FAMILY FEELS RESIDENTIAL CARE

Official classification

Type A

Official code

87705(b)(1)

Regulation authority

CCR

What the official deficiency says

87705 Care of Persons with Dementia (b) Licensees shall be responsible for the following: (1) Ensuring staff receive the following training as part of the training requirements specified in Section 87208 Plan of Operation. 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 by not ensuring S2 completed the required direct staff of 12 hours dementia care training devoted to care of persons with dementia. Based on record review 2 out of 4 resident are diagnosed with dementia, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/23/2026 Plan of Correction ADM stated that he/she will notify licensee and will submit a written plan of correction to address the training requiremnet of S2 by the POC due date of 04/23/2026.

Official classification

Type A

Official code

1569.695(b)

Regulation authority

HSC

What the official deficiency says

§1569.695 Emergency Plans (b) A facility shall provide training on the plan to each staff member upon hire and annually thereafter. The training shall include staff responsibilities during an emergency or disaster. 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 by not ensuring that emergency plans are done annually that includes the staff responsibility during an emergency or disaster. Based on record review the facility conducted the emergency plan on 08/05/2024, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/23/2026 Plan of Correction ADM stated that he/she will notify the licensee and will submit a written plan of correction to address the required emergency plan, and include stasff responsibilities during an emergency or disaster to comply with the Health and Safety Code 1569.695. ADM stated that he/she will submit the plan of correction by the POC due date of 04/23/2026.

Official classification

Type A

Official code

1569.695(c)

Regulation authority

HSC

What the official deficiency says

§1569.695 Emergency Plans (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...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 record review the licensee did not comply with the section cited above by not conducting the drills at least quarterly for each shift, the facility conducted the fire drill on 04/16/2025, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/23/2026 Plan of Correction ADM stated that he/she will notify the licensee and will submit a written plan of correction to address quarterly drills for each shift and taking into account different emergency scenarios. ADM stated that he/she will submit the written plan of correction by the POC due date of 4/23/2026.

Official classification

Type A

Official code

87224(a)

Regulation authority

CCR

What the official deficiency says

87224 Eviction Procedures(a)...Thirty (30) days written notice to the resident is required...This requirement is not met as evidenced by: Based on interviews and record review, Licensee did not follow eviction procedure as stipulated on the admission agreement by not issuing a 30-day eviction notice to R1s and CM and provide CM & R1 time to relocate on 12/16/25, which pose/s an immediate health, safety and personal rights risks to persons in care.

Official plan of correction

DADM, stated that licensee will be notified that a plan of correction needs to be submitted to LPA within 24 hours (02/21/2026).

Deadline recorded: Feb 21, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87224(f)

Regulation authority

CCR

What the official deficiency says

87224(f) Eviction procedure (f) A written report of any eviction shall be sent to the licensing agency within five (5) days. This requirement is not met as evidenced by: Based on interview and record review, the Licensee did not submit a written report within 5 days to CCLD and R1s CM commencing on 12/17/25, which pose/s a potential health, safety and personal right risk to persons on care.

Official plan of correction

DADM stated that he/she will notify Licensee/administrator that a plan of correction is required to handle notification regarding eviction procedures by 03/02/2026.

Deadline recorded: Mar 2, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87355(e)(3)

Regulation authority

CCR

What the official deficiency says

87355 Criminal Record Clearance (e) All individuals...pursuant toHealth and Safety Code Section 1569.17(b) shall prior to working...(3) Request a transfer of a criminal record clearance as specified in Section 87355(c). This requirement is not met as evidenced by: Based on document review, S3 has a clear FP scan on 4/11/25, but was not received by CPMB. CPMB, notified applicant (S3)regarding incomplete app on 8/14/25. Application was closed by CPMB due to no response received from S3. S3 is separated from the facility. Which

Official plan of correction

con't - pose, poses a immediate health safety and personal rights risk for persons in care. Plan of correction: LIC/ADM stated that a written plan of correction will be submitted to LPA by POC due date 12/23/25 stating that the LIC/ADM will call CPMB, to complete S3s requirement for the BG clearance prior to working at the facility.

