FAIRFIELD MEADOWS

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

(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 and interview, the licensee did not comply with the section cited above in 4 out of 8 instances of facility repair which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/28/2026 Plan of Correction Licensee to provide photo proof of installation of 4 new & properly working smoke detectors to replace older discolored yellow detectors that are not emitting loud enough alarms. In addition, licensee to submit evidence of replacement of 2 deck boards just outside central sliding doors that represent a tripping hazard, repair of loose drawer face to the left of stove, as well as, evidence of a hole in the exterior wall behind wash/dry machines narrowed with wire, wood or other by 01/28/2026

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. 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 ensuring kitchen knives, other sharp objects, and poisonous (toxic) substances were locked in their stored locations in the kitchen and outdoor storage shed which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/15/2025 Plan of Correction Licensee corrected this immediately the day of the initial inspection 2/14/25 by locking the cabinet in the kitchen where knives and sharp objects are kept as well as the outdoor shed where the poisonous (toxic chemicals) substances are stored. POC cleared during today's visit 3/14/25.

Official classification

Type B

Official code

87411(f)

Regulation authority

CCR

What the official deficiency says

(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure. A report shall be made of each screening, signed by the examining physician. The report shall indicate whether the person is physically qualified to perform the duties to be assigned, and whether he/she has any health condition that would create a hazard to him/herself, other staff members or residents. A signed statement shall be obtained from each volunteer affirming that he/she is in good health.Personnel with evidence of physical illness or emotional instability that poses a significant threat to the well-being of residents shall be relieved of their duties. 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 ensuring that all staff have proof of a negative TB test in their facility file which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/14/2025 Plan of Correction Licensee to submit proof of negative TB results for S1 and S3 to CCL by POC due date 04/14/2025.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

(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 ensuring that all the smoke and carbon monoxide detectors are in working order, holes in the living room ceiling are patched, and the Sheetrock in the garage is repaired which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/14/2025 Plan of Correction Licensee replaced smoke and carbon monoxide detectors that where observed inoperable during the 2/14/25 inspection. Facility has been awarded a County grant for repairs to the facility and the county is coordinating the construction project which will address the issues identified. POC cleared during today's visit.

Official classification

Type B

Official code

87307(a)(3)(B)

Regulation authority

CCR

What the official deficiency says

(B) Bedroom furniture, which shall include, for each resident, a chair, night stand, a lamp, or lights sufficient for reading, and a chest of drawers. 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 ensuring that each resident had a designated chest of drawers in their bedroom for personal use which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/14/2025 Plan of Correction Licensee has ensured that all residents have a designated chest of drawers in their bedroom since the 2/14/25 inspection. POC cleared during today's visit 3/14/25.

Official classification

Type B

Official code

87412(a)

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: 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 ensuring that a complete personnel record is maintained for each staff member which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/14/2025 Plan of Correction Licensee to submit proof of the noted deficient training hours, proof of negative TB results, and the Administrator's certificate to CCL by POC due date 4/14/25.

Official classification

Type B

Official code

1569.625(b)(1)

Regulation authority

HSC

What the official deficiency says

(1) The department shall adopt regulations to require staff members of residential care facilities for the elderly who assist residents with personal activities of daily living to receive appropriate training. This training shall consist of 40 hours of training. A staff member shall complete 20 hours, including six hours specific to dementia care, as required by subdivision (a) of Section 1569.626 and four hours specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696, before working independently with residents. The remaining 20 hours shall include six hours specific to dementia care and shall be completed within the first four weeks of employment. The training coursework may utilize various methods of instruction, including, but not limited to, lectures, instructional videos, and interactive online courses. The additional 16 hours shall be hands-on training. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, record review, the licensee did not comply with the section cited above in ensuring that all staff have documented proof of completion of the required initial, annual, and medication training hours which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/14/2025 Plan of Correction Licensee to submit proof of all the required initial, annual, and medication training hours for S1, S2, and S3 to CCL by POC due date 04/14/2025.

Official classification

Type B

Official code

87219(a)

Regulation authority

CCR

What the official deficiency says

(a) Residents shall be encouraged to maintain and develop their quality of life through participation in a variety of planned activities. The activities made available shall include: 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 ensuring that the facility plans and conducts regularly scheduled activities and provides a variety of options for resident engagement in activities which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/14/2025 Plan of Correction Licensee to submit an activity schedule along with any receipts if applicable to show that the facility has been brought into compliance with offering a variety of stimulating and engaging activities for the residents in care to CCL by POC due date 04/14/25.

Official classification

Type B

Official code

87555(b)(23)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (23) All readily perishable foods or beverages capable of supporting rapid and progressive growth of micro-organisms which can cause food infections or food intoxications shall be stored in covered containers at appropriate temperatures. 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 ensuring that food is covered, dated, labeled, and stored in compliance with regulation which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/14/2025 Plan of Correction Licensee to submit proof of proper food handling and food safety training to CCL by POC due date 04/14/25.

