SWEET DREAMS CARE HOME LLC

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

87465 Incidental Medical and Dental Care (h)(2) 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. During inspection visit, resident's(R1) During the visit, medication was found in the his/her bathroom in bedroom #3 accessible. Although R1 states he/she is able to administer and store his/her own medication, it was not locked which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator agrees to provide a plan of correction by the POC due date (08/01/2026) to CCL office and provides the staff training log to CCL office. ADminstrtor stated the facility will instruct all staff to check each resident room every 4 hours and keep a checking log.

Deadline recorded: Aug 1, 2026. 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

87309 Storage Space and Access the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. During the visit, LPA/LPM observed a can of comet accessible in bedroom#3's bathroom. toxins which could pose a danger to residents are in not locked storage and are not left unattended orage.disinfectant was found in the of resident room #3 and was accessible to resident which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator agrees to provide a plan of correction by the POC due date (08/01/2026) to CCL office and provides the staff training log to CCL office.Administrator stated the facility will instruct all staff to check each resident room regualrly to make sure there is no toxic measterial left in the resident rooms. Adminstrator stated will provide a log for the checking for every 4 hours.

Deadline recorded: Aug 1, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87608(a)(5)(B)

Regulation authority

CCR

What the official deficiency says

87608 Postural Supports (a)(5)(B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails. During inspection visit, there are two residents utilizing full bed rails (R2 and R3) due to safety concerns and are at risk of falling. Although, R2 has MD order but it does not specify the need for it which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator agrees to provide a plan of correction by the POC due date (08/01/2026) to CCL office and to read Title 22 to understand the regulations. Adminstrator stated the facility will contact residents' doctor to obtain the medical order which justify residents' condtion and needs for full bedrial and will be ready in one week.

Deadline recorded: Aug 1, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87608(a)(5)(A)

Regulation authority

CCR

What the official deficiency says

87608 Postural Supports (a)(5)(A) A bed rail that extends from the head half the length of the bed and used only for assistance with mobility shall be allowed. During inspection, R4 to R6 are utilizing 1/2 bedrails for both safety and mobility with no medical order which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator agrees to provide a plan of correction by the POC due date (08/01/2026) to CCL office and to read Title 22 to understand the regulations. Administrator stated the faciity will contact residents' doctors to obtain medical order to use heal bedrail for mobility. It will be ready in one week.

Deadline recorded: Aug 1, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87608(a)(3)

Regulation authority

CCR

What the official deficiency says

87608 Postural Supports (a) (3)A written order from a physician indicating the need for the postural support shall be maintained in the resident’s record. The licensing agency shall be authorized to require other additional documentation if needed to verify the order. During inspection visit, R2 was observed utilizing a wheelchair with seat belt. ADM stated there is no medical note for it. R2 is alert and oriented who stated he/she likes to have it for his/her safety but when asked if he/she can unbuckled, he/she unable due to weakness. which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator agrees to provide a plan of correction by the POC due date (08/01/2026) to CCL office and to read Title 22 to understand the regulations. Adminstrator stated the facility will contact resident's doctor to get medical order. It will be ready in 7 days. Administrator stated the facility will make sure the resident is able to realese the seatbelt.

Deadline recorded: Aug 1, 2026. 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

87303 Maintenance and Operation (a) 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 evidenced by: Based on observation, interview and record review, the licensee did not comply with the section cited above in that the facility does not obtain fire clearance document and allows staff to occupied the new bedroom and staff admitted they live in the bedroom since January and March 2026 which poses/posed a potential safety or personal rights risk.

Official plan of correction

Administrator stated he/she will read the regulation and will submit a plan of correction by 5/8/2026 to CCL office.

Deadline recorded: May 8, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.605

Regulation authority

HSC

What the official deficiency says

On and after July 1, 2015, all residential care facilities for the elderly, except those facilities that are an integral part of a continuing care retirement community, shall maintain liability insurance covering injury to residents and guests in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in the total annual aggregate, caused by the negligent acts or omissions to act of, or neglect by, the licensee or its employees. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview and record review, the licensee did not comply with the section cited above in that the facility is unable to provide the evidence of valid liability insurance which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/28/2026 Plan of Correction Administrator stated he/she will read the regulation and will submit a plan of correction by 1/28/2026 to CCL office.

