FAMILY FEELS RESIDENTIAL CARE 3

Official classification

Type B

Official code

87211(a)(1)(D)

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 (D) Any incident which threatens the welfare, safety or health of any resident...this requirement is not met as evidenced by: Based on records review, licensee did not submit a written Unusual Incident Report (UIR / LIC 624) and notify the Department of a known cockroach infestation observed in 01/2026, which pose/s a potential health safety and personal rights risk to persons in care.

Official plan of correction

DADM stated that any incident that may affect resident health or safety, including pest infestations will be reported to the Department on a timely manner, staff will be trained in reporting requirement and corrections will be submitted to LPA on the POC due date of 08/28/2026

Deadline recorded: Aug 28, 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 (a) Except as specified in subsection (b), the licensee shall ensure...cleaning solutions ...knives.. are in locked storage and are not left unattended if outside the locked storage. This requirement is not met as evidenced by: Based on LPA observation during inspection, the LIC/ADM did not ensure that the Arm & Hammer laundry detergent, Downy Softener and steak knife are in locked storage and are not left unattended when not in use.

Official plan of correction

DADM, stated that he/she will ensure that LIC/ADM is aware of the deficiency and will have LIC/ADM submit a written plan of correction to address the deficiency regarding storage of laundry detergents and sharp objects by the POC due date of 03/26/2026.

Deadline recorded: Mar 26, 2026. 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 & 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 LPAs observation during facility inspection, LIC/ADM did not ensure that the facility is kept maintained by not addressing the following: back ramp rail sturdiness, frayed sliding door screen in room #3, kitchen vent is kept free from accumulated residue, smoke alarm is

Official plan of correction

properly installed,upholstered furnitures, and excercise equipment that were placed outdoors are in good and usable condition. for the safety and well-being of residents, employees and visitors. DADM, stated that he/she will ensure that LIC/ADM is aware of the deficiency and will have LIC/ADM submit a written plan of correction to address the deficiency regarding maintenance of the facility by the POC due date of 03/26/2026.

Deadline recorded: Mar 26, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(h)(5)

Regulation authority

CCR

What the official deficiency says

87465 Incidental Medical and Dental Care (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: Based on LPAs observation and staff statement, resident's morning medications are pre-prepared the night before and given to residents in the morning during breakfast. The LIC/ADM did not ensure that resident's medication are stored in its original received

Official plan of correction

container and not transferred between container. DADM, stated that he/she will ensure that LIC/ADM is aware of the deficiency and will have LIC/ADM submit a written plan of correction to address the deficiency regarding transfering of medication between containers by the POC due date of 03/26/2026.

Deadline recorded: Mar 26, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87455(b)(7)

Regulation authority

CCR

What the official deficiency says

87455 Acceptance and Retention Limitations (b) The following persons may be accepted or retained in the facility: (7) Persons who are under 60 years of age whose needs are compatible with other residents in care, if they require the same amount of care and supervision as do the other residents in the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above, 2 out of 6 residents under the age of 60. The facility has a census of 5 resident who is over the age of 60. ADM did not submit an exception request prior to admitting R2, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/12/2024 Plan of Correction The administrator stated that he/she will submit an exception request in compliance with the 25% under age resident allowed by the regulation in an RCFE facility. The plan will be submitted to LPA by the due date.

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: Deficient Practice Statement Based on observation the licensee did not comply with the section cited above in 1 out 1 objects. The licensee did not keep the resident's bendroom i in good repair at all times, the blinds in Bedroom 4 was falling apart and falling off the latch. Blind shade planks were cut in half and seucred by a tape, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/22/2024 Plan of Correction ADM stated the licensee will be notified that vertical window blinds in bedroom #4 requires replacement. ADM stated the plan of correction will be submitted to LPA by the due date