Official classification

Type B

Official code

87465(h)(4)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (4) All centrally stored medications shall be labeled and maintained in compliance with state and federal laws. No persons other than the dispensing pharmacist shall alter a prescription label. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, record review, the licensee did not comply with the section cited above in ensuring that centrally stored medications were properly labeled and maintained in compliance as evidenced by pre-poured medications several days in advance, refrigerated medications in unlocked plastic storage container, and logs not maintained current and accurately which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/14/2025 Plan of Correction Licensee has locked the medication plastic storage container in the refrigerator, no longer pre-pours medications and agrees to submit a self-certification to CCL by POC due date 04/14/25 which states that facility will ensure that all medications are properly stored and medications records are maintained incompliance with regulation moving forward.

Official classification

Type B

Official code

87506(b)

Regulation authority

CCR

What the official deficiency says

(b) Each resident's record shall contain at least the following information: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, record review, the licensee did not comply with the section cited above in ensuring that all resident records are maintained in compliance with regulation, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/14/2025 Plan of Correction Licensee to submit signed care plans for each resident, proof of negative TB results for R1 and R2, and an emergency contact information form for both R2 and R5 to CCL by POC due date 04/14/25.

Official classification

Type B

Official code

87219(i)

Regulation authority

CCR

What the official deficiency says

87219(i) Facilities shall provide sufficient equipment and supplies to meet the requirements of the activity program... necessary to accommodate physically handicapped persons... This requirement was not met as evidenced by: Based on LPA observation and Admin confirmation facility does not currently offer or provide access to any activities, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Admin to purchase a variety of cognitive games and offer activities that encourage physical activity. Admin will submit LIC9098 self-certifing appropriate activities now available along with pictures of purchases and residents engaging in activities by plan of correction due date of 2/5/2024.

Deadline recorded: Feb 5, 2024. A deadline is not proof that correction was completed.

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...shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance...as required by the Department... This requirement was not met as evidenced by: Based on statements and records reviewed, Administrator did not ensure the above regulation due to Individual (I1) working and providing services in the facility without a fingerprint clearance as required. This is an immediate health, safety, and personal rights risk to residents in care.

Official plan of correction

Individual(I1)'s last day working int he facility was 1/11/2023. Administrator to submit a written statement that they understand the regulation and will be in future compliance. Statement to be submitted to CCL by POC due date 01/30/2023. ***An immediate civil penalty was assessed in the total amount of $500

Deadline recorded: Jan 23, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87355(e)(2)

Regulation authority

CCR

What the official deficiency says

87355 Criminal Record Clearance: (e) All individuals subject to a criminal record review ...shall prior to working, residing or volunteering in a licensed facility: Request a transfer of a criminal record clearance... This requirement was not met as evidenced by: Based on statements and records reviewed, Administrator did not ensure the above regulation due to Individual (I1) working and providing services in the facility without being associated as required. This is a potential health, safety, and personal rights risk to residents in care.

Official plan of correction

Individual(I1)'s last day working int he facility was 1/11/2023. Administrator to submit a written statement that they understand the regulation and will be in future compliance with associating individuals as required. Statement to be submitted to CCL by POC due date 01/30/2023. ***An immediate civil penalty was assessed in the total amount of $500

Deadline recorded: Jan 30, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87608(a)(5)(B)

Regulation authority

CCR

What the official deficiency says

87608 Postural Supports: (a) ...Postural supports may be used under the following conditions. (5) Under no circumstances shall...limiting the use of a resident's hands or feet. (B) Bed rails that extend the entire length of the bed are prohibited... This requirement was not met as evidenced by: Based on statements and records reviewed, Administrator did not ensure the above regulation due to Iresident (R1) who has Full Bed Rails on their bed. S1 stated it is to prevent R1 from falling out of bed. This is a potential health, safety, and personal rights risk to residents in care.

Official plan of correction

Licensee to request an exception for postural support - full bed rails and include supporting documentation or remove the full bedrails. Licensee to submit an exception request and supporting documents to CCL to clear the citation by POC due date 02/03/2023

Deadline recorded: Feb 3, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

Not listed

Regulation authority

Not listed

What the official deficiency says

87465 Incidental Medical and Dental Care: (h) The following requirements shall apply to medications...(2)Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement was not met as evidenced by: Based on LPA's observation and interviews, Administrator due to staff leaving (staff and resident) medication unlocked and accessible to residents in care. This is an immediate health, safety and personal rights risk to residents in care.

Official plan of correction

POC of facility plan, pictures, and statement due by 02/25/2022. Administrator to notify LPA if more time is needed.

Deadline recorded: Feb 25, 2022. A deadline is not proof that correction was completed.