Deadline recorded: Dec 23, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87458(a)

Regulation authority

CCR

What the official deficiency says

87458 Medical Assessment (a) Prior to a person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment, signed by a licensed medical professional... This requirement was not met as evidenced by; Based on record review and interview; R1’s Physician's Report dated 8/18/23. R1's physician's report is not signed by the physician. ADM2 stated that physicians report on file was the only one the facility had. This poses a potential threat to residents health, safety and personal rights.

Official plan of correction

ADM2 stated she will send a letter of understanding regarding the regulation. ADM2 stated she shall obtain a new physician's report for R1 and send CCL a copy of the physician's report by POC due date, November 13, 2025.

Deadline recorded: Nov 13, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87463(a)

Regulation authority

CCR

What the official deficiency says

87463 Reappraisals (a)The pre-Admission appraisal... shall be updated in writing as frequently as necessary or once every 12 months ... to keep the appraisal accurate... This requirement was not met as evidenced by; Based on record review and interview, ADM2 stated the appraisal needs and service plan dated August 1, 2023 is the only needs and services plan they have on file. This poses a potential threat to residents health, safety and personal rights.

Official plan of correction

ADM2 stated she will send a letter of understanding regarding the regulation. ADM2 stated she will send LPA an updated appraisal needs and service plan for R1 by November 13, 2025.

Deadline recorded: Nov 6, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

1569.50(a)(3)

Regulation authority

CCR

What the official deficiency says

1569.50 Denial, suspension or revocation of license; ...exclusion from licensee without right to petition for reinstatement (a)(3) Conduct that is inimical to the health, morals, welfare, or safety ... from the facility or the people of the State of California. This requirement was not met as evidenced by; Based on interviews conducted, and evidenced reviewed, staff S1 and S3 admitted to loaning money from R1. This action is a violation of resident R1’s personal rights. This poses an immediate threat to residents health, safety and personal rights.

Official plan of correction

ADM stated she will conduct a personal rights training with her staff. ADM stated she will send documentation of the training with the following information: who participated, who conducted the training, duration of the training, what materials were used. ADM stated she will send a letter of understanding regarding the regulation. ADM stated she will send the plan of corrections to LPA by POC date, October 29, 2025.

Deadline recorded: Oct 29, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87303(a)(1)

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. (1) Floor surfaces in bath, ...shall be maintained in a clean, sanitary, and odorless condition. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation the licensee did not comply with the section cited above by not maintaining floor and sink surfaces in bath clean and sanitary which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/08/2024 Plan of Correction

Official classification

Type A

Official code

87355(e)(1)

Regulation authority

CCR

What the official deficiency says

87355 Criminal Record Clearance (e) All individuals subject to a criminal record review...(b) shall prior to working...in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department 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 by not obtaining a California clearance or criminal record exemption as required by the department for S1, prior to working in a licensed facility, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/05/2024 Plan of Correction LIcensee/Administrator stated that they will work on the criminal record exemption for S1 prior to S1 working in the licensed facility. The licensee stated understanding of the requirement and will submit the plan of correction on the due date.

Official classification

Type A

Official code

87405(d)(1)(2)

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). The licensee is also the administrator, all requirements for an administrator shall apply. (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 record review,LIC/ADM did not comply with the section cited above. The LIC/ADM diid not adhere to the requirement and conform to the applicable laws, rules and regulations. LIC/ADM stated that he/she is not aware S1's exemption was not processedt and a board resolution for permanent designated administrator was not submitted to licensing, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/05/2024 Plan of Correction LIC/ADM stated a designation of facillity responsibility (LIC 308) will be submitted to licensing and requirement for S1s exemption will be provided, LIC 308 and a board of resolution will be submitted to licensing for designation of facility responisbility on the plan of correction due date. LIC/ADM stated understanding of the requirement.