 5 clients, and copies will be sent to CCLD BY DUE DATE

Official classification

Type B

Official code

87463(h)

Regulation authority

CCR

What the official deficiency says

(h) The licensee shall request that all residents receive an annual routine visit with a licensed medical professional once every twelve months, either in person or by video appointment. This requirement is not met as evidenced by: Deficient Practice Statement Based on records review, the licensee did not comply with the section cited above in 4 out of 7 client records reviewed, which pose a potential health, safety or personal rights risk to persons in care. - Medical assessments are dated over 12 months ago for clients #2, #3, #6, #7.

Official plan of correction

POC Due Date: 12/17/2025 Plan of Correction Medical assessments for 4 clients will be completed and copies sent to CCLD BY DUE DATE. If resident(s) refuse to be medically evaluated, documentation of such will be submitted, as well.

Official classification

Type A

Official code

87211(b)

Regulation authority

CCR

What the official deficiency says

REPORTING REQUIREMENTS Any suspected physical abuse that results in serious bodily injury of an elder or dependent adult shall be reported to the local ombudsman, the corresponding licensing agency, & the local law enforcement agency within 2 hours as required by WIC Section 15630(b)(1). This requirement was not met as the facility did not report the suspected sexual to the Department, based on interviews and documentation reviewed.. This poses an immediate health and safety risk to residents in care.

Official plan of correction

Plan of correction to be submitted to CCLD in writing indicating that all incidents regarding sexual abuse will be reported to the Department within 2 hours regardless if the allegation is under investigation by the facility or other agencies.

Deadline recorded: Aug 27, 2025. A deadline is not proof that correction was completed.