AGING IN THE BAY 4

Official classification

Type A

Official code

87465(d)(3)

Regulation authority

CCR

What the official deficiency says

Incidental Medical and Dental Care (d)if the resident is unable to determine his/her own need for prescription..medication...facility staff...shall be permitted to assist with...self-administration, provide... (3) The date and time the...medication was taken, and the residents response....be maintatined in the resident's facility record. This requirement is not met as evidenced by: Based on observation and interview the licensee did not comply with the section cited above in five (5) of six (6) records which poses an immediate risk to persons in care

Official plan of correction

Licensee will acknowledge review of General regulations in CCR 87465, as well as specific regulations of CCR 87465(d)(3) AND will provide the names of staff and medicine administration training that will occur by end of business day on 07/08/2026

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

Official classification

Type B

Official code

87468.2(a)(1)

Regulation authority

CCR

What the official deficiency says

87468.2 Additional Personal Rights of Residents...to have reasonable level of personal privacy in accomodations... personal care and assistance, visits, communications, telephone conversations...and meetings of residents and family groups. This requirement is not met as evidenced by: Based on LPA and lIcensee observation and interview, the licensee did not comply with the section cited above in that video surveillance with audio was found facing private rooms which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Facility to immediatly turn cameras away from private areas. By 11/14/2025 licensee to provide proof of removal of all cameras or to provide evidence that audio recording portion of cameras have been removed or disabled. Facility to submit LIC9098 ensuring all video does not include audio recordings by plan of correction due date.

Deadline recorded: Nov 14, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87412(a)(13)(B)

Regulation authority

CCR

What the official deficiency says

Personnel Records: (a) The licensee shall ensure that personnel records are maintained on the...each employee. Each record shall contain...(13) For employees that are required to be fingerprinted...section 87355. Criminal record clearance: (B) Documentation of either a criminal record clearance or a criminal record exemption as required by Section 87355(e) This requirement is not met as evidenced by: LPA observation of E1 providing direct resident care including feeding and hand held guiding of residents.

Official plan of correction

Licensee agree to read regulation 87412(a)(13)(B) and self-certifiy in writing, understanding of the regulation by 10/22/2025

Deadline recorded: Oct 22, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87412(a)(13)(B)

Regulation authority

CCR

What the official deficiency says

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (13) For employees that are required to be fingerprinted pursuant to Section 87355, Criminal Record Clearance: (B) Documentation of either a criminal record clearance or a criminal record exemption as required by Section 87355(e). This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, and record review, the licensee did not comply with the section cited above in four (4) out of five (5) staff members which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/26/2025 Plan of Correction Licensee agrees to read read regulation 87412(a)(13)(B), as well as provide proof (screen shot of access into Guardian website) by 09/27/2025, as well as, state in writing, they will not allow employees to work/enter Aging in the Bay 4 until an employee is associated on Guardian.