VALLEY PINES

Official classification

Type B

Official code

Not listed

Regulation authority

Not listed

What the official deficiency says

(c) All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69 (1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross. This requirement was not met as evidenced by: Licensee did not ensure that 4 out of 5 reviewed staff records did not have a current first aid certification on file, which poses a potential safety risk to residents in care.

Deadline recorded: Dec 17, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

Not listed

Regulation authority

Not listed

What the official deficiency says

(a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. This requirement was not met as evidenced by: Licensee did not ensure that resident R2's record had an Appraisal/Needs and Services Plan and R3's record had an Admission Agreement, which poses a potential personal rights risk to residents in care.

Official plan of correction

by 12/17/2025.

Deadline recorded: Dec 17, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

Not listed

Regulation authority

Not listed

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (6) The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained for at least one year and includes: (A) The name of the resident for whom prescribed. (B) The name of the prescribing physician. (C) The drug name, strength and quantity. (D) The date filled. (E) The prescription number and the name of the issuing pharmacy. (F) Instructions, if any, regarding control and custody of the medication. This requirement was not met as evidenced by: Licensee did not ensure that residents R1 and R2's Centrally Stored Medication and Destruction Records did not have missing medications, which poses a potential health risk to residents in care.

Deadline recorded: Dec 17, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87625(b)(2)

Regulation authority

CCR

What the official deficiency says

(b) In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for the following: (2) Ensuring that incontinent residents are checked during those periods of time when they are known to be incontinent, including during the night. This requirement is not met as evidenced by: Based on interview, record review and observation the licensee did not ensure that staff checks and changes R1’s throughout the night resulting in R1 being left soiled throughout the night which poses an immediate health, safety and personal rights risk to persons in care.

Official plan of correction

Licensee will submit a written plan to ensure compliance with the section cited to LPA Kabariti by POC due date.

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

Official classification

Type B

Official code

87411(c)

Regulation authority

CCR

What the official deficiency says

(c) All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69. This requirement is not met as evidenced by: Based on interview, record review and observation the licensee did not ensure to provide staff (S1) and (S2) with training which poses/posed a potential health, safety, and personal rights risk to persons in care.

Official plan of correction

Licensee states to have provided training for S1 and S2. During visit, LPA obtained the training records for S1. Licensee will fax S2's training records to the Department by POC due date.

Deadline recorded: Mar 28, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)

Regulation authority

CCR

What the official deficiency says

(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. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. This requirement is not met as evidenced by: Based on interview, record review, and observation the licensee did not ensure to submit a written incident report and death report to the licensing Department for R1 during an incident that occurred in March 2024 which poses a potential health, safety and personal rights risk to persons in care.

Official plan of correction

Licensee states they will submit a statement of understanding of the section cited. Licensee will also submit a plan in writing to ensure all fax cover sheets will be attached to incident reports and death reports. Licensee will submit the plan of correction to LPA Dolores via fax by 10/01/2024.

Deadline recorded: Oct 1, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87505

Regulation authority

CCR

What the official deficiency says

Each facility shall document in writing the findings of the pre-admission appraisal and any reappraisal or assessment which was necessary in accordance with Sections 87457, Pre-admission Appraisal, and 87463, Reappraisals. If supporting documentation from a physician is required, this input shall also be obtained and may be the same assessment as required in Section 87458, Medical Assessment. This requirement is not met as evidenced by: Based on interview, record review and observation the licensee did not ensure to update R2's reappraisal and physician's report upon a change on condition based on the licensee's observations which poses a potential health, safety and personal rights risk to persons in care.

Official plan of correction

Licensee will submit R2's updated physician's report and appraisal/needs and services plan that will be reviewed by R2's responsible party to LPA Dolores via fax by 10/01/2024.

Deadline recorded: Oct 1, 2024. A deadline is not proof that correction was completed.