NEW LIFE RESIDENCE

Official classification

Type B

Official code

87464(h)

Regulation authority

CCR

What the official deficiency says

REAPPRAISALS The licensee shall request that all residents receive an annual routine visit with a licensed medical professional once every 12 months, either in person or by video appointment. Documentation of the annual routine visit... shall be added to the resident's record. This requirement is not met, as MD reports for clients #2 & #3 are dated more than a year ago. Licensee failed to ensure that annual MD evaluations are maintained, which poses a potential health or safety risk to clients in care.

Official plan of correction

MD reports for clients #2 and #3 will be updated, signed, and sent to CCLD BY DUE DATE

Deadline recorded: Jan 13, 2026. 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

REAPPRAISALS The 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... and to keep the appraisal accurate. This requirement is not met, as appraisal for client #3 is not maintained. Licensee failed to ensure that annual appraisals are maintained, which poses a potential health, safety or personal rights risk to clients in care.

Official plan of correction

Updated signed appraisal for client #3 will be sent to CCLD BY DUE DATE

Deadline recorded: Jan 13, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.695(f)(2)

Regulation authority

HSC

What the official deficiency says

HEALTH AND SAFETY CODE A facility shall have a set of keys available to facility staff on each shift for use during an evacuation that provides access to all occupied resident units, facility vehicles, all exit doors, all cabinets...or files that contain elements of the emergency disaster plan, including... food supplies & protective shelter supplies. This requirement was not met, as extra set of keys is not maintained in the event of an emergency. Licensee failed to maintain spare set of keys, which poses a potential health, safety or personal rights risk. This was discussed w/ administrator on 1/30/24.

Official plan of correction

Spare set of emergency ksys will be maintained and separate from everyday use keys. Proof of correction to be sent to CCLD BY DUE DATE

Deadline recorded: Jan 24, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87609(b)(4)(B)

Regulation authority

CCR

What the official deficiency says

ALLOWABLE HEALTH CONDITIONS/ USE OF HOME HEALTH AGENCIES ..Written agreement shall include day and evening contact information for the HH agency...method of communication between the agency & facility, which may include verbal contact, electronic mail, or logbook. This requirement was not met, as there are no progress notes maintained from home health providers whenever they visit a resident. Licensee failed to ensure maintenance of HH notes from visiting providers, which poses a potential health, safety or personal rights risk. This was discussed with administrator on 1/30/24.

Official plan of correction

Administrator to ensure that home health visiting nurses document each visit. Plan/proof of correction to be sent to CCLD BY DUE DATE

Deadline recorded: Jan 24, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.69(b)

Regulation authority

HSC

What the official deficiency says

HEALTH AND SAFETY CODE Each employee who received training, passed the examination required in paragraph (5) of subdivision (a), who continues to assist with the self-administration of medicines, shall also complete 8 hours of training on med -related issues in each succeeding 12- month period. This requirement was not met, as S1 & S ____ who manage and administer clients' medications, have not received annual medication training for 2024. Licensee failed to ensure that staff who handle medications receive required training, which poses a potential health, safety or personal rights risk. S1 received 1 hour of med training in 2024 & there is no record that S __ received any medication training in 2024.

Official plan of correction

Staff who handle and administer clients' medications will receive annual required medications training. Proof of corrction to be sent to CCLD BY DUE DATE.

Deadline recorded: Jan 24, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.626(a)(2)

Regulation authority

HSC

What the official deficiency says

HEALTH AND SAFETY CODE All RCFEs shall meet the following training requirements, as described in Section 1569.625, for all direct care staff: 8 hours of in-service training per year on the subject of serving residents with dementia. This requirement was not met, as there is no record that staff #3 and #4 received ANY training in 2024. Licensee failed to ensure that staff received required training, which poses a potential health, safety or personal rights risk to clients in care.

Official plan of correction

Staff #3 and #4 will receive required annual dementia training. Proof of correction to be sent to CCLD BY DUE DATE.