Official classification

Type B

Official code

87465(h)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: 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 3 clients, R1's centrally stored medication form is inaccurate and did not match with the medications which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/28/2026 Plan of Correction Administrator stated the facility will provide staff training and submit plan of correction by 1/28/2026 to CCL office to prevent the incident to happen again. Administrator agreed to submit the staff training log.

Official classification

Type B

Official code

1569.695(c)

Regulation authority

HSC

What the official deficiency says

(c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of residents is not required during a drill. While a facility may provide an opportunity for residents to participate in a drill, it shall not require any resident participation. Documentation of the drills shall include the date, the type of emergency covered by the drill, and the names of staff participating in the drill. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview and record review, the licensee did not comply with the section cited above in that the facility has no emergency drill or fire alarm drill logs which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/28/2026 Plan of Correction Administrator stated to read the regulation and submit plan of correction by 1/28/2026 to CCL office.

Official classification

Type B

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

87465 Incidental Medical and Dental Care(h)(2)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 is not met as evidenced by: On 09/11/25, During inspection, R1 to R3's prescribed medications were observed accessible/unlocked. Staff S1 and S2 had forgotten to locked it in the centrally stored cabinet after residents' administration. this poses an potential health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator (ADM) stated he/she will provide staff in service training on medication ensuring that medicines are always locked at all times. ADM stated he/she will submit a copy of staff in service training to CCL by POC date.

Deadline recorded: Sep 18, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87207

Regulation authority

CCR

What the official deficiency says

87207 False Claims. No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility. This requirement is not met as evidenced by: Licensee and Administrator provided false or misleading statement regarding the facility and the service, The licensee and administrator stated that administrator will stay at the facility at 20 hours during business hours, but administrator is unable to be at the facility from 8:00AM - 5:00PM on Monday - Friday, this poses an potential health, safety or personal rights risk to persons in care..

Official plan of correction

Administrator stated he/she will provide a written statement that he/she will not make any false claims and that he/she will comply with his/her working hours and also, licensee's son will be the back ADM who will submit his qualifications. ADM stated he/she will submit a copy of a signed written statement to CCL.

Deadline recorded: Sep 18, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87463(e)

Regulation authority

CCR

What the official deficiency says

87463 Reappraisals. (e)The licensee shall immediately, or as soon as reasonably possible, bring any significant change in condition, as defined in Section 87101, Definitions, to the attention of the appropriate licensed medical professional and if applicable, other specialized care provider. Documentation of such communication shall be added to the resident's record and shall include: This requirement is not met as evidenced by: Administrator did not observed the resident R1's change in condition and did not update R1's care plan, this poses an potential health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator stated the facility staff will provide care and supervision and to observe residents for any change in condition. The facility will update resident's care plan immediately and as necessary by submitting a written statement by ADM that care plan will be completed and adhered to by POC due date.

Deadline recorded: Sep 18, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87405(d)(1)

Regulation authority

CCR

What the official deficiency says

87405 Administrator - Qualifications and Duties (d) The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7)...(1) Knowledge of the requirements for providing care and supervision appropriate to the residents. This requirement is not met as evidenced by: Based on overall deficiencies cited, ADM made false statement, ADM did not assess resident's care needs, medication accessibility and not spending 20 hours in the facility. This poses an potential health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator stated he/she will review his/her duties and responsibility as the ADM and to make to apply properly by submitting self certification to CCL by POC date.

Deadline recorded: Sep 18, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87411(a)

Regulation authority

CCR

What the official deficiency says

87411 - Personnel Requirements - (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This requirement was not met as evidenced by: Based on interview with witnesses, staff S1 is unable to comprehend English, and inability to communicate in English wherein they had to use body language/gestures to communicate.

Official plan of correction

Administrator agreed to send plan of correction by the POC due date to ensure the facility to hire competent staff to provide care and service to residents in care. The facility already sent the plan of correction on 2/20/2025.

