HEIRLOOM ROSE GARDEN

Official classification

Type B

Official code

87211(a)(1)

Regulation authority

CCR

What the official deficiency says

87211 Reporting Requirements: (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below... Violation of this regulation is evidenced by: Based on interviews conducted, the Co-Adminstrator indicated that an incident report was not submitted to CCL when Resident 1 (R1) was admitted to the hospital on December 9, 2022.

Official plan of correction

Licensee/Administrator to submit acknowledgement of CCR 87211.

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

Official classification

Type B

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. This requirement is not met as evidenced by: Deficient Practice Statement Based on observations, LPAs observed toxins and chemicals in the garage to be unlocked and accessible to residents which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/28/2023 Plan of Correction Facility to lock the toxins and chemicals and provide LPA with a photo of locked chemicals. Facility to conduct in-service training regarding the important of storing chemicals and toxins in a locked area.

Official classification

Type B

Official code

87705(f)(1)

Regulation authority

CCR

What the official deficiency says

(f) The following shall be stored inaccessible to residents with dementia: (1) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s). This requirement is not met as evidenced by: Deficient Practice Statement Based on observations, LPAs observed knives drawers to be unlocked and scissors to be in another drawer to be unlocked which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/28/2023 Plan of Correction Facility to lock the knives and provide LPA with a photo of locked sharps. Facility to conduct in-service training regarding the important of locking sharps immediately especially when there is no staff present in the kitchen.

Official classification

Type B

Official code

87705(j)

Regulation authority

CCR

What the official deficiency says

87705 Care of Persons with Dementia: (j) The licensee shall have an auditory device or other staff alert feature to monitor exits, if exiting presents a hazard to any resident. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above as door alarm for bedroom #3 (dementia resident's room) and office room was observed to not be in working condition which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/28/2023 Plan of Correction Facility administrator to either repair or purchase new alarms and install them. Facility to submit a picture and video to LPA of working alarms in bedroom 3 and office room. Facility to also submit a copy of receipt for purchased alarms.