HIGHLANDS CARE HOME III, THE

Official classification

Type B

Official code

87463(a)

Regulation authority

CCR

What the official deficiency says

(a) The pre-admission appraisal, as specified in Section 87457, Pre-Admission Appraisal, shall be updated, in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition, as defined in Section 87101, Definitions, and to keep the appraisal accurate. For the purposes of this section, the updated pre-admission appraisal shall be referred to as the reappraisal. 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 3 out of 3 residents did not have a current appraisal which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/05/2026 Plan of Correction Licensee stated they will submit current appraisals for all residents by 5:00 PM on Plan of Correction due date of 2/5/2026.

Official classification

Type A

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 and record review, the licensee did not comply with the section cited above in that one (1) staff member (S2) was observed to have a medical assessment and Tuberculosis test that was dated prior to six (6) months before employment] which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/14/2025 Plan of Correction Administrator or Designated Responsible Party will submit to Community Care Licensing a current medical assessment and Tuberculosis test for staff member S2 by POC due date of 2/14/2025.

Official classification

Type B

Official code

1569.625(b)(2)

Regulation authority

HSC

What the official deficiency says

(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. 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 that four (4) of four (4) staff files for S1, S2, S3, S4 were observed to lack proper training documentation which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/05/2025 Plan of Correction Administrator or Designated Responsible Party will submit to Community Care Licensing proof that staff members S1, S2, S3 and S4 have began their 20 hours of required annual training by POC due date of 3/5/2025.

Official classification

Type B

Official code

1569.319(a)

Regulation authority

HSC

What the official deficiency says

(a) A licensee of a facility that has internet service shall provide at least one internet access device, such as a computer, smart phone, tablet, or other device, that can support real-time interactive applications, is equipped with videoconferencing technology, including microphone and camera functions, and is dedicated for resident use. 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 that at least one internet access device was dedicated and available for client use, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/12/2025 Plan of Correction Administrator or Designated Responsible Party will self certify that at least one internet access device, such as a computer, smart phone, tablet, or other device, that can support real-time interactive applications, is equipped with video conferencing technology, including microphone and camera functions, and is dedicated for client use is on the facility premises by POC due date of 3/12/2025

Official classification

Type B

Official code

87412(c)

Regulation authority

CCR

What the official deficiency says

87412(c) Personnel Records (c) Licensees shall maintain in the personnel records verification of required staff training and orientation. This requirement was not met. As evidenced by: during review of medication, LPA discovered staff did not have proof of required training. This is a potential risk to the health and Safety of residents in care.

Official plan of correction

Facility to send in proof of required training and training certificates for staff. Facility to send in written statement they understand requirement and how they will ensure they stay in compliance. POC due date for staff training due 3/29/2024 Attention LPA A canela

Deadline recorded: Mar 29, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(a)(4)

Regulation authority

CCR

What the official deficiency says

87465(a)(4) Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following: (4) The licensee shall assist residents with self-administered medications as needed. This requirement was not met, As evidenced by: Based on medication count for R1, some medication bottles had too much medication left or were missing medication. This is an immediate risk to the Health & Safety of residents in care.

Official plan of correction

Facility to send in written statement on how they will stay in compliance and assist residents correctly with their medications. Facility to provide proof ALL staff have received medication training and confirm they have reviewed and all medication is properly documented in the centrally stored log. POC for written statement due 3/19/24, Proof of staff training due 3/25/24 and medication audit/log due 3/29/24 to LPA A Canela

Deadline recorded: Mar 19, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87555(b)(26)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above because LPA observed a near empty refridgerator and freezer, and the nonperishable food supply will not sustain three meals a day for seven days, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/15/2024 Plan of Correction By 01/15/2024, Licensee shall submit a written plan of correction how they shall ensure the perishable and nonperishable food supply shall be maintained per the regulations.

Official classification

Type A

Official code

87458(c)

Regulation authority

CCR

What the official deficiency says

Medical Assessment The licensee shall obtain an updated medical assessment when required by the department 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 because LPA observed one resident (R1) leave the facility and when LPA reviewed the physician's report the physician's report stated the resident may not leave unassisted, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/15/2024 Plan of Correction By 01/15/2024, Licensess shall at minimum schedule a medical appointment for R1 to have another medical assessment done to determine if R1 is able to the leave the facility by themselves. The medical appointment shall be scheduled as soon as possible. If the doctor determines R1 is not able to leave the facility unassisted then the licensee shall come up with a written plan of care to addres R1 wishing to leave the facility for personal reasons.

Official classification

Type B

Official code

87468.1(a)(2)

Regulation authority

CCR

What the official deficiency says

Personal Rights of Residents in All Facilities. Residents in all residential care facilities for the elderly shall have all of the following personal rights: To be accorded safe, healthful and comfortable accomodations, furnishings, and equipment. 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 because there are locks on the freezer and refridgerator which LPA was told are locked at night. The locks are not locked during the day, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/26/2024 Plan of Correction By 01/26/2024, the locks on the freezer and refridgerator shall be removed or if the licensee wishes to continue to use it the licensee shall submit for a waiver.