Deadline recorded: Feb 26, 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

(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above.LPA observed two sheds in the backyard were not locked and contained tools and other toxic materials such as; WD-40 and a paint can. While, touring , LPA observed next to the side of the home next to the garage/office, a gallon of windshield washer fluid accessible and a shovel. This poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/24/2025 Plan of Correction ADM locked the storage shed during visit and secured winshield wiper fluid during visit, ADM will submit a letter of understanding regarding the importance of keeping toxics/detergents/other hazardous objects such as tools should be inaccessible to residents in care. ADM stated will send POC by due date January 24,2025.

Official classification

Type B

Official code

87457(c)

Regulation authority

CCR

What the official deficiency says

87457 Pre-admission Appraisal - General (c)Prior to admission... resident's suitability for admission shall be completed... an appraisal of his/her individual service needs ... This requirement was not met as evidenced by; Based on interview and record review, ADM stated the facility did not document the pre-admission apprisal for resident R1. This poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

ADM stated she will send a written letter of understanding regarding the regulation. ADM stated she will send this letter of understanding to LPA, by POC date, December 23, 2024.

Deadline recorded: Dec 23, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87202(a)

Regulation authority

CCR

What the official deficiency says

87202 Fire Clearance (a) All facilities shall maintain a fire clearance approved ... Prior to accepting or retaining any of the following types of persons,... obtain an appropriate fire clearance approved ... the State Fire Marshal. This requirement was not met as evidenced by Based on interviews and records reviewed, resident R1 is a bedridden resident who resides in bedroom #6. Based on a review of the facility's fire cleareance, bedroom #6 is not cleared for the use of a bedriddent resident. This poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

ADM stated she will send a written letter of understanding regarding the regulation. ADM stated she will send this letter of understanding to LPA, by POC date, December 23, 2024.

Deadline recorded: Dec 23, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

87303 Maintenance and Operation (a) 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 evidenced by: Based on observation the LIC did not comply with the above by not maintaining the facility clean, sanitary and in good repair. LPAs observed piled up household items no longer in use,broken window glass, non-operating appliances, vehicle, and medical equipments and pile of woods.

Official plan of correction

ADM stated that she will notify the licensee of the broken glass window, the piled up household items, unused medical equipement, & applicance. ADM will submit a written plan of correction on how the facility will ensure that facility is maintained and in good repair at all times by the due date con't. Which can serve as a place for rodents and other animals to breed, which pose/poses an immediate, health, safety and personal rights risks to persons in care.

Deadline recorded: Oct 31, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87411(a)

Regulation authority

CCR

What the official deficiency says

87411 Personnel Requirements - General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs... This requirement is not met as evidenced by: Based on interview and record review the LIC did not comply by not having sufficient personnel who are competent to provide necessary services. LPAs interviewed ADM/S1 and stated that he/she cover other staff breaks, and is the overnight staff. Based on review and assessment of LIC 500,

Official plan of correction

ADM stated that he/she will notify the LIC regarding staffing shortage. ADM will submit a written plan of correction on how the faciltiy will address staffing shortages by the due date. con't. the facility does not have a night staff and have no sufficient coverage for breaks and days off.

Deadline recorded: Oct 31, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87205(a)

Regulation authority

CCR

What the official deficiency says

87205(a) Accountability of Licensee Governing Body (a) The licensee, whether an individual or entity ...shall excercise general supervision over the affairs of the licensed facility ... policies..in confrmance with these regulations and welfare of the individuals it serves: This requirement is not met as evidenced by: Based on interview, the LIC did not notify CCL of their prolong absence leaving the facility without proper general supervision to conform with regulations and welfare of the individualls in the facilty whic pose/poses a potential health, safety and personal rights

Official plan of correction

ADM stated that he/she will notify the LIC of the need to inform CCL of their prolonged absence due to issues that may arise at any time. ADM will submit a written plan of correction on how the facility will ensure that general supervision and conformance to regulations is followed. con't to persons in care.

