COGIR OF ROHNERT PARK

Official classification

Type B

Official code

87468.2(a)(4)

Regulation authority

CCR

What the official deficiency says

87468.2(a)(4) Additional Personal Rights of Residents in Privately Operated Facilities- In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. A dependent resident (R1) was left sitting on the toilet for a period of approximately fifty-five (55) minutes by a caregiver; The resident requested the staff to return within thirty (30) minutes, but the staff went off shift, leaving the facility.The staff never returned to assist the resident. Resident was left waiting in the bathroom, until a visitor arrived and found them. The visitor notified staff on duty. This a risk to resident's personal rights.

Official plan of correction

CORRECTED-ADMINISTRATOR PROVIDED COPIES OF IN-SERVICE HELD WITH ALL DIRECT CARE STAFF. LPA WAS PROVIDED A COPY OF S'3s TERMINATION PAPERWORK. POC CLEARED.

Deadline recorded: Feb 27, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87465(G)

Regulation authority

CCR

What the official deficiency says

87465(g) Incidental Medical and Dental Care-The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health including, but not limited to, an apparent life-threatening medical crisis except as specified in Sections 87469(c)(2), (c)(3), or (c)(4). This requirement was not met as evidenced by: LPA's review of incident report, interviews with staff, and review of facility's policy. Staff failed to contact 911 for resident incident, resident hit their head. This is a health & safety risk to residents in care, as well as a personal rights risk.

Official plan of correction

CORRECTED BY INTERIM ADMINISTRATOR OMAR MENDOZA,WHO PROVIDED PROOF OF TRAINING, AS REQUIRED FOR CORRECTION OF THE DEFICIENCY, DURING TODAY'S INSPECTION. POC CLEARED.

Deadline recorded: Dec 1, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

1569.69

Regulation authority

HSC

What the official deficiency says

HSC1569.69(a)(1)(b) Employees assisting residents with self-administration of medication; training requirements-Each residential care facility for the elderly licensed under this chapter shall ensure that each employee of the facility who assists residents with the self-administration of medications meets all of the following training requirements: In facilities licensed to provide care for 16 or more persons, the employee shall complete 24 hours of initial training, including 16 hours of hands-on shadowing training, which shall be completed prior to assisting with the self-administration of medications, and 8 hours of other training or instruction, as described in subdivision (f), which shall be completed within the first four weeks of employment. Each employee required in paragraph (5) of subdivision (a), and who continues to assist with the self-administration of medicines, shall also complete eight hours of in-service training in each succeeding 12-month period This requirement was not met as evidenced by:Per review of records, the investigation revealed, S3 last completed required medication training hours on 11/11/2023 and 11/12/2023. This is a health & safety risk to residents' in care.

Official plan of correction

Licensee to ensure all facility staff have required medication training per HSC1569.69, including any appropriately cleared agency staff that are assisitng residents' with medications. Licensee to submit written plan of future facility compliance regarding HSC requirement by all staff assisitng residents' with medications. POC due 7/30/2025. Note: In addition to the above, If facility hires S3 to work in the facility, and they handle medications, submit completed HSC medication proof of training, and update employee roster, LIC500, to the Department.

Deadline recorded: Jul 30, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87355(e)(2)(3)

Regulation authority

CCR

What the official deficiency says

87355(e)(2)(3) Criminal Record Clearance- 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: Obtain a California clearance or a criminal record exemption as required by the Department or Request a transfer of a criminal record clearance as specified in Section 87355(c). This requirement was not met as evidenced by: Per review of Guardian, criminal record clearance database, S3 is not associated to the facility and was separated by Cogir of Rohnert Park on 12/5/2023. It was also identified that S3's fingerprint clearance was separated from North Bay Home Care agency on 10/9/2024, and separated from North Bay Home Care, INC. agency on 2/18/2025. This is a risk to the' health & safety of all residents'.

Official plan of correction

Licensee to ensure compliance with requirements of regulation 87355 regarding criminal record clearances, with facility staff and/or employees of licensed home health agencies. Ensure staff have required criminal record clearance and are associated to the facility as needed per regulation. Licensee to submit written plan of future facility compliance regarding 87355 regulation requirements. POC due 7/30/2025

Deadline recorded: Jul 30, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

(e) Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degrees C) and not more than 120 degree F (49 degrees C). This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's observation, LPA checked a resident bathroom sink, and the hot water was checked at 122.9 degrees Fahrenheit, which is not within regulation., the licensee did not comply with the section cited above 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 Licensee/Administrator to ensure the hot water heater is turned down and the hot water is within regulation, no lower than 105. degrees Fahrenheit and no higher than 120. degrees Fahrenheit. Submit plan of correction. Submit log of monitoring the hot water for a period of five days. Copy of hot water log submitted by 2/20/25. POC due 2/14/25.

