Allegations3 substantiated · 0 unsubstantiated · 0 unfounded · 3 cited
Resident rightsType A
- Official classification
- Type A
- Official code
- 87468.2(a)(4)
- Regulation authority
- CCR
What the official deficiency says
87468.2(a)(4) Additional Personal Rights of Residents in Privately Operated Facilities. Residents shall have all of the following personal rights ...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 was not met as evidenced by: Based on investigation interviews with Witness 1 and administrator, the licensee did not comply with the section cited above, as resident was not properly supervised which led to three elopements, which posed an immediate safety, and personal rights risk to residents in care.
Official plan of correction
Administrator will review facilities Plan of Operation that discusses elopement and dementia processes. Licensee will provide a written statement to CCL by 6/20/25 stating how they will prevent future incidents from reoccurring.
Deadline recorded: Jun 20, 2025. A deadline is not proof that correction was completed.
Incident reportingType B
- Official classification
- Type B
- Official code
- 87211(a)(1)(D)
- Regulation authority
- CCR
What the official deficiency says
87211 Reporting Requirements (a)(1)A written report shall be submitted to the licensing agency…within seven days of the occurrence of any of the events specified…(D) Any incident which threatens the welfare, safety or health of any resident, such as… unexplained absence of any resident. This requirement is not met as evidenced by:Based on interview and record review, facility failed to provide report of elopement incidents to Licensing as required which posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
Licensee will review 87211 reporting requirements and provide CCL with a written statement of understanding. Licensee agrees to complete a Unusual Incident Report for each elopement and submit them to licensing by 06/30/2025.
Deadline recorded: Jun 30, 2025. A deadline is not proof that correction was completed.
Medical and dental careType B
- Official classification
- Type B
- Official code
- 87465(a)(4)
- Regulation authority
- CCR
What the official deficiency says
87465 Incidental Medical and Dental Care (a)A plan for incidental medical…care shall be developed…plan shall encourage routine medical…care and provide for assistance in obtaining such care...(4)The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Based on interview and record review, Resident 1(R1) did not received medication ordered by physician which posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
Administrator agrees to submit a written statement of understanding of CCR 87465 in its entirety. As well as review Medication guidance from the Technical Support Program.
Deadline recorded: Jun 30, 2025. A deadline is not proof that correction was completed.