Deadline recorded: Nov 6, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87507(d)

Regulation authority

CCR

What the official deficiency says

87507 Admission Agreements (d) The licensee shall retain in the resident's file the original signed and dated admission agreement and all subsequent signed and dated modifications. This requirement was not met as evidenced by; Based on record review, the facility did not have a copy of R3's admission agreement. LPA's asked ADM if she had the R3's admission agreement, and ADM stated she did not have a copy and cannot find it. This poses a potential heath, safety and personal rights risk to persons in care.

Official plan of correction

The administrator stated she will send a plan of action on how the facility will retain residents's admission agreements. Administrator stated she will send plan to LPA by POC date, Janurary 11, 2024.

Deadline recorded: Jan 11, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87202(a)

Regulation authority

CCR

What the official deficiency says

(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: This requirement is not met as evidenced by: Deficient Practice Statement Based on interview with 2 staff, ADM and S1 admitted the facility is using the converted garage(office) as a bedroom for residents R1 & R2. This poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/15/2023 Plan of Correction ADM will submit a picture documentation showing the office is no longer being used as a resident bedroom. ADM stated he will also send a letter of understanding stating no staff, volunteer or resident is allowed to sleep in the following areas without building permit and fire clearance such as but not limited storage room, living room, and office (converted garage).

Official classification

Type A

Official code

87468.1(a)(1)

Regulation authority

CCR

What the official deficiency says

87468.1(a)(1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement is not met as evidenced by: Deficient Practice Statement Based on interviews with 2 staff, staff confirmed that R1/R2 is in the office (converted garage). Staff stated the Licensee L1 did not have a key to open the office door while LPA was in the facility. This poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/15/2023 Plan of Correction Licensee will send a letter of understanding regarding the regulation and the licensee's role in ensuring residents are accorded dignity.

Official classification

Type A

Official code

87207

Regulation authority

CCR

What the official deficiency says

No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview with 2 staff members, the facility did not comply with their licensed capacity. The facility was over capacity by two residents. The facility providing misleading statements regarding the capacity.

Official plan of correction

POC Due Date: 12/15/2023 Plan of Correction Licensee will submit a written plan to demonstrate Licensee's understanding of Title 22 policies pertaining to this regulation and to submit a written and signed statement understanding of this regulation by POC date

Official classification

Type A

Official code

87405(d)(1)(2)

Regulation authority

CCR

What the official deficiency says

(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. (1) Knowledge of the requirements for providing care and supervision appropriate to the residents. (2) Knowledge of and ability to conform to the applicable laws, rules and regulations. This requirement is not met as evidenced by: Deficient Practice Statement Based on interviews with facility staff, ADM and staff S1onfirmed the facility had residents R1 and R2 sleeping in the converted garage (office.) Staff also admitted that the facility was over capacity and had 8 residents, when the facility's capacity is 6 residents.

Official plan of correction

POC Due Date: 12/15/2023 Plan of Correction Licensee will submit the Department with updated Administration Certification and a written plan to demonstrate Licensee's understanding of Title 22 policies pertaining to care and supervision of residents. Licensee to submit a written and signed statement understanding of this regulation by POC date.

Official classification

Type A

Official code

87204(a)

Regulation authority

CCR

What the official deficiency says

(a) A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including specification of the maximum number of persons who may receive services at any one time. An exception may be made in the case of catastrophic emergency when the licensing agency may make temporary exceptions to the approved capacity. This requirement is not met as evidenced by: Deficient Practice Statement Based on interviews with 2 staff, the facility currently has 8 residents. The facility is currently licensed for 6 residents. The facility is operating beyond the conditions and limitations specified on the license. This poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/15/2023 Plan of Correction Licensee will send LPA plan of action on how he/she will relocate the two surplus residents to comply with the conditions and limitations specified on the license.

Official classification

Type B

Official code

87303(e)(5)

Regulation authority

CCR

What the official deficiency says

(e) Water supplies and plumbing fixtures shall be maintained as follows: (5) Non-skid mats or strips shall be used in all bathtubs and showers. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, a bathroom at the end of the hallway on the left hand side, adjecent to the laundry room, did not have a non-skid mat in the bathtub. This poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/21/2023 Plan of Correction Licensee will send plan of action on how the facility will comply with the regulation requiring non-skid mats in the bathtubs/ showers.