Official classification

Type B

Official code

87411(c)(1)

Regulation authority

CCR

What the official deficiency says

Personnel Requirements - General Section 87411(c)(1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's review of staff records], the licensee did not comply with the section cited above in [6) out of [8] staff, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/26/2024 Plan of Correction Licensee/Administrator to ensure that all staff providing care to residents have first aid as required by regulation. Ensure all six (6) staff identified, obtain required first aid. Submit copies of first aid certificates to the Department by POC due date of 2/26/24.

Official classification

Type A

Official code

87555(b)(9)

Regulation authority

CCR

What the official deficiency says

General Food Service Requirements 87555(b)(9) The following food service requirements shall apply: Procedures which protect the safety, acceptability and nutritive values of food shall be observed in food storage, preparation and service. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's observation, during tour of the kitchen with the Administrator,the facility did not ensure that fruit, mayonnaise, an open box of beans, and open bags of rice were stored appropriately to protect the safety and acceptability necessary to prevent contamination, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/31/2023 Plan of Correction Facility to hold an in-service training with all kitchen staff regarding facility’s storage of food, food preparation, and food services. Submit plan of correction in how the facility will correct the deficiency, and the plan to hold an in-service training with staff. Proof of training to, include trainer, topics, date, time spent, attendees, and employee signatures. Submit proof of training by 2/6/23. Submit plan of correction by 1/31/23.

Official classification

Type A

Official code

87555(b)(9)(23)

Regulation authority

CCR

What the official deficiency says

87555 (b)(9)(23)General Food Service Requirements-Procedures which protect the safety, acceptability and nutritive values of food shall be observed in food storage, preparation and service.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 has not been met as evidenced by: LPA observed food prepared for residents out on a table in the dining room area for resident pick-up at dinner time; There were salads in plastic containers, drinks/juice/milk in cups w/lids, fruit bowls covered by parchment paper-wine in glasses covered by parchment paper, pie slices , all items not kept at refrigerated temperatures as needed. Hot foods will be prepared and put in containers put out for pick-up but not kept in something to retain heat as needed. Per the Administrator the food was being done earlier and served -put out on table fto have it ready when residents want to pick it up. This is a risk of resident's health & safety and/or a personal rights risk to residents in care.

Official plan of correction

Licensee to ensure that the facility is following regulations, and that cold food items are kept cold at appropriate temperature, and hot foods are kept at appropriate hot temperature. Licensee to ensure food is also safe for resident consumption, and food is nutritious. Licensee to submit how the food service will be handled regarding residents picking up their meals and/or having their meals delivered where the food is kept healthy and safe to serve to residents in care.Submit policies and procedures on the above by 10/24/22. Plan of correction is due 10/21/22.

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

Official classification

Type B

Official code

1569.652(c)

Regulation authority

HSC

What the official deficiency says

H & S Code- 1569.652(c) Termination of admission agreement upon death of resident; or removal of resident’s property; refund of fees paid; notice of contract termination and refunds. A refund of any fees paid in advance covering the time after the resident’s personal property has been removed from the facility shall be issued to the individual, individuals, or entity contractually responsible for the fees or, if the deceased resident paid the fees, to the resident’s estate, within 15 days after the personal property is removed. This requirement has not been met based on record reviews, and interviews, The resident had all belongings removed by 7/22/21, and did not receive due refund timely per law and regulations. The refund fee was provided o the resident/responsible party on 9/9/2021. This is a personal rights risk to residents in care.

Official plan of correction

Licensee/Administrator to ensure all due refunds are provided in a timely manner, which would be within law and regulation. Please provide refund policy and procedures of the facility and a written self confirmation of the understanding of refunds due to those that have had terminated contracts and those that have given 30 day notice-ensure compliance with Health and safety Code. POC due by 10/15/2021.

Deadline recorded: Oct 15, 2021. A deadline is not proof that correction was completed.