Deadline recorded: Jan 24, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87465(h)(6)

Regulation authority

CCR

What the official deficiency says

iNCIDENTAL MEDICAL CARE A record of centrally stored prescription medications for each resident shall be maintained and include names of the resident for whom prescribed, prescribing physician and pharmacist, drug name, strength and quantity, dates filled, started & expiration, prescription number and instructions. This requirement is not met, as 2 OTC meds for client #2, OTC Senna and Rx Vit D3 for C5, & medications received but not yet started, are not recorded on CSMR. This poses a potential health, safety or personal rights risk to clients in care.

Official plan of correction

Medications will be recorded on Centrally Stored Medications Records upon RECEIPT. Proof/plan of correction will be sent to CCLD BY DUE DATE

Deadline recorded: Jan 24, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

INCIDENTAL MEDICAL CARE Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement was not met, as 2 bottles of Vit D3 stored in common bathroom,and acetaminophen and Vit C stored in kitchen cabinet, where items are accessible to residents. Licensee failed to ensure that medications are stored where inaccessible to clients, which poses an immediate health, safety or personal rights risk to clients in care.

Official plan of correction

Vitamin D3, acetaminophen and Vit C relocated to inaccessible storage area in LPA's presence. Deficiency corrected and cleared

Deadline recorded: Jan 14, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

STORAGE SPACE AND ACCESS The licensee shall ensure that disinfectants, cleaning solutions, poisonous substances... and other similar items which could pose a danger to residents are in locked storage and are not left unattended... This requirement is not met, as Windex is stored in common bathroom cabinet, accessible to clients. Licensee failed to ensure that cleaning solutions are secured, which poses an immediate health, safety or personal rights risk to clients in care.

Official plan of correction

Bottle of Windex was removed from common bathroom in LPA's presence and secured. Deficiency corrected and cleared in LPA's presence.

Deadline recorded: Jan 14, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.1(a)(13)

Regulation authority

CCR

What the official deficiency says

PERSONAL RIGHTS Residents in all RCFEs shall have the personal right to have access to individual storage space for private use. This requirement is not met, as personal items belonging to staff are stored in closet in client room #3. Licensee failed to ensure that residents' closets are limited to residents' personal items, and not used by staff. This poses a potential health, safety or personal rights risk to clients in care.

Official plan of correction

Personal belongings of staff will be removed from clients' rooms and proof of correction to be sent to CCLD BY DUE DATE

Deadline recorded: Jan 21, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87633(b)

Regulation authority

CCR

What the official deficiency says

HOSPICE CARE OF TERMINALLY ILL A current and complete hospice care plan shall be maintained in the facility for each hospice resident and include specific information. This requirement is not met, as there is no hospice care plan maintained for client #3, including use of half bed rails. Licensee failed to ensure that hospice care plan is maintained for all hospice clients, which poses a potential health, safety or personal rights risk to clients in care.

Official plan of correction

Hospice care plan for client #3 will be sent to CCLD BY DUE DATE, and shall include order for use of half bed rails.

Deadline recorded: Jan 21, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

MAINTENANCE AND OPERATION The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement is not met, as discarded furnishings are observed in backyard--table, chairs, bed frame, 2 bicycles, scooters, shelf--and pipe and insulation are exposed in room #6 as a 3' x 18 " section of ceiling is missing. This poses a potential health, safety or personal rights risk to clients in care.

Official plan of correction

Ceiling was temporarily covered in LPA's presence. Discarded items will be removed from premises and proof of correction to be sent to CCLD BY DUE DATE

Deadline recorded: Jan 21, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87457(c)

Regulation authority

CCR

What the official deficiency says

PREADMISSION APPRAISAL Prior to admission a determination of the prospective resident's suitability for admission shall be completed & shall include an appraisal of their individual service needs... This requirment is not met, as appraisals for clients #2, #3, #4, #5 are missing or incomplete. Licensee failed to ensure that all residents have completed, signed and dated appraisals on file, which poses a potential health, safety or personal rights risk to clients in care.

