LIFE PASTICHE

Official classification

Type A

Official code

87355(e)(3)

Regulation authority

CCR

What the official deficiency says

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (3) Request a transfer of a criminal record clearance as specified in Section 87355(c) or 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 of 1, staff member did not have a criminal record transfer request in their file, and is not associated in guardian to the facility which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/02/2026 Plan of Correction Licensee will submit a criminal record transfer request for Alyssa Gonzalez to community care licensing. Licensee will have staff member Alyssa Gonzalez associated to the facility guardian.

Official classification

Type B

Official code

87307(d)(6)

Regulation authority

CCR

What the official deficiency says

(6) All outdoor and indoor passageways and stairways shall be kept free of obstruction. 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 3 of 5 bedrooms had exits to the outside. All of these outside exits were blocked not allowing access to the backyard from the bedroom which posesd a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/11/2024 Plan of Correction The staff cleared exit doors to three resident rooms.

Official classification

Type B

Official code

87608(a)(5)(A)

Regulation authority

CCR

What the official deficiency says

(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. 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 in 2 of 6 residents had bedrails with no medical order in the file which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/25/2024 Plan of Correction The administrator will remove the bed rails or get a medical order and and exception for the residents who need bed rails. Administrator will email photos to the LPA.

Official classification

Type A

Official code

87205(a)

Regulation authority

CCR

What the official deficiency says

Accountability of Licensee Governing Body (a)The licensee, whether an individual or other entity, shall exercise general supervision over the affairs of the licensed facility and establish policies concerning its operation in conformance with these regulations... This requirement is not met as evidenced by: based on The licensee did not exercise internal supervision over the affairs of the facility which lead to staff financially abusing a resident for a year and a half. This poses an immediate Health, Safety and Personal Rights risk to clients in care

Official plan of correction

Licensee agree to reimburse R1, for $13,612.81 ($10,100 + $3,512.81) Licensee is to provide the Regional Office proof of payment made to R1’s or a payment plan by 08/01/2022.

Deadline recorded: Aug 1, 2022. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87468.2(a)(8)

Regulation authority

CCR

What the official deficiency says

Additional Personal Rights of Residents in Privately Operated Facilities (a)(8) To be free from neglect, financial exploitation, involuntary seclusion, punishment, humiliation, intimidation, and verbal, mental, physical, or sexual abuse. This requirement is not met as evidenced by: based on The licensee did not protect R1 from S1's financial abuse for over a year. This poses an immediate Health, Safety and Personal Rights risk to clients in care.

Official plan of correction

POC already completed. licensee has new hires sign a policy regarding taking gifts from residents in care.

Deadline recorded: Aug 2, 2022. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87405(h)(5)

Regulation authority

CCR

What the official deficiency says

Administrator - Qualifications and Duties (h)(5) Provide or ensure the provision of services to the residents with appropriate regard for the residents' physical and mental well-being and needs This requirement is not met as evidenced by: based on Adminitrator did not provide supervision and security regarding one of one (1 of 1) residents financial property. This poses an immediate Health, Safety and Personal Rights risk to clients in care

Official plan of correction

Licensee agrees to read Regulation 87405(h)(5) and sign a statement that it is understood and provide that statement to the department by 08/01/2022.

Deadline recorded: Aug 1, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87505(a)

Regulation authority

CCR

What the official deficiency says

87405(a) (a) All facilities shall have a qualified and currently certified administrator. The licensee and the administrator may be one and the same person. The administrator shall have sufficient freedom from other responsibilities and shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility as specified in this section. When the administrator is not in the facility, there shall be coverage by a designated substitute who shall have qualifications .......

Official plan of correction

The Licensee shall submit an updated LIC500 as well as LIC308 with the Administrator designated substitute within seven (7) days.

Deadline recorded: Apr 21, 2022. A deadline is not proof that correction was completed.