Official plan of correction

Appraisals shall be completed, signed and dated for 4 clients, and copies will be sent to CCLD BY DUE DATE

Deadline recorded: Jan 21, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

1569.185(e)

Regulation authority

HSC

What the official deficiency says

HEALTH AND SAFETY CODE The failure of an applicant for licensure or a licensee to pay all applicable and accrued fees and civil penalties shall constitute grounds for denial or forfeiture of a license. This requirement is not met, as licensee has failed to pay annual licensing renewal fees for 2023, 2024 and 2025, which poses an immediate health, safety or personal rights risk to clients in care. Licensee was reminded to pay licensing fee on 1/30/24 during annual visit.

Official plan of correction

Annual licensing fees and late charges totalling $1979 will be paid BY DUE DUE DATE. Proof of payment/correction to be sent to CCLD BY DUE DATE.

Deadline recorded: Jan 15, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.69(b)

Regulation authority

HSC

What the official deficiency says

HEALTH AND SAFETY CODE Each employee who received training and passed the exam required in paragraph (5) of subdivision (a)... who continues to assist with the self-administration of medicines, shall also complete 4 hours of in-service training on medication-related issues in each succeeding 12-month period. This requirement is not met, as all staff have not received 4 hours of continuing medication training, which poses a potential health, safety or personal rights risk to clients in care.

Official plan of correction

Staff who handle clients' medications will receive at least 4 hours of annual medication training. Proof/plan of correction to be sent to CCLD BY DUE DATE.

Deadline recorded: Jan 21, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.696

Regulation authority

HSC

What the official deficiency says

HEALTH AND SAFETY CODE All RCFEs shall provide training to direct care staff on postural supports, restricted conditions or health services, & hospice care as a component of the training requirements specified in Section 1569.625. The training shall include... 4 hours of training thereafter of in-service training per year on the subject of serving those residents. This requirement was not met, as staff #3 and #4 have not received this training for 2024. Licensee failed to ensure that all staff receive required training, which poses a potential health, safety or personal rights risk to clients in care.

Official plan of correction

Staff #3 and #4 will received required training on postural supports, restricted health conditions and hospice care. Proof of training to be sent to CCLD BY DUE DATE.

Deadline recorded: Jan 21, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87465(h)(5)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation of clients' medications, the licensee did not comply with the section cited above, as staff prepare clients' medications 7 days in advance, which poses a potential health, safety or personal rights risk to persons in care. Plastic containers containing daily medications for 7 days are observed.

Official plan of correction

POC Due Date: 02/13/2024 Plan of Correction Effective immediately, medication shall not be prepared more than ONE day in advance. Plan/proof of correction to be submitted to CCLD BY DUE DATE.

Official classification

Type B

Official code

87468.2(a)(4)

Regulation authority

CCR

What the official deficiency says

In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (4) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation of facility log and interview with co-administrator, the licensee did not comply with the section cited above, as daily temperature and COVID symptom checks are not recorded for staff and clients since March 2022, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/16/2022 Plan of Correction Staff shall limmediately resume logging COVID symptom checks and temperatures of staff and clients. Plan of correction to be sent to CCLD BY DUE DATE.

Official classification

Type A

Official code

87608

Regulation authority

CCR

What the official deficiency says

POSTURAL SUPPORTS A bed rail that extends from the head half the length of the bed and used only for assistance with mobility shall be allowed. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation of 2 half bed rails on bed in room #4, occupied by client #3, the licensee did not comply with the section cited above. There are 2 half bed rails installed on both sides of bed at the foot of the bed, in addition to 2 half rails installed at the head of the bed on both sides. This poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/09/2022 Plan of Correction Two half bed rails at the foot of the bed in room #4 were removed in LPA's presence. Deficiency corrected and